There is a high prevalence of left ventricular systolic dysfunction (LVSD) in patient with ESRD being evaluated for kidney transplant (KT). Assessing cardiovascular reserve (CR) in these patients is imperative as it influences transplant candidacy but is very challenging as there no established guideline. We aimed to analyze CR in patient with LSVD (defined as EF <45%) based on cardiac function parameters based on right heart cardiac catheterization (RHC) and cardiopulmonary exercise testing (CPET)

We analyzed 400 patient referred for cardiac risk stratification (CRS). Of these 39 (9.7%) had LVSD, and were subdivided into moderate LSVD (EF 31-45%, n=14, 35%, group 1) and severe LSVD (EF <30%, n=25, n=25,65%, group 2).

The mean EF in group 1 and group 2 were 38±3% and 23±8% respectively. The groups were similar in age, gender, proportion of CAD, DM and dialysis dependence. Based on the clinical assessment, RHC, and CPET, most patients in group 1 were considered unsuitable for KT alone and simultaneous heart-kidney transplant (SHT) evaluation was initiated. On the other had most patient in group 2 were able to proceed with KT alone evaluation.

Conclusions: At our center, 9.7% of KT candidates had LVSD with 6% having severe LVSD. Consistent use of advance tests to measure CR can improve the CRS and triage patients into KT alone vs SHT.

CITATION INFORMATION: Punnoose L., Fonseka N., Lashner M., Mythili G., Rao S. Improved Cardiac Risk Stratification Method in Kidney Transplant Candidates. Am J Transplant. 2017;17 (suppl 3).

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