Date: Saturday, June 2, 2018
Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background: CT scans of the abdomen and pelvis (CT A/P) are performed for pre-transplant (tx) evaluation in patients (pts) at high risk for post-operative cardiovascular events (POCVE). The purpose of this study is to examine the severity and distribution of common iliac artery (CIA) and external iliac artery (EIA) calcifications and the associations with outcomes following renal tx. Methods: Retrospective analysis of 202 renal tx recipients between 2/2013-11/2014 who underwent CT A/P within 3 years of tx. Scans were scored using a previously described system (Table 1). Results: There was no difference in calcification scores between sides (Table 2). Pts with moderate REIA plaque (morphology score ≥ 2) more often required arterial reconstruction compared to those with no/mild plaque (4/34 [11.7%] v. 3/130 [2.3%]; p=0.03). There were 58 cases of delayed graft function (DGF), 51 of which occurred in tx to the REIA. In these cases, DGF was associated with moderate REIA plaque (OR 2.82, p=0.009). In a multivariable logistic regression model, history of coronary artery disease (OR 3.79, p=0.03) or congestive heart failure (OR 5.54, p=0.009), and severe RCIA plaque (morphology score=3) (OR 4.98, p=0.04) were associated with POCVE. In a multivariable model, diabetes mellitus (p=0.05) and previous stroke (p=0.02) were associated with increased risk of death. Conclusions: A larger burden of calcified iliac artery plaque is associated with increased operative complexity and higher rates of DGF and POCVE. Pre-tx CT A/P may guide operative strategy and facilitate management to improve outcomes.
|Morphology||Greatest degree of calcification|
|1||Thin linear calcifications (≤1mm)|
|2||Thick linear calcifications (>1mm)|
|3||Bulky calcifications (>2mm)|
|Circumference/Length||Greatest percentage of circumference/length involved|
|1||1 – 25%|
|2||26 – 50%|
|3||51 – 75%|
|4||76 – 100%|
|R CIA||2.01 ± 1.25||1.69 ± 1.36||2.34 ± 1.67|
|R EIA||0.70 ± 1.07||0.87 ± 1.42||0.79 ± 1.31|
|L CIA||1.90 ± 1.32||1.67 ± 1.45||2.06 ± 1.70|
|L EIA||0.66 ± 1.04||0.81 ± 1.34||0.80 ± 1.35|
CITATION INFORMATION: Werlin E., Walker J., Freise J., Stock P., Hiramoto J. Utility of Preoperative CT to Guide Perioperative Management for Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Werlin E, Walker J, Freise J, Stock P, Hiramoto J. Utility of Preoperative CT to Guide Perioperative Management for Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/utility-of-preoperative-ct-to-guide-perioperative-management-for-kidney-transplantation/. Accessed October 1, 2020.
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