Role Of A Cardio-Renal Multi-Disciplinary Team Meeting In Managing Cardiovascular Risk In Patients On Kidney Transplant Waitlists

Background Waitlisted kidney transplant patients suffer from excess cardiovascular events. The benefits of regular cardiac investigations, potentially harmful and expensive, are unknown. We investigate the effectiveness of a cardio-renal MDT in managing high cardiovascular risk waitlisted transplant patients to prevent events and enable transplantation. Methods Clinical outcomes in waitlisted transplant candidates managed by our cardio-renal MDT protocol were compared against our standard protocol. Data compared include the transplantation, event, and death rates, cost of cardiac investigations and procedures, and graft, patient survival, and re-hospitalization rates in transplanted patients. Results 207 patients were studied (81 standard, 126 cardio-renal MDT). Over 2.7 years, the cardio-renal MDT protocol transplanted more patients than the standard group (35% vs 21%;P = .02). The managing cost per patient per year was higher in the standard group (692 pound vs 610) pound. This was driven by more echocardiograms and more tests per patient in the standard group (P < .01). There was no difference in adverse events or death. There was no difference in re-hospitalization, graft or patient survival rate in transplanted patients. Conclusions Our cardio-renal MDT was effective in managing high-risk kidney transplant candidates with greater rates of transplantation and low rates of events at a lower cost.