Kardiovaskuläre Abklärung vor Listung und kardiovaskuläres Risikomanagement nach Transplantation

Cardiovascular events are the leading cause of death in patients on the waiting list and after renal transplantation. To minimize the perioperative risk and to estimate the potential success of transplantation, the clarification of cardiovascular diseases is of utmost importance. In order to standardize cardiovascular screening and to avoid superfluous diagnostics, several guidelines have been published taking the individual risk factors of patients into account. For all candidates a physical examination, electrocardiogram and echocardiography are recommended. Additional diagnostic tests are performed depending on the clinical symptoms, the risk of coronary artery disease or after a previously diagnosed heart disease. During the long waiting time on the transplantation list and after successful transplantation cardiovascular risk management is extremely important for survival of the patients. Management of hypertension, elevated cholesterol levels and the adjustment of a diabetes are critical factors for minimizing risks. This review summarizes the currently valid recommendations for cardiovascular clarification in the preparation for transplantation and for risk management after renal transplantation.