Abstract
Patients undergoing renal transplantation (RTx) have high risks for coronary artery diseases and congestive heart failure (CHF). Therefore a preoperative survey includes myocardial perfusion images and echocardiography. If a patient has more than two revised cardiac risk Index, a β blocker should be considered by careful titration to maintain the mean heart rate ≦70 bpm. Percutaneous coronary intervention (PCI) should be avoided when the volume of ischemic myocardium is less than 20%. Left ventricular ejection fraction of less than 45% indicates two fold high incidences of cardiovascular events following RTx. Patients undergoing RTx tend to have left ventricular diastolic dysfunction, which is prone to result in CHF by volume overload or high blood pressure during the perioperative period. Tissue Doppler derived E/e' or e' should be assessed. Following PCI, aspirin should not be discontinued among patients with high risk for stent thrombosis. Discontinuation of dual anti-platelet therapy should be done in a hospital without substitution of heparin.
