Stroke and kidney transplantation

Abstract

Purpose of review This review will focus on the epidemiological data, risk factors, and management of stroke before and after kidney transplant. Stroke is highly prevalent in waitlisted patients as well as kidney transplant recipients and is associated with impaired transplant outcomes. Multiple traditional, nontraditional, and transplanted risk factors increase the risk of stroke. Recent findings Although the risk of stroke is reduced after kidney transplantation compared with remaining on dialysis, the morbidity and mortality from stroke after transplantation remain significant. Summary Early screening for risk factors before and after a kidney transplant and following the Kidney Disease Improving Global Outcomes (KDIGO) management guidelines could minimize the incidence of stroke and transplant outcomes.

Incidence and Risk Factors for Stroke After Combined Heart‐Kidney and Heart‐Liver Transplantation

“…Stroke is a well-recognized complication after isolated heart, isolated kidney, and isolated liver transplantation [2,5,6]. In addition to classical cardiovascular risk factors such as hypertension and tobacco smoking, specific risk factors for stroke after single-organ transplantation include previous stroke, atrial fibrillation, post-transplant erythrocytosis, and, importantly, use of preoperative mechanical circulatory support (MCS) [7][8][9] Under the 2018 heart allocation update from the Organ Procurement and Transplantation Network (OPTN) and United Network for Organ Sharing (UNOS), status 1, 2, and 3 exclusively include patients requiring MCS [10]. The use of MCS in the pre-transplant and post-transplant settings has increased in the last decade [11].…”