Myocardial Perfusion Is a Useful Screening Test for the Evaluation of Cardiovascular Risk in Patients Undergoing Simultaneous Pancreas Kidney Transplantation

Cardiovascular disease is the leading cause of death in simultaneous pancreas kidney transplantation (SPKT) patients. SPKT is increasingly being undertaken to manage patients with advanced diabetic nephropathy and type 1 diabetes mellitus. Traditionally, invasive angiography has been used as a tool to diagnose significant coronary disease and inform decision making with regard to coronary revascularization prior to transplantation. In our retrospective analysis of 167 consecutive patients who underwent SPKT in our center, we show that using myocardial perfusion scintigraphy (MPS) as the first-line screening tool is highly sensitive without exposing the patient to undue investigative procedural risks (or an unacceptably high false-negative rate) and it provides 1-year cardiovascular outcomes that are comparable with those of patients managed via the more traditional but riskier invasive route.