Coronary artery bypass grafting in a renal transplant patient: case report

Abstract

The patients with end-stage renal disease have an increased risk of atherosclerosis and the probability ofcardiovascular diseases. Due to the use of immunosuppressive agents, the patients having renal graft carry anadditional risk of atherosclerosis or endocarditis. A 67-year-old male patient with a history of renaltransplantation was referred to our hospital with a severe chest pain and dyspnea. After diagnosing severeischemic coronary artery disease by coronary angiography, the patient underwent a successful operation of asingle vessel coronary artery bypass grafting (CABG) in beating heart. Up to 20% of post-renal transplantationmortality is attributed to cardiovascular diseases. Graft rejection, the need of hemodialysis, perioperativeinfection are some of the major complications for renal transplant patients undergoing CABG surgery. Offpump CABG (OPCABG) surgery is a less invasive technique in comparison with CABG with cardiopulmonarybypass (CPB), and protects the patient from negative effects of CPB such as complement system activation,inflammatory mediator secretion, thrombocytopenia, clotting disorders. We recommend to prefer OPCABGand have preoperative prophylaxis in order to avoid both perioperative infection and renal graft rejection inrenal transplant patients undergoing CABG surgery