P1623MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) AFTER KIDNEY TRANSPLANTATION: A POPULATION-COHORT ANALYSIS OF ENGLISH TRANSPLANT CENTRES

Abstract Background and Aims Due to a high burden of cardiovascular disease in end-stage kidney failure, candidates for kidney transplantation must undergo cardiac screening to determine their ‘cardiac fitness’ to proceed with surgery even when asymptomatic and in the absence of robust evidence. MACE rates within the first year after kidney transplantation in North American centres are reported at between 7.0% and 8.7% but data from an European cohort is lacking. Therefore, the aim of this population-cohort analysis was to determine the MACE rate within the first year after kidney transplantation for all kidney transplant recipients in England. Method We obtained data from every kidney transplant procedure performed in England between 1st April 2002 and 31st March 2018. Data was extracted from Hospital Episode Statistics using administrative ICD-10 and OPCS-4 codes, with linkage to the national death registry for mortality data (including causality). We excluded age ≤18, repeat transplant in same period, multi-organ transplant and residence outside England. MACE was defined as any hospital admissions with myocardial infarction, stroke, unstable angina, heart failure, any coronary revascularisation procedure and/or any cardiovascular-related death. Univariable and multivariable logistical regression analyses were conducted to investigate the odds for MACE after kidney transplantation. Results After exclusions, we had a cohort of 30,325 kidney transplant recipients for analysis. MACE events occurred in 781 kidney transplant recipients within the first-year post-transplantation (2.6% of all kidney transplant procedures). Of these 781 MACE events, 201 occurred during the index admission for kidney transplantation surgery (representing 25.7% of all first-year MACE events and 0.7% of all kidney transplant procedures). Predictors of long-term mortality on Cox regression include; age, non-White ethnicity, socio-economic deprivation, deceased donor, pre-existing diabetes, increased Charlson score, previous cardiac history and MACE within the first year (HR 2.59; 95% CI 2.34-2.88, p