LAUSR

Prior to renal transplant listing, cardiovascular screening is performed to stratify the risk of cardiovascular disease (CVD). During pre-assessment in our centre, patients undergo a ramp test (a timed assessment to walk 130m), which is a rapid and non-invasive method of quantifying exercise tolerance. The purpose of this study is to correlate ramp test time (RTT) with transplant waiting list status, cardiac stress testing, and post-transplant CV events and mortality. Retrospective analysis of patients that underwent pre-assessment. Data collection included patient demographics, history of CVD and diabetes, RTT, ejection fraction and evidence of myocardial ischaemia, transplant list status, any subsequent CV event, and mortality. Three groups were analysed: (1) patients unable to perform the test; (2) RTT≥2mins; (3) RTT≤1min. 1508 patients were pre-assessed for transplantation between 2014-2022. Mean RTT was 86 seconds (SD±26 seconds). Patients with RTT<1min were younger with less pre-existing CVD, of whom 93% had normal cardiac stress testing. Over half of the patients who either had RTT >2mins or were unable to perform the test had abnormal cardiac function, with a 3-year mortality of about 30%. RTT can be used to assess cardiovascular suitability for transplantation. Patients unable to perform the test are unlikely to be listed for transplantation, with a quarter suffering a CV event post-assessment. In contrast, patients with RTT≤1min are almost all activated with no subsequent CV events. The low rate of CV events or abnormal stress tests in this group may allow early activation without extensive cardiovascular assessment.