Impact of perioperative renal dysfunction in heart transplantation: combined heart and kidney transplantation could help to reduce postoperative mortality.

  • Lee J
  • Lee S
  • Cho H
 et al. 
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Abstract

BACKGROUND: Renal dysfunction is a frequent problem in heart failure patients. We aimed to investigate the predictors of mortality after heart transplantation and the impact of perioperative renal dysfunction on short-term and long-term prognosis. MATERIAL AND METHODS: We analyzed the outcomes of patients undergoing isolated heart transplantation (IHT, n=62) and combined heart-kidney transplantation (CHKT, n=5) between October 2007 and May 2012. Among all patients, 55.2% had preoperative renal dysfunction. RESULTS: Compared with the IHT group, the CHKT group had a lower estimated glomerular filtration rate (p=0.001), and higher proportion of diabetes (p=0.008), hypertension (p=0.010), renal failure (p=0.036), and greater incidence of preoperative continuous renal replacement therapy (CRRT) (p=0.025). Despite unfavorable baseline conditions in the CHKT group, there was no postoperative mortality. Early 30-day postoperative mortality only occurred in the IHT group (5 patients, 8.1%). In multivariate analysis, persistent renal dysfunction (HR 29.356, p

Author-supplied keywords

  • combined heart and kidney
  • heart transplantation
  • renal
  • survival
  • transplantation

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Authors

  • Joo Myung Lee

  • Seung-Ah Lee

  • Hyun-Jai Cho

  • Han-Mo Yang

  • Hae-Young Lee

  • Ho Young Hwang

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