Determinants of renal impairment in heart transplant recipients: The ischaemic cardiomyopathy group is more prone to adverse renal outcome

Abstract

Background: The aim of the study was to identify factors affecting renal outcome in Heart Transplant recipients (HTxR). Methods: Clinical information on 155 HTxR was analysed. Data from 16858 blood samples over a nine-year period were calculated. Multiple regression analysis was used to identify perioperative factors affecting postoperative renal outcome. Furthermore, renal outcome of the ischaemic cardiomyopathy group (IHD) was compared with that of the non-ischaemic cardiomyopathy group (Non-IHD). Results: A strong correlation between pre and postoperative renal function up to five years post transplantation was observed. (spearman r = 0.68). Multiple Regression analysis identified preoperative diagnosis of ischaemic heart disease (p=0.002), the presence of preoperative renal impairment (p=0.042), duration of donor organ ischaemic time (p=0.007) and cardiopulmonary bypass (CPB) time (p=0.002) as independent risk factors for postoperative renal impairment. Significant difference in renal function was observed postHTx in the IHD group as opposed to the Non-IHD group. Conclusions: This study links independent perioperative risk factors to adverse renal outcome in HTxR. In addition, the decline in the glomular filtration rate (GFR) and "renal event" free survival of IHD patients is worse than that of the Non-IHD group. The IHD group is possibly more vulnerable to developing renal impairment postHTx.