Implications of acute kidney injury after heart transplantation: what a surgeon should know

Santo, Luca Salvatore De; Romano, Gianpaolo; Amarelli, Cristiano; Maiello, Ciro; Baldascino, Francesco; Bancone, Ciro; Grimaldi, Francesco; Nappi, Gianantonio

doi:10.1016/j.ejcts.2011.02.068

Cited by 29 publications

(61 citation statements)

References 24 publications

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“…Acute kidney injury after HTX is a strong predictor of mortality, and therefore RRT can be considered a clinically relevant endpoint 23, 24, 25. Both NLR and PLR were significantly associated with RRT.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

et al. 2017

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AimsThe aim of this study was to evaluate whether neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) predict outcome in heart failure (HF) patients undergoing heart transplantation (HTX).Methods and resultsData from 111 HF patients undergoing HTX 2010–2015 were retrospectively reviewed. NLR and PLR were calculated before HTX, immediately after HTX, and at 6 and 24 hours. Primary endpoint was in‐hospital mortality, and secondary endpoints were 1 year mortality and renal replacement therapy (RRT). Prognostic factors were assessed by multivariate analysis, and the predictive values of NLR and PLR for mortality were compared. The discriminatory performance for predicting in‐hospital mortality was better for NLR [area under the receiver operating characteristic curve (AUC) = 0.644, 95% confidence interval 0.492–0.797] than for PLR (AUC = 0.599, 95% confidence interval 0.423–0.776). Best cut‐off value was 2.41 for NLR (sensitivity 86%, specificity 67%) and 92.5 for PLR (sensitivity 86%, specificity 68%). When divided according to best cut‐off value, in‐hospital mortality was significantly higher in the high NLR group (17.5% vs. 3.2%, P < 0.05), but not in the high PLR group (16.5% vs. 6.3%, P = ns). One year mortality was not significantly higher for either group (37.5% vs. 6.5% for NLR; 36.7% vs. 9.4% for PLR, P = ns for both), while RRT was significantly higher in both the NLR and PLR high groups (33.8% vs. 0%; 32.9% vs. 3.1%, respectively, P < 0.001). Multivariate analysis indicated that only high NLR (hazard ratio = 3.403, P < 0.05) and pre‐transplant diabetes (hazard ratio = 3.364, P < 0.05) were independent prognostic factors for 1 year mortality.ConclusionsHigh NLR was a predictor for in‐hospital mortality, and an independent prognostic factor for 1 year mortality. Both high NLR and high PLR were predictors for RRT.

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Section: Discussionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

et al. 2017

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“…In fact, insignificant small variations in renal function in cardiac surgery patients are very important and greatly influence short-and long-term results (5). The RIFLE criteria have been newly used in a few heart transplantation studies 5,6 and we have also used it.…”

Section: Discussionmentioning

confidence: 99%

“…A patient with ARF can perform the criteria direct changes in serum creatinine, estimated glomerular filtration rate or urine output, this classification that pioneers to the worst possible classification should be used (5). There are a few studies about RIFLE-based ARF after CT and its risk factors (5,6). In the present study, we evaluated the incidence and risk factors for acute renal failure and also the associated hazard of death in recipients of cardiac transplant patients.…”

Section: Introductionmentioning

confidence: 99%

“…That classificated regulation contains separate criteria for creatinine and urine output. A patient with ARF can perform the criteria direct changes in serum creatinine, estimated glomerular filtration rate or urine output, this classification that pioneers to the worst possible classification should be used (5). There are a few studies about RIFLE-based ARF after CT and its risk factors (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…However, information regarding risk factors of acute renal failure after cardiac transplantation is limited (4)(5)(6)(7). In some studies, the main reason associated with renal failure after CT are the use of calcineurin inhibitors (cyclosporine and tacrolimus), diabetes mellitus, cardiopulmonary bypass time, transfusion requirements, albumin, donor age, ischemic heart disease, preoperatively impaired renal function, and low cardiac output after transplantation (2)(3)(4)(5). Thus, the existing data regarding the risk for posttransplantation ARF are provided beneficial clinical decision.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Renal Failure and Its Impact on Survival Following Cardiac Transplantation

Sezer¹,

Yavuz²,

Canöz³

et al. 2016

Turk Neph Dial Transpl

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OBJectIVe: We evaluated the incidence and risk factors for acute renal failure (ARF) and also the associated hazard of death in recipients of cardiac transplants. MAterIAl and MetHODS:We included 25 patients in the study; 18 patients developed ARF (72%) and underwent continuous venovenous hemodiafiltration (Group I) and 7 patients had stable renal function (28%) (Group II). We retrospectively retrieved demographic variables; clinical, perioperative, postoperative complications and echocardiographic data; and biochemical parameters at the time of the surgery and six months later. reSultS:Cumulative survival was 72.2% after 6 months, 64.2% after 24 months, and 51.4% after 32 months for Group I and 50% after 32 months for Group II (p>0.05). A total of 8 patients died (32%); 1 (5.5%) from Group I and 7 (87.5%) from Group II. Risk factors for ARF were preoperative serum BUN, creatinine levels, and cardiopulmonary bypass time (p<0.05). Only one patient underwent chronic hemodialysis because of chronic renal dysfunction in Group I while there was no such patient in group II.cOncluSIOn: Preoperative serum BUN, creatinine value, and cardioopulmonary bypass time were found to be risk factors for ARF after cardiac transplantation. Postoperative renal dysfunction did not affect long-term renal function and survival.

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Hyperammonemia in lung transplant patients and its management: a review

Kumar

Advani

Kichloo

et al. 2022

Indian J Thorac Cardiovasc Surg

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Implications of acute kidney injury after heart transplantation: what a surgeon should know

Abstract: AKI is a highly prevalent and prognostically important complication. Some of the risk factors for AKI identified may be modifiable.

Cited by 29 publications

References 24 publications

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

Acute Renal Failure and Its Impact on Survival Following Cardiac Transplantation

Hyperammonemia in lung transplant patients and its management: a review

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