Pre-existing renal failure doubles 30-day mortality after heart transplantation

Ostermann, Marlies; Rogers, Chris; Saeed, Imran; Nelson, Stephen R.; Murday, Andrew J.

doi:10.1016/j.healun.2003.09.006

Cited by 36 publications

(22 citation statements)

References 17 publications

(16 reference statements)

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“…In this current series, patients with preoperative serum creatinine !2 mg dl À1 had a higher 30-day mortality compared to patients with serum creatinine <2 mg dl À1 . The mortality rate of 18% in our patients with preoperative renal dysfunction is similar to that reported in the previous studies [18][19][20][21]. However, our patients undergoing isolated heart transplantation had a comparable survival rate to our patients undergoing simultaneous heart and kidney transplantation.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have demonstrated that preoperative renal dysfunction and postoperative renal dysfunction are associated with mortality of heart transplantation [17][18][19][20][21]. Preoperative serum creatinine >1.5-2.0 mg dl À1 or creatinine clearance <40-50 ml min À1 predicts the development of postoperative renal failure and mortality in patients undergoing heart transplantation [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative serum creatinine >1.5-2.0 mg dl À1 or creatinine clearance <40-50 ml min À1 predicts the development of postoperative renal failure and mortality in patients undergoing heart transplantation [19][20][21]. In re-transplantation, patients with serum creatinine !2.0 mg dl À1 had a high probability of requiring postoperative dialysis and also of mortality [22].…”

Section: Discussionmentioning

confidence: 99%

“…An abnormal renal function before surgery portends a worse prognosis in adult recipients after heart transplantation [17][18][19][20][21]. However, when serum creatinine was evaluated as a continuous variable, no specific level was identified beyond which the risk of heart transplantation was unacceptable [2].…”

Section: Heart and Kidney Transplantationmentioning

confidence: 99%

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Effect of simultaneous kidney transplantation on heart-transplantation outcome in recipients with preoperative renal dysfunction

Hsu¹,

Chang²,

Tsai³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Heart and Kidney Transplantationmentioning

confidence: 99%

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Effect of simultaneous kidney transplantation on heart-transplantation outcome in recipients with preoperative renal dysfunction

Hsu¹,

Chang²,

Tsai³

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…Abnormal kidney function is a known risk factor for both early and late heart transplant mortality in all patients . Posttransplant renal dysfunction is a significant cause of morbidity that continues to increase in prevalence over time .…”

Section: Introductionmentioning

confidence: 99%

Heart Retransplant Recipients Have Better Survival With Concurrent Kidney Transplant Than With Heart Retransplant Alone

Savla

Lin

Pradhan

et al. 2015

JAHA

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BackgroundHeart retransplant (HRT) recipients represent a growing number of transplant patients. The impact of concurrent kidney transplants (KTs) in this population has not been well studied. We tested the hypothesis that recipients of HRT with concurrent KT (HRT‐KT) would have worse survival than recipients of HRT alone.Methods and ResultsA retrospective analysis of the United Network of Organ Sharing database was performed for all patients undergoing HRT from 1987 to 2011. There were 1660 HRT patients, of which 116 (7%) received concurrent KT. Those who received HRT‐KT had older age, longer wait‐list time, worse kidney function, and more known diabetes. Survival among recipients of HRT‐KT was significantly better than that of recipients of HRT alone (P=0.005). A subgroup of 323 HRT patients with severe kidney dysfunction (estimated glomerular filtration rate <30 mL/min per 1.73 m2 or on dialysis) was studied in more detail, and 76 (24%) received concurrent KT. Those on dialysis at the time of HRT had better survival with versus without concurrent KT (P<0.0001). On multivariable analysis, concurrent KT was independently associated with better outcomes for all patients with HRT and for the subgroup of patients with severe kidney dysfunction.ConclusionsRecipients of HRT‐KT have better survival than recipients of HRT alone. Further research is needed to determine which HRT patients may benefit the most from concurrent KT.

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