Results of Cardiac Operations in Five Kidney Transplant Patients

Abstract

Because of the paucity of literature reports about cardiac operations in renal-transplant patients we performed a retrospective study encompassing all such patients operated upon in our institution in 1993 and 1994. During this time 5 renal transplant patients underwent cardiac surgical procedures between 1 and 9 years after transplantation: in 4 patients coronary artery bypass grafting (CABG) was carried out and in one patient aortic valve replacement. We analyzed pre-, peri-, and postoperative data. Late results were obtained by questionnaire from the patients' primary physicians. Short- and long-term results were excellent. Mortality was 0%. At late follow-up (8-23 months) all patients were in NYHA class II or better. Postoperatively all patients experienced a clear improvement of their cardiac symptoms. None of the transplanted kidneys deteriorated. One patient who had to undergo intermittent hemodialysis preoperatively improved so much that she did not require any dialysis postoperatively. Although the total number of patients in this study is limited we believe it can be stated that renal transplant patients can undergo cardiac operations with generally good results.

Long-Term Outcome of Renal Transplant Recipients in the United States After Coronary Revascularization Procedures

“…Published data on survival after CAB surgery or percutaneous coronary intervention are limited to reports in small numbers of patients. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] Also, the impact of internal mammary grafting with survival after CAB surgery in these patients is unknown.…”

Cardiac surgery outcomes in patients with antecedent kidney, liver, and pancreas transplantation: a meta-analysis

“…Our meta-analysis revealed that open cardiac surgery in abdominal transplant recipients might be challenging and hazardous, owing to an increased risk of infection, with higher rates of septicemia and wound infections. In particular, opportunistic infections are considered among the most feared in transplant patients due to immunosuppression therapy (Christiansen et al, 1997). Although the authors of the included studies reported infections of the lower respiratory tract, we found no difference in pneumonia between groups (Basic-Jukic et al, 2015;Bolman et al, 1984).…”

Myocardial revascularization in renal transplant patients

“…Since then, reports on the experience of surgical teams with this type of patient have been scarce, most of them in the form of case reports or small case series (tab. I [7][8][9]13,14,[16][17][18][19][20][21][22][23][24][25] ). In 1997, Dresler et al 26 carried out a study, one of the largest case series in the literature, with 45 renal transplant patients undergoing cardiac surgery, 31 being myocardial revascularization.…”

“…This risk increases when the duration of extracorporeal circulation exceeds 60 minutes 14 . In our study, no patient had a definitive lesion in the transplanted kidney, but 1 had a reduction in renal function, requiring slow hemodialysis for 24 hours in the postoperative period.…”