Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

Journal of Cardiothoracic Surgery

Fen-Long Xue¹  Fei Wu¹  Xiang-Rong Kong¹  Hong-Lei Chen¹  Kai Wang¹  Wei Zhou¹  Jun-Wu Chai¹  Zhi-Long Li¹  Shan-Shan Jiang¹  Yi-Yao Jiang² 

[1] Department of Cardiovascular Surgery, Tianjin First Center Hospital and NanKai University, Tianjin, China;Department of Cardiovascular Surgery, Tianjin First Center Hospital and NanKai University, Tianjin, China;Department of Cardiovascular Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China;

关键词: Acute kidney injury;    Heart transplantation;    Mortality;    Outcomes;   

DOI  :  10.1186/s13019-020-01351-4

来源: Springer

【 摘 要 】

ObjectivesThis study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx).MethodsThis single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival.ResultsThirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (P < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P < 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, P = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P = 0.096).ConclusionsAKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

【 授权许可】

CC BY