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Use of durable mechanical circulatory support on outcomes of heart-kidney transplantation

Chan, Joshua L ; Patel, Deven C ; Megna, Dominick ; Dimbil, Sadia J ; Levine, Ryan ; Moriguchi, Jaime ; Czer, Lawrence S ; Kobashigawa, Jon A ; Arabia, Francisco ; Esmailian, Fardad

Interactive cardiovascular and thoracic surgery, 2018-11, Vol.27 (5), p.773-777 [Periódico revisado por pares]

England

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  • Título:
    Use of durable mechanical circulatory support on outcomes of heart-kidney transplantation
  • Autor: Chan, Joshua L ; Patel, Deven C ; Megna, Dominick ; Dimbil, Sadia J ; Levine, Ryan ; Moriguchi, Jaime ; Czer, Lawrence S ; Kobashigawa, Jon A ; Arabia, Francisco ; Esmailian, Fardad
  • É parte de: Interactive cardiovascular and thoracic surgery, 2018-11, Vol.27 (5), p.773-777
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: Previous studies have demonstrated that preheart transplant mechanical circulatory support (MCS) can lead to a small but significant increase in mortality. However, data on outcomes of patients with MCS who require simultaneous heart-kidney transplant are limited. A retrospective review of simultaneous heart-kidney transplantations (HKTxs) performed at a single institution over a 5-year period was performed. Patients were divided based on the preoperative use of durable MCS. Renal graft-related end points were evaluated, including glomerular filtration rate following transplantation, prevalence of delayed renal graft function and freedom from antibody and cellular-mediated graft rejection. Patient-specific outcomes, including survival and frequency of non-fatal major adverse cardiac events at 1 year, were additionally assessed. During the study period, 50 HKTxs were performed, 14 of which had preoperative MCS. HKTx patients with and without MCS implantations had a similar prevalence of delayed graft function (57.1% vs 50.0%; P = 0.757). A numerical trend was observed towards a reduced glomerular filtration rate 1-month post-transplant in patients without an MCS device (81.2 ± 32.8 vs 64.4 ± 27.5; P = 0.072), but no significant difference was observed at 6 and 12 months. No significant difference was observed on the need for post-transplant renal replacement therapy, non-fatal major adverse cardiac events, freedom from graft rejection and overall survival at 1 year. The use of preoperative MCS in patients undergoing combined HKTx was not found to affect renal graft function post-transplantation and does not seem to be associated with increase in morbidity or mortality.
  • Editor: England
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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