Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients

Abstract Renal dysfunction is considered as a relative contraindication for heart transplantation (HTx). However, in the real world setting, many patients with advanced heart failure (HF) experience worsening of renal function and some even require renal replacement therapy (RRT) by the time they un...

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Autores principales:	Darae Kim, Jin-Oh Choi, Yang Hyun Cho, Kiick Sung, Jaewon Oh, Hyun Jai Cho, Sung-Ho Jung, Hae-Young Lee, Jin Joo Park, Dong-Ju Choi, Seok-Min Kang, Jae-Joong Kim, Eun-Seok Jeon
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9470bfab208d46efa5302a0491f66d64
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spelling	oai:doaj.org-article:9470bfab208d46efa5302a0491f66d642021-12-02T18:18:44ZImpact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients10.1038/s41598-021-92800-02045-2322https://doaj.org/article/9470bfab208d46efa5302a0491f66d642021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92800-0https://doaj.org/toc/2045-2322Abstract Renal dysfunction is considered as a relative contraindication for heart transplantation (HTx). However, in the real world setting, many patients with advanced heart failure (HF) experience worsening of renal function and some even require renal replacement therapy (RRT) by the time they undergo HTx. We aimed to investigate the prognosis and clinical outcomes of HTx patients who required RRT during the perioperative period. The Korean Organ Transplant Registry (KOTRY) is a nationwide organ transplant registry in Korea. A total of 501 HTx patients had been prospectively enrolled in the KOTRY registry during 2014–2018. Among the 501 patients, 13 underwent combined heart and kidney transplantation (HKTx). The 488 patients who underwent isolated HTx were grouped according to their pre- and postoperative RRT status. The primary outcome was progression to dialysis-dependent end-stage renal disease (ESRD) after HTx. The secondary outcome was all-cause mortality after HTx. The median follow-up was 22 months (9–39 months). Patients who needed preoperative RRT but were free from postoperative RRT showed comparable overall survival and renal outcome to patients who were free from both pre- and postoperative RRT. In multivariable analysis, preoperative RRT was not associated with progression to ESRD or all-cause mortality after HTx; however, postoperative RRT was a significant predictor for both progression to ESRD and all-cause mortality after HTx. Preoperative creatinine or estimated glomerular filtration rate (eGFR) were not predictive of progression to ESRD after HTx. The present analysis suggests that preoperative RRT requirement does not indicate irreversible renal dysfunction in patients waiting for HTx. However, postoperative RRT was associated with progression to ESRD and mortality after HTx.Darae KimJin-Oh ChoiYang Hyun ChoKiick SungJaewon OhHyun Jai ChoSung-Ho JungHae-Young LeeJin Joo ParkDong-Ju ChoiSeok-Min KangJae-Joong KimEun-Seok JeonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
description	Abstract Renal dysfunction is considered as a relative contraindication for heart transplantation (HTx). However, in the real world setting, many patients with advanced heart failure (HF) experience worsening of renal function and some even require renal replacement therapy (RRT) by the time they undergo HTx. We aimed to investigate the prognosis and clinical outcomes of HTx patients who required RRT during the perioperative period. The Korean Organ Transplant Registry (KOTRY) is a nationwide organ transplant registry in Korea. A total of 501 HTx patients had been prospectively enrolled in the KOTRY registry during 2014–2018. Among the 501 patients, 13 underwent combined heart and kidney transplantation (HKTx). The 488 patients who underwent isolated HTx were grouped according to their pre- and postoperative RRT status. The primary outcome was progression to dialysis-dependent end-stage renal disease (ESRD) after HTx. The secondary outcome was all-cause mortality after HTx. The median follow-up was 22 months (9–39 months). Patients who needed preoperative RRT but were free from postoperative RRT showed comparable overall survival and renal outcome to patients who were free from both pre- and postoperative RRT. In multivariable analysis, preoperative RRT was not associated with progression to ESRD or all-cause mortality after HTx; however, postoperative RRT was a significant predictor for both progression to ESRD and all-cause mortality after HTx. Preoperative creatinine or estimated glomerular filtration rate (eGFR) were not predictive of progression to ESRD after HTx. The present analysis suggests that preoperative RRT requirement does not indicate irreversible renal dysfunction in patients waiting for HTx. However, postoperative RRT was associated with progression to ESRD and mortality after HTx.
format	article
author	Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon
author_facet	Darae Kim Jin-Oh Choi Yang Hyun Cho Kiick Sung Jaewon Oh Hyun Jai Cho Sung-Ho Jung Hae-Young Lee Jin Joo Park Dong-Ju Choi Seok-Min Kang Jae-Joong Kim Eun-Seok Jeon
author_sort	Darae Kim
title	Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
title_short	Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
title_full	Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
title_fullStr	Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
title_full_unstemmed	Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
title_sort	impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9470bfab208d46efa5302a0491f66d64
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Impact of preoperative renal replacement therapy on the clinical outcome of heart transplant patients

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