scholarly journals MO422ACUTE KIDNEY INJURY AFTER HEART TRANSPLANTATION , INCIDENCE AND PREDICTIVE FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Nooshin Dalili
Keyword(s):  
Risk Factors ◽  
Heart Transplantation ◽  
Renal Dysfunction ◽  
Heart Transplant ◽  
Univariate Analysis ◽  
Time History ◽  
Kidney Injury ◽  
Liver Function Tests ◽  
Ischemic Time ◽  
Post Transplant

Abstract Background and Aims Abruptly decreased kidney function is one of the common scenarios after heart transplantation and the risk factors for renal dysfunction in this population can be various. The purpose of the present study was to determine the incidence and predictors for renal dysfunction among 126 patients in early postoperative heart transplantation period between January 2015 and November 2019. Method The study was conducted at the department of cardio-thoracic intensive care unit of an affiliated teaching hospital. 126 patients had cardiac transplantation surgery during four years. Information from these patients collected on a daily basis using standardized forms. Results Out of 126 heart transplant recipients 58.7 % (n=74) developed AKI and 10% (n=13) required renal replacement therapy after transplant. After performing univariate analysis, predictors of AKI were: age, duration of anesthesia, cold ischemia time, Voluven (Starch) dose, pre-operative BUN, creatinine and serum albumin, level of liver function tests, and Hemoglubin at three-days post-transplant and urine output of less than 200ml/ hour at six-hours post-transplant. Conclusion The findings of our study suggest that longer duration of graft ischemic time, history of previous cardiac operation and transfusion of more than four blood units can independently predict the chance of developing AKI following heart transplant. Therapies, which target these modifiable risk factors, may offer protection against this complication.

scholarly journals Long-Term Outcomes and Risk Factors of Renal Failure Requiring Dialysis after Heart Transplantation: A Nationwide Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2455 ◽  
Author(s):  
Tsai-Jung Wang ◽  
Ching-Heng Lin ◽  
Hao-Ji Wei ◽  
Ming-Ju Wu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Heart Transplantation ◽  
Renal Dysfunction ◽  
Heart Transplant ◽  
Kidney Injury ◽  
Dialysis Patients ◽  
Term Survival

Acute kidney injury and renal failure are common after heart transplantation. We retrospectively reviewed a national cohort and identified 1129 heart transplant patients. Patients receiving renal replacement therapy after heart transplantation were grouped into the dialysis cohort. The long-term survival and risk factors of dialysis were investigated. Patients who had undergone dialysis were stratified to early or late dialysis for subgroup analysis. The mean follow-up was five years, the incidence of dialysis was 28.4% (21% early dialysis and 7.4% late dialysis). The dialysis cohort had higher overall mortality compared with the non-dialysis cohort. The hazard ratios of mortality in patients with dialysis were 3.44 (95% confidence interval (CI), 2.73–4.33) for all dialysis patients, 3.58 (95% CI, 2.74–4.67) for early dialysis patients, and 3.27 (95% CI, 2.44–4.36; all p < 0.001) for late dialysis patients. Patients with diabetes mellitus, chronic kidney disease, acute kidney injury, and coronary artery disease were at higher risk of renal failure requiring dialysis. Cardiomyopathy, hepatitis B virus infection, and hyperlipidemia treated with statins were associated with a lower risk of renal dysfunction requiring early dialysis. The use of Sirolimus and Mycophenolate mofetil was associated with a lower incidence of late dialysis. Renal dysfunction requiring dialysis after heart transplantation is common in Taiwan. Early and late dialysis were both associated with an increased risk of mortality in heart transplant recipients.

scholarly journals Sirolimus-Based Immunosuppression Is Associated with Decreased Incidence of Post-Transplant Lymphoproliferative Disorder after Heart Transplantation: A Double-Center Study

2022 ◽  
Vol 11 (2) ◽  
pp. 322
Author(s):  
Rabea Asleh ◽  
Darko Vucicevic ◽  
Tanya M. Petterson ◽  
Walter K. Kremers ◽  
Naveen L. Pereira ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Lymphoproliferative Disorder ◽  
Univariate Analysis ◽  
Mammalian Target Of Rapamycin ◽  
Mtor Inhibitors ◽  
Lymphoid Cells ◽  
Post Transplant ◽  
Barr Virus ◽  
Increased Risk ◽  
Epstein Barr

Mammalian target of rapamycin (mTOR) inhibitors have been shown to reduce proliferation of lymphoid cells; thus, their use for immunosuppression after heart transplantation (HT) may reduce post-transplant lymphoproliferative disorder (PTLD) risk. This study sought to investigate whether the sirolimus (SRL)-based immunosuppression regimen is associated with a decreased risk of PTLD compared with the calcineurin inhibitor (CNI)-based regimen in HT recipients. We retrospectively analyzed 590 patients who received HTs at two large institutions between 1 June 1988 and 31 December 2014. Cox proportional-hazard modeling was used to examine the association between type of primary immunosuppression and PTLD after adjustment for potential confounders, including Epstein–Barr virus (EBV) status, type of induction therapy, and rejection. Conversion from CNI to SRL as primary immunosuppression occurred in 249 patients (42.2%). During a median follow-up of 6.3 years, 30 patients developed PTLD (5.1%). In a univariate analysis, EBV mismatch was strongly associated with increased risk of PTLD (HR 10.0, 95% CI: 3.8–26.6; p < 0.001), and conversion to SRL was found to be protective against development of PTLD (HR 0.19, 95% CI: 0.04–0.80; p = 0.02). In a multivariable model and after adjusting for EBV mismatch, conversion to SRL remained protective against risk of PTLD compared with continued CNI use (HR 0.12, 95% CI: 0.03–0.55; p = 0.006). In conclusion, SRL-based immunosuppression is associated with lower incidence of PTLD after HT. These findings provide evidence of a benefit from conversion to SRL as maintenance therapy for mitigating the risk of PTLD, particularly among patients at high PTLD risk.

Onset, timing and risk for depression and anxiety in family caregivers to heart transplant recipients

2004 ◽  
Vol 34 (6) ◽  
pp. 1065-1082 ◽  
Author(s):  
MARY AMANDA DEW ◽  
LARISSA MYASKOVSKY ◽  
ANDREA F. DIMARTINI ◽  
GALEN E. SWITZER ◽  
HERBERT C. SCHULBERG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychiatric Disorder ◽  
Family Caregivers ◽  
Heart Transplant ◽  
Transplant Recipients ◽  
Post Traumatic Stress ◽  
Entire Study ◽  
Post Transplant ◽  
Potential Risk Factors ◽  
The Impact

Background. Family members adopt key caregiving roles in the maintenance of transplant recipients' health. While the bulk of the caregiving literature suggests that rates of psychiatric disorder should be high in these caregivers, the potential benefits of transplantation may instead lead to less distress than in other caregiving situations. We examined prevalence and risk factors for depressive and anxiety-related disorders in caregivers throughout 3 years after their family member's heart transplant.Method. A total of 190 caregivers (97% of eligible respondents) were enrolled. They received psychiatric and psychosocial evaluations at 2, 7, 12 and 36 months post-transplant. Survival analysis determined cumulative rates of psychiatric disorders and the impact of potential risk factors.Results. Rates of depressive and anxiety-related disorders met or exceeded other caregiver populations' rates. By 3 years post-transplant, cumulative onset rates were: Major Depressive Disorder (MDD), 31·6%, Adjustment disorders, 35·4% (29·4% with anxious mood); Post-Traumatic Stress Disorder related to the transplant (PTSD-T), 22·5%, Generalized Anxiety Disorder, 7·3%, and any assessed disorder, 56·3%. PTSD-T occurred primarily during the first year post-transplant. Other disorders' rates increased over the entire study period. Risk for disorder was elevated by positive lifetime history of psychiatric disorder, greater post-transplant caregiving responsibilities, and a poorer relationship with the patient. Risk for MDD was further increased by caregiver unemployment, and risk for anxiety disorders was further increased by younger age, low sense of personal mastery, and high use of avoidance coping strategies.Conclusions. Transplantation is associated with costs and benefits for not only patients but family caregivers. Caregivers' risk for psychiatric illness should be considered when developing interventions to promote families' long-term adjustment to the transplant process.

Venous thromboembolism (VTE) risk in patients with localized urinary tract tumors (UTT).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 422-422 ◽  
Author(s):  
Jorge Ramos ◽  
Yu-Ning Wong ◽  
Simon J. Crabb ◽  
Guenter Niegisch ◽  
Joaquim Bellmunt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Dysfunction ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Model ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors ◽  
Metastatic Setting ◽  
Chi Squared ◽  
Localized Disease

422 Background: VTE is common in cancer patients, but there is limited data in patients with UTT. We previously demonstrated that non-urothelial histology, cardiovascular disease (CVD) or CVD risk factors or renal dysfunction increased VTE risk in metastatic UTT. In this study, we assessed the frequency and risk factors for VTE in localized disease. Methods: Data was collected via an electronic data capture platform from 29 centers. Patients diagnosed with < cT2, > N1, or M1 disease at diagnosis were excluded. Patients without a date of diagnosis, last follow up, or VTE data were excluded. Cumulative, unadjusted VTE incidence was calculated from time of diagnosis, excluding VTEs diagnosed in the metastatic setting. Chi-squared analyses were used to assess differences in VTE rates for various patient, therapy, and tumor-related factors. Significant covariates were incorporated into a multivariate, logistic regression model. Results: 1131 patients were eligible for analysis. Perioperative chemotherapy was utilized in 46.9% (530/1131) of patients. 70.8% (801/1131) underwent definitive surgical intervention. There were 64 VTEs (cumulative incidence 5.7%). Treatment with chemotherapy (p = 0.609) or surgery (p = 0.886) did not increase VTE risk. In the univariate analysis, non-urothelial histology (p = 0.025), CVD or CVD risk factors (p = 0.004), renal dysfunction (p = 0.023), and radiation to the primary tumor (p = 0.048) were statistically significant factors. Multivariate analysis demonstrated that non-urothelial histology and CVD or CVD risk factors were associated with increased VTE risk (table). Conclusions: The VTE incidence of 5.7% in localized disease is lower than our previously reported rate in the metastatic setting (8.2%). Consistent with our findings in metastatic UTT, non-urothelial histology and CVD or CVD risk factors increase VTE risk in localized disease. Additional analyses to control for baseline demographics in patients treated with surgery and chemotherapy will be performed. [Table: see text]

scholarly journals PROGNOSTIC VALUE OF RENAL DYSFUNCTION AND THE IMBALANCE OF BODY AQUATIC ENVIRONMENTS IN PATIENTS WITH ACUTE CORONARY PATHOLOGY

2017 ◽  
Vol 21 (1) ◽  
pp. 39-45
Author(s):  
E. O. Golovinova ◽  
M. M. Batiushin ◽  
E. S. Levitskaya ◽  
A. V. Khripun
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Dysfunction ◽  
Myocardial Revascularization ◽  
Kidney Injury ◽  
Cardiovascular Complications ◽  
Aquatic Environments ◽  
Prognostic Impact ◽  
Late Period ◽  
The Impact

THE AIM. Assessment of the impact of renal dysfunction and imbalance of body aquatic environments distribution on the risk of developing cardiovascular complications in the late period after acute coronary syndrome (ACS) and myocardial revascularization. PATIENTS AND METHODS. We examined 120 patients with ACS undergoing myocardial revascularization. We estimated traditonal and renal risk factors (albuminuria 30-300 mg/l, the value of GFR, acute kidney injury development), and body aquatic environments factors. Upon completion of the primary material processing, to determine the effect of the studied risk factors, we selected combined endpoint of the study – development of arrhythmias or death of patients, which were registered 6 months after restoration of coronary blood flow. RESULTS. By results of the carried out research we established effect on the probability of cardiovascular complications (CVC) by such risk factors as the presence of albuminuria, and acute kidney injury (AKI). AKI episode in patients with ACS associated with increase of arrhythmias and death possibilities in late period. It is established that AKI coupled with an imbalance of body aquatic environments increases the CVC development possibility 6 months after percutaneous coronary intervention in patients with ACS. CONCLUSION. In patients with ACS and myocardial revascularization revealed prognostic impact of the AKI and failure of body aquatic environments at the risk of CVC. 

scholarly journals THE INCIDENCE AND RISK FACTORS OF CONTRAST INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Pradeep Kurmi ◽  
Deepak Ameta ◽  
Chandra Bhanu Chandan
Keyword(s):  
Risk Factors ◽  
Contrast Media ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Contrast Induced Nephropathy ◽  
Absolute Increase ◽  
Increased Risk ◽  
Adequate Hydration

Background: Contrast induced nephropathy remains important cause of hospital-acquired acute kidney injury and affects between 2% of the general population to 50% of high-risk subgroups following coronary intervention. Objectives: To determine the incidence and to study the various risk factors associated with CIN. Patients and Methods: In our study, total of 212 patients (154 males and 58 females) who received non ionic iso osmolar contrast media during percutaneous transluminal coronary intervention (PCI) were included. We diagnosed CIN by a relative increase of >25% or an absolute increase of >0.5 mg/dl in serum creatinine levels two days after procedure. Results: The incidence of CIN in our study was 15.1%. In univariate analysis: age >75 years, hypertention diabetes mellitus (DM), heart failure, hypotension, CKD [creatinine  >1.5mg/dl] and increased contrast volume were associated with increased  risk of CIN whereas,  gender, anemia and use of IABP failed to reach statistical significance. As the number of risk factor and/or volume of contrast increases, the incidence of CIN increases exponentially. Conclusion: Since there is no established treatment for CIN, all possible efforts should be taken to prevent it from occurring by identifying patients at risk. CIN is related with many risk factors, so whenever multiple risk factors are present in an individual patient, lowest dose of contrast should be used and adequate hydration should be given. Key Words: Contrast-induced nephropathy, Non ionic iso-osmolar contrast media, percutaneous coronary intervention.

Sign in / Sign up

Export Citation Format

Share Document