Early Renal Outcomes Following Heart Transplantation Using Organs Procured After Circulatory Death

Bibliographic Details
Title: Early Renal Outcomes Following Heart Transplantation Using Organs Procured After Circulatory Death
Authors: Joyce C. Zhou, Meghan E. Sise, Kamila Drezek, Stanley B. Wolfe, Asishana A. Osho, Monica N. Prario, S. Alireza Rabi, Eriberto Michel, Lana Tsao, Erin Coglianese, Meaghan Doucette, Christopher Newton‐Cheh, Sunu Thomas, Van‐Khue Ton, Nilay Sutaria, Mark W. Schoenike, Anastasia M. Christ, Dane C. Paneitz, Mauricio Villavicencio, Joren C. Madsen, Richard Pierson, Gregory D. Lewis, David A. D'Alessandro, Daniel A. Zlotoff
Source: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 20 (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: acute kidney injury, donation after circulatory death, heart transplantation, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Background Transplantation using hearts obtained through donation after circulatory death (DCD) is increasing, but data on recipient renal outcomes are limited. Methods and Results Patients at a single institution who underwent heart transplantation using organs procured through DCD or donation after brain death (DBD) from April 2016 to August 2022 were included in this retrospective cohort study. Hemodynamic measures were collected via right heart catheterization performed 1 week after transplantation. Posttransplantation renal outcomes included estimated glomerular filtration rate at 1 week, 4 weeks, and 16 weeks, and the incidence of acute kidney injury (AKI) and renal replacement therapy within 1 week. The analysis included 225 patients (55 recipients of DCD). Baseline characteristics were comparable between recipients of DCD and DBD. Renal outcomes within 1 week posttransplantation in recipients of DCD were similar to recipients of DBD, including percent change in estimated glomerular filtration rate (−37.9% [−58.6 to −6.2] versus −31.9% [−52.4 to −9.9]; P=0.91), incidence of AKI (47.3% versus 46.5%; P>0.99) and incidence of renal replacement therapy (3.6% versus 4.7%; P>0.99). Recipients of DCD with AKI within 1 week (“early AKI”) did not recover to baseline estimated glomerular filtration rate (75.8 [60.2–91.3] mL/min per 1.73 m2) by week 16 (59.3 [46.9–73.6] mL/min per 1.73 m2; P=0.002), whereas recipients without early AKI exhibited comparable estimated glomerular filtration rate to baseline by week 4 (84.5 [70.8–98.5] mL/min per 1.73 m2; P=0.084). Similar trends were observed in recipients of DBD. Conclusions Recipients of DCD demonstrated similar renal outcomes compared with recipients of DBD, supporting the ongoing use of DCD transplantation. Early AKI was associated with persistent renal dysfunction for recipients of both DCD and DBD.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2047-9980
Relation: https://doaj.org/toc/2047-9980
DOI: 10.1161/JAHA.124.035443
Access URL: https://doaj.org/article/d7037408954342b89deb701bbf03c4f1
Accession Number: edsdoj.7037408954342b89deb701bbf03c4f1
Database: Directory of Open Access Journals
More Details
ISSN:20479980
DOI:10.1161/JAHA.124.035443
Published in:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Language:English