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Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.

Publication ,  Journal Article
Nicoara, A; Kretzer, A; Cooter, M; Bartz, R; Lyvers, J; Patel, CB; Schroder, JN; McCartney, SL; Podgoreanu, MV; Milano, CA; Swaminathan, M ...
Published in: Transpl Int
August 2020

Acute kidney injury (AKI) and primary graft dysfunction (PGD) are serious complications after heart transplantation (HT). The relationship between AKI and PGD is poorly understood. We sought to examine the incidence of AKI and identify risk factors associated with AKI. We hypothesized that PGD is one of the risk factors independently associated with post-HT AKI. We gathered data for all adult patients who underwent HT between 2009 and 2014. AKI was defined by the KDIGO criteria. PGD was categorized using ISHLT criteria. We assessed univariable and multivariable logistic regression to identify risk factors independently associated with post-HT AKI. Out of 316 patients, postoperative AKI occurred in 273 (86%) patients: 188 (68%) stage I, 44 (16%) stage II, and 41 (15%) stage III. Stage II/III AKI was associated with increased risk of mortality at 1 year. There was significant association between severe PGD and stage II/III AKI (P = 0.001, OR 3.63, 95% CI: 1.69-7.94). Other clinical factors significantly associated with stage II/III AKI included longer donor brain death duration and lower recipient baseline creatinine. We found that stage II/III AKI is common and independently associated with severe PGD. Another potentially modifiable risk factor is donor brain death duration.

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Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

August 2020

Volume

33

Issue

8

Start / End Page

887 / 894

Location

Switzerland

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Incidence
  • Humans
  • Heart Transplantation
  • Cohort Studies
  • Adult
  • Acute Kidney Injury
 

Citation

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Nicoara, A., Kretzer, A., Cooter, M., Bartz, R., Lyvers, J., Patel, C. B., … Stafford-Smith, M. (2020). Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study. Transpl Int, 33(8), 887–894. https://doi.org/10.1111/tri.13615
Nicoara, Alina, Adam Kretzer, Mary Cooter, Raquel Bartz, Jeffrey Lyvers, Chetan B. Patel, Jacob N. Schroder, et al. “Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.Transpl Int 33, no. 8 (August 2020): 887–94. https://doi.org/10.1111/tri.13615.
Nicoara A, Kretzer A, Cooter M, Bartz R, Lyvers J, Patel CB, et al. Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study. Transpl Int. 2020 Aug;33(8):887–94.
Nicoara, Alina, et al. “Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.Transpl Int, vol. 33, no. 8, Aug. 2020, pp. 887–94. Pubmed, doi:10.1111/tri.13615.
Nicoara A, Kretzer A, Cooter M, Bartz R, Lyvers J, Patel CB, Schroder JN, McCartney SL, Podgoreanu MV, Milano CA, Swaminathan M, Stafford-Smith M. Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study. Transpl Int. 2020 Aug;33(8):887–894.
Journal cover image

Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

August 2020

Volume

33

Issue

8

Start / End Page

887 / 894

Location

Switzerland

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Primary Graft Dysfunction
  • Incidence
  • Humans
  • Heart Transplantation
  • Cohort Studies
  • Adult
  • Acute Kidney Injury