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Abstracts: ASAIO Cardiac Abstracts

FAVORABLE HEMODYNAMIC AND RENAL PROTECTIVE PROPERTIES OF BNP INFUSION DURING CARDIAC TRANSPLANTATION

Moazami, Nader1; Safarzadeh, Elika1; Pasque, Micheal K1; Moon, Marc R1; Lawton, Jennifer1; Damiano, Ralph J1

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Background:

B-type natriuretic peptide (BNP) reduces pulmonary artery pressure, causes renal afferent arteriole dilation and increases diuresis and natriuresis.

Methods:

From June 2003 to November 2004, 12 patients recieved infusion of BNP at a dose of 0.01 μg/kg/min prior to initiation of cardioplumonary bypass. All patients recieved either tacrolimus or cyclosporine as induction therapy. Hemodynamics, urine output and serum creatinine were collected prospectively on all patients.

Results:

All patients were seperated from CPB without difficulty. BNP infusion was continued for a mean of 3.3 (±1.9) days. In addition to BNP, 10 (83%) were on low dose inotropic support and 2 (17%) were on low dose pressor support. Mean BP at 4 hours post -op was 77±27 mmHg, CVP was 15±7 mmHg, PAP was 23±10 mmHg, and cardiac index was 2.8±0.7 L/min/m2.The hemodynamics remained unchanged during the first 48 hours after transplantation. Post-operative urine output remained at 50–100 ml/hr. There was no significant change in mean serum creatine (pre-op= 1.3±0.4 mg/dl, 24 hour post op =1.5 ±0.5 mg/dl, 7 days post-op=1.0±0.4 mg/dl).

Conclusion:

BNP is a novel neurohormone with ideal pharmocologic profile for heart transplant patients. Our results suggest that infusion during transplantation may have favorable effects on right heart function allowing separation from CPB on low dose inotropes. Importantly, BNP seems to have renal protective properties. A multicenter prospective trial of BNP infusion during heart transplantation is warranted.

Copyright © 2005 by the American Society for Artificial Internal Organs