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Pre- and Post Renal Dysfunction Predicts a Worst Outcome in Patients with Heart Transplantation

Altieri, Pablo I.1; Banchs, Hector L.1; Gonzalez-Cancel, Ivan F.2; Calderon, Rafael E.1

doi: 10.1097/

1Medicine and Physiology, University of Puerto Rico, San Juan, Puerto Rico; 2Heart Transplant Program, Cardiovascular Center of Puerto Rico and the Caribbean, San Juan, Puerto Rico.

Introduction: It is the purpose of this study to review the renal function of the transplanted patients (P.) pre- and post-transplantation. Several reports have shown a poor prognosis in P. with heart transplantation who developed moderate renal dysfunction post transplantation.

Methods: We reviewed our data and survival of 140 P. who underwent heart transplants in our institution.

Results: 72% were males and 28% were females with a mean age of 46 years old. The ischemic period was 123 minutes. 62 P. developed moderate renal dysfunction (creatinine >2.5 mg%). We compared the pre-operative creatinine (1.83 mg%) with the creatinine at one year. There was an increase from 1.83 ± 10 to 3.35 mg% (P < 0.5). The survival rate was from 1 to 5 years. The deaths were multifactorial, but the renal dysfunction was the culprit.

Conclusions: The preservation of the renal function during the first year is crucial due to the high comorbidities seen in this group like diabetes mellitus, hypertension and the sub-clinical rejection which was low proven by myocardial biopsies (1R). Strict control of these comorbidities or better selections of P. will improve total survival of our group.

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