BACKGROUND:
Acute kidney injury (AKI) is an outcome that represents a significant increase in morbidity and mortality rates; however, limited information exists about the incidence of AKI after cardiac transplantation.
METHODS:
This single-center, retrospective study from 2009 to 2014 analyzed pre-, intra-, and post-operative characteristics of 111 patients who underwent orthotopic cardiac transplantation to identify risk factors for AKI and validate findings of existing literature.
RESULTS:
AKI based on the RIFLE criteria (risk, injury, failure, loss, and end-stage) occurred in 65 patients (58.6%) during the hospitalization period, with 38 patients requiring early dialysis. Risk factors for AKI were longer cardiopulmonary bypass duration (P = .008), higher packed cell (P = .004) and cryoprecipitate (P = .022) transfusions, and post-operative bleeding with subsequent surgical re-exploration (P = .008). The development of AKIwas also associated with longer inotropic (P ≤ .001) and ventilation duration (P ≤ .001) as well as higher mortality rates (P = .048).
CONCLUSIONS:
AKI after cardiac transplantation is prevalent and prognostically significant. Although there is yet to be a strategy that conclusively demonstrated its ability to prevent AKI after cardiac surgery, therapies targeted at modifiable risk factors may offer protection against this outcome.
