Beyazpinar Deniz Sarp, Diken Adem İlkay, Hafez İzzet, Karslioğlu Arif Okay, Akpinar Denizhan, Özkan Murat, Akay Hakkı Tankut, Gültekin Bahadır, Sezgin Atilla
Cardiovascular Surgery Department, Başkent University Ankara Hospital, Ankara, Turkey.
Cardiovascular Surgery Department, Başkent University Adana Hospital, Adana, Turkey.
Transplant Proc. 2024 Mar;56(2):358-362. doi: 10.1016/j.transproceed.2024.01.051. Epub 2024 Feb 15.
In this study, we try to determine risk factors for acute kidney injury in orthotopic cardiac transplantation patients.
Between February 2003 and December 2022, all cardiac transplantation patients were retrospectively reviewed. Finally, 102 patients enrolled in this study. Demographic data, comorbidities, preoperative cardiac catheterization parameters, preoperative and postoperative blood test results, intraoperative parameters, acute kidney injury developed or not, stage of acute kidney injury, and whether renal replacement therapy was required or not was recorded.
Of the 102 patients, 68 were male. Fifty-four of these patients developed acute kidney injury, and 31 required renal replacement therapy postoperatively. The mean age of developed acute kidney injury group (AKI+) was older than non-developed acute kidney injury group (non-AKI) (P = .01). The average body surface area of the AKI+ was 1.81 ± 0.32, whereas in non-AKI it was 1.57 ± 0.35 (P = .01). More patients were ex-smokers (P = .007) and had a history of hypertension (P= .011) in the AKI+ group. Preoperative serum creatinine was 1.12 ± 0.26 mg/dL in the AKI+ group and 0.82 ± 0.13 mg/dL in the non-AKI group (P = .02). The intraoperative urine output was 491.20 ± 276.48 mL for AKI+ and 676.45 ± 478.84 mL for the non-AKI group (P = .03).
Acute kidney injury development after cardiac transplantation is common. In our study, high body surface area, older age, ex-smoker, hypertension, low intraoperative urine output, and high preoperative serum creatinine levels were risk factors for acute kidney injury development in cardiac transplantation patients. Mortality and morbidity after cardiac transplantation might be reduced if acute kidney injury development can be lowered.
在本研究中，我们试图确定原位心脏移植患者急性肾损伤的危险因素。
回顾性分析2003年2月至2022年12月期间所有心脏移植患者。最终，102例患者纳入本研究。记录人口统计学数据、合并症、术前心脏导管检查参数、术前和术后血液检查结果、术中参数、是否发生急性肾损伤、急性肾损伤分期以及是否需要肾脏替代治疗。
102例患者中，68例为男性。其中54例患者发生急性肾损伤，31例术后需要肾脏替代治疗。发生急性肾损伤组（AKI+）的平均年龄大于未发生急性肾损伤组（非AKI）（P = 0.01）。AKI+组的平均体表面积为1.81±0.32，而非AKI组为1.57±0.35（P = 0.01）。AKI+组中既往吸烟者更多（P = 0.007）且有高血压病史者更多（P = 0.011）。AKI+组术前血清肌酐为1.12±0.26mg/dL，非AKI组为0.82±0.13mg/dL（P = 0.02）。AKI+组术中尿量为491.20±276.48mL，非AKI组为676.45±478.84mL（P = 0.03）。
心脏移植后发生急性肾损伤很常见。在我们的研究中，高体表面积、高龄、既往吸烟者、高血压、术中低尿量以及术前高血清肌酐水平是心脏移植患者发生急性肾损伤的危险因素。如果能降低急性肾损伤的发生，可能会降低心脏移植后的死亡率和发病率。
