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Renal failure and heart transplant

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https://www.readbyqxmd.com/read/28727227/long-term-outcomes-of-simultaneous-heart-and-kidney-transplantation-in-pediatric-recipients
#1
Patricia L Weng, Juan Carlos Alejos, Nancy Halnon, Qiuheng Zhang, Elaine F Reed, Eileen Tsai Chambers
Pediatric sHKTx has become an effective therapy for patients with combined cardiac and renal failure. Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re-transplant. We describe the largest case series of a predominantly sensitized pediatric sHKTx with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short- and long-term patient and allograft outcomes of all sHKTx performed between 2002 and 2015...
July 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#2
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995-2015. Nineteen patients were switched from tacrolimus(n=15) or cyclosporin(n=4) to everolimus(n=4) or sirolimus(n=15) due to nephrotoxicity(n=5), malignancy(n=8), EBV viremia/reactive plasmacytic changes(n=5) and immune hemolytic anemia(n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#3
Julius I Ejiofor, Robert C Neely, Maroun Yammine, Siobhan McGurk, Tsuyoshi Kaneko, Marzia Leacche, Lawrence H Cohn, Prem S Shekar
BACKGROUND: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). METHODS: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28678923/cardiac-amyloidosis-and-its-new-clinical-phenotype-heart-failure-with-preserved-ejection-fraction
#4
Evandro Tinoco Mesquita, Antonio José Lagoeiro Jorge, Celso Vale Souza, Thais Ribeiro de Andrade
Heart failure with preserved ejection fraction (HFpEF) is now an emerging cardiovascular epidemic, being identified as the main phenotype observed in clinical practice. It is more associated with female gender, advanced age and comorbidities such as hypertension, diabetes, obesity and chronic kidney disease. Amyloidosis is a clinical disorder characterized by the deposition of aggregates of insoluble fibrils originating from proteins that exhibit anomalous folding. Recently, pictures of senile amyloidosis have been described in patients with HFpEF, demonstrating the need for clinical cardiologists to investigate this etiology in suspect cases...
June 29, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28612323/risk-assessment-and-outcomes-of-vasoplegia-after-cardiac-surgery
#5
Athanasios Tsiouris, Lynn Wilson, Ala S Haddadin, James J Yun, Abeel A Mangi
OBJECTIVE: The aim of this study was to analyze risk factors and outcomes of vasoplegia after cardiac surgery based on our experience with almost 2000 cardiac operations performed at our institution. METHODS: We retrospectively analyzed patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between 2011 and 2013. Data were available for a total of 1992 patients. We defined vasoplegia as hypotension with persistently low systemic vascular resistance (<800 dyn/s/cm) and preserved Cardiac Index (>2...
June 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28611860/renal-function-and-outcomes-with-use-of-left-ventricular-assist-device-implantation-and-inotropes-in-end-stage-heart-failure-a-retrospective-single-center-study
#6
Sean Verma, Emmanuel Bassily, Shane Leighton, Rahul Mhaskar, Igor Sunjic, Angel Martin, Nancy Rihana, Tambi Jarmi, Claude Bassil
BACKGROUND: Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. METHODS: In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28602210/renal-allograft-outcome-after-simultaneous-heart-and-kidney-transplantation
#7
Avishay Grupper, Ayelet Grupper, Richard C Daly, Naveen L Pereira, Matthew A Hathcock, Walter K Kremers, Fernando G Cosio, Brooks S Edwards, Sudhir S Kushwaha
Chronic kidney disease frequently accompanies end-stage heart failure and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years, there has been a significant increase in SHKT. This single-center cohort consisted of 35 patients who underwent SHKT during 1996 to 2015. The aim of this study was to review factors that may predict better long-term outcome after SKHT. Thirteen patients (37%) had delayed graft function (DGF) after transplant (defined as the need for dialysis during the first 7 days after transplant), which was significantly associated with mechanical circulatory support device therapy and high right ventricular systolic pressure before transplant...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28599901/esrd-after-heart-failure-myocardial-infarction-or-stroke-in-type%C3%A2-2-diabetic-patients-with-ckd
#8
David M Charytan, Scott D Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E Cooper, Janet B McGill, Hans-Henrik Parving, Patrick Parfrey, Ajay K Singh, Emmanuel A Burdmann, Andrew S Levey, Dick de Zeeuw, Kai-Uwe Eckardt, John J V McMurray, Brian Claggett, Eldrin F Lewis, Marc A Pfeffer
BACKGROUND: How cardiovascular (CV) events affect progression to end-stage renal disease (ESRD), particularly in the setting of type 2 diabetes, remains uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 4,022 patients with type 2 diabetes, anemia, and chronic kidney disease from the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT). PREDICTOR: Postrandomization CV events. OUTCOMES: ESRD (defined as initiation of dialysis for >30 days, kidney transplantation, or refusal or nonavailability of renal replacement therapy) and post-ESRD mortality within 30 days and during overall follow-up after an intercurrent CV event...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#9
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28501318/mortality-rehospitalization-and-post-transplant-complications-in-gender-mismatched-heart-transplant-recipients
#10
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Limited research has been published on outcomes in heart transplant (HT) recipients with gender-mismatched donors. OBJECTIVE: Compare 3-year post-transplant outcomes in 2 groups of gender-mismatched HT recipients and a no-mismatch group. METHODS: Sample: 347 HT recipients: 21.3% (74) received a heart from the opposite gender: Group 1: same gender donor/recipient (273, 78.7%); Group 2: female donor/male recipient (40, 11.5%); Group 3: male donor/female recipient (34, 9...
July 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#11
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
June 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28486870/long-term-cardiac-morbidity-and-mortality-in-patients-with-aortic-valve-disease-following-liver-transplantation-a-case-matching-study
#12
Ramona Nicolau-Raducu, Thomas Marshall, Hamang Patel, Kelly Ural, Joseph Koveleskie, Susan Smith, Donald Ganier, Bryan Evans, Brian Fish, William Daly, Ari J Cohen, George Loss, Amjad Bokhari, Bobby Nossaman
INTRODUCTION: This retrospective study examined the role of aortic valve (AV) disease in patients who underwent orthotopic liver transplantation (OLT) to determine the incidence of postoperative cardiac morbidity and mortality when compared with a matched control group without AV disease. METHODS: Patients were included in the AV group if diagnosed with aortic stenosis (AS) or aortic regurgitation or had received AV replacement prior to OLT. The AV group (n = 53) was matched to a control group (n = 212) with the following preoperative variables: type of organ transplanted, age, gender, race, body mass index, MELD, redo-transplantation, preoperative renal replacement therapy, nonalcoholic steatohepatitis, viral hepatitis, diabetes, and coronary artery disease...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28466760/peripheral-arterial-disease-preoperatively-may-predict-graft-failure-and-mortality-in-kidney-transplant-recipients
#13
Salma I Patel, Harini A Chakkera, Paul W Wennberg, David A Liedl, Fadi Alrabadi, Stephen S Cha, Darren D Hooley, Hatem Amer, Hani M Wadei, Fadi E Shamoun
Patients with end-stage renal disease undergoing kidney transplant often have diffuse atherosclerosis and high cardiovascular morbidity and mortality rates. We analyzed the correlation of peripheral arterial disease (PAD), here quantified by an abnormal ankle-brachial index (ABI) measured within the 5 years prior to kidney transplant, with graft failure and mortality rates (primary end points) after adjusting for known cardiovascular risk factors (age, sex, smoking history, hypertension, diabetes, stroke, known coronary artery disease or heart failure, years of dialysis)...
March 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28452970/one%C3%A2-year-survival-of-ambulatory-patients-with-end%C3%A2-stage-heart-failure-the-analysis-of-prognostic-factors
#14
Bożena Szygula-Jurkiewicz, Wioletta Szczurek, Michał Skrzypek, Michał Zakliczyński, Łukasz Siedlecki, Piotr Przybyłowski, Marian Zembala, Mariusz Gąsior
INTRODUCTION    An increasing number of ambulatory patients are placed on orthotopic heart transplantation (OHT) waiting lists, which results in an extended waiting time and a higher mortality rate. OBJECTIVES    The aim of this study was to identify the factors associated with reduced survival during a 1‑year follow‑up in patients with end‑stage heart failure listed for an OHT. PATIENTS AND METHODS    We retrospectively analyzed the data of 221 adult patients, who were accepted for OHT in our institution over a 2‑year period between 2013 and 2014...
April 28, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28429125/low-plasma-homoarginine-concentration-is-associated-with-high-rates-of-all-cause-mortality-in-renal-transplant-recipients
#15
Arslan Arinc Kayacelebi, Isidor Minović, Erik Hanff, Anne-Roos S Frenay, Martin H de Borst, Martin Feelisch, Harry van Goor, Stephan J L Bakker, Dimitrios Tsikas
In renal transplant recipients (RTR), we recently found that low urinary excretion of homoarginine (hArg) is associated with mortality and graft failure. However, it is not known whether such prospective associations also hold true for plasma concentrations of hArg. In the present study, we therefore determined plasma concentrations of hArg in the same cohort, i.e. in 687 RTR (functioning graft ≥1 year), and in 140 healthy donors, before and after kidney donation. Plasma hArg concentrations were significantly lower in RTR compared to healthy controls [1...
April 20, 2017: Amino Acids
https://www.readbyqxmd.com/read/28361119/evaluation-of-carotid-ultrasonography-screening-among-kidney-transplant-candidates-a-single-center-retrospective-study
#16
Chad W Rossitter, Ronald B Vigo, Ahmed Osama Gaber, Joshua T Swan, Wadi N Suki
BACKGROUND: Kidney transplant candidates undergo rigorous testing prior to clearance for transplantation. Because kidney transplant candidates may be at increased risk for carotid artery stenosis because of arteriosclerosis and atherosclerosis secondary to hypertension, vascular calcification, and diabetes, carotid ultrasound is often performed with the intent of preventing a cerebrovascular accident in the perioperative or posttransplant period. To our knowledge, there has not been a study investigating the utility of screening carotid ultrasonography in pretransplant candidates...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28331061/an-intracellular-matrix-metalloproteinase-2-isoform-induces-tubular-regulated-necrosis-implications-for-acute-kidney-injury
#17
Carla S Ceron, Celine Baligand, Sunil Joshi, Shaynah Wanga, Patrick M Cowley, Joy P Walker, Sang Heon Song, Rajeev Mahimkar, Anthony J Baker, Robert L Raffai, Zhen J Wang, David H Lovett
Acute kidney injury (AKI) causes severe morbidity, mortality, and chronic kidney disease (CKD). Mortality is particularly marked in the elderly and with preexisting CKD. Oxidative stress is a common theme in models of AKI induced by ischemia-reperfusion (I-R) injury. We recently characterized an intracellular isoform of matrix metalloproteinase-2 (MMP-2) induced by oxidative stress-mediated activation of an alternate promoter in the first intron of the MMP-2 gene. This generates an NH2-terminal truncated MMP-2 (NTT-MMP-2) isoform that is intracellular and associated with mitochondria...
June 1, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28298957/the-intersection-of-pulmonary-hypertension-and-solid-organ-transplantation
#18
REVIEW
Adaani E Frost
Pulmonary hypertension (PH) is a complication and marker of disease severity in many parenchymal lung diseases. It also is a frequent complication of portal hypertension and negatively impacts survival with liver transplant. Pulmonary hypertension is frequently diagnosed in patients with end-stage renal disease who are undergoing dialysis, and it has recently been demonstrated to adversely affect posttransplant outcome in this patient population even though the mechanism of PH is substantially different from that associated with liver disease...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#19
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28270107/incidence-of-cardiovascular-events-and-associated-risk-factors-in-kidney-transplant-patients-a-competing-risks-survival-analysis
#20
María Teresa Seoane-Pillado, Salvador Pita-Fernández, Francisco Valdés-Cañedo, Rocio Seijo-Bestilleiro, Sonia Pértega-Díaz, Constantino Fernández-Rivera, Ángel Alonso-Hernández, Cristina González-Martín, Vanesa Balboa-Barreiro
BACKGROUND: The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. METHODS: An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed...
March 7, 2017: BMC Cardiovascular Disorders
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