Influence of Hemodialysis on Clinical Outcomes After Lung Transplantation

Overview

Journal J Surg Res

Specialty General Surgery

Date 2013 Mar 14

PMID 23481566

Citations 4

Authors

Sara A Hennessy

Jacob R Gillen

Tjasa Hranjec

Benjamin D Kozower

David R Jones

Irving L Kron

Christine L Lau

Affiliations

Soon will be listed here.

Abstract

Background: Chronic renal failure after lung transplantation is associated with significant morbidity. However, the significance of acute kidney injury (AKI) after lung transplantation remains unclear and poorly studied. We hypothesized that hemodialysis (HD)-dependent AKI after lung transplantation is associated with significant mortality.

Materials And Methods: We performed a retrospective review of all patients undergoing lung transplantation from July 1991 to July 2009 at our institution. Recipients with AKI (creatinine > 3 mg/dL) were identified. We compared recipients without AKI versus recipients with and without HD-dependent AKI. Kaplan-Meier survival curves were compared by log rank test.

Results: Of 352 lung transplant recipients reviewed at our institution, 17 developed non-HD-dependent AKI (5%) and 16 developed HD-dependent AKI (4.6%). Cardiopulmonary bypass was significantly higher in patients with HD-dependent AKI. None of the recipients who required HD had recovery of renal function. The 30-day mortality was significantly greater in recipients requiring HD (63% versus 0%; P < 0.0001). One-year mortality after transplantation was significantly increased in recipients with HD-dependent AKI compared with those with non-HD-dependent AKI (87.5% versus 17.6%; P < 0.001).

Conclusions: Hemodialysis is associated with mortality after lung transplantation. Fortunately, AKI that does not progress to HD commonly resolves and has a better overall survival. Avoidance, if possible, of cardiopulmonary bypass may attenuate the incidence of AKI. Aggressive measures to identify and treat early postoperative renal dysfunction and prevent progression to HD may improve outcomes after lung transplantation.

Citing Articles

Kidney injury after lung transplantation: Long-term mortality predicted by post-operative day-7 serum creatinine and few clinical factors.

Doricic J, Greite R, Vijayan V, Immenschuh S, Leffler A, Ius F PLoS One. 2022; 17(3):e0265002.

PMID: 35245339 PMC: 8896732. DOI: 10.1371/journal.pone.0265002.

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis.

Lertjitbanjong P, Thongprayoon C, Cheungpasitporn W, OCorragain O, Srivali N, Bathini T J Clin Med. 2019; 8(10).

PMID: 31627379 PMC: 6833042. DOI: 10.3390/jcm8101713.

Lung Transplantation in Patients With Systemic Sclerosis.

Shah R, Boin F Curr Rheumatol Rep. 2017; 19(5):23.

PMID: 28386760 DOI: 10.1007/s11926-017-0650-z.

Lung transplantation in telomerase mutation carriers with pulmonary fibrosis.

Silhan L, Shah P, Chambers D, Snyder L, Riise G, Wagner C Eur Respir J. 2014; 44(1):178-87.

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