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Published on: April 12, 2021

Predictors of renal dysfunction at 1 year in heart transplant patients

Josep Navarro-Manchón1, Luis Martínez-Dolz, Luis Almenar Bonet

  • 1Department of Cardiology, Heart Failure and Transplant Unit, La Fe University Hospital, Valencia, Spain. villacampus@hotmail.com

Transplantation
|April 21, 2010
PubMed

Insights

Fifty-seven percent of heart transplant patients develop renal dysfunction within one year. Pre-transplant creatinine, cytomegalovirus infection, and diabetes are key predictors, while specific immunosuppressants and prophylaxis can protect kidney function.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Renal dysfunction (RD) is a major long-term complication following heart transplantation (HT).
  • While calcineurin inhibitors are often implicated, multiple factors likely contribute to RD development.
  • Identifying predictors of RD is crucial for improving long-term outcomes in HT patients.

Purpose of the Study:

  • To identify predictor variables for renal dysfunction (RD) at one year post-heart transplantation (HT).
  • To analyze the relationship between pre-transplant and 1-year follow-up variables and the incidence of RD.

Main Methods:

  • Evaluated 316 consecutive heart transplantation (HT) patients.
  • Analyzed the relationship between renal dysfunction (RD) at 1 year (glomerular filtration rate <60 mL/min/1.73 m2) and pre-transplant/1-year follow-up variables.

Main Results:

  • 57% of HT patients exhibited renal dysfunction (RD) at 1 year post-transplant.
  • Significant predictors of RD included pre-transplant serum creatinine and cytomegalovirus (CMV) infection.
  • Interleukin-2 receptor antagonists, mycophenolate mofetil, and CMV antiviral prophylaxis were protective against RD.

Conclusions:

  • Renal dysfunction (RD) affects a majority of heart transplant (HT) recipients within the first year.
  • Pre-transplant serum creatinine, CMV infection, and diabetes mellitus are associated with post-HT RD.
  • Specific immunosuppressive strategies (IL-2 receptor antagonists, mycophenolate mofetil) and CMV prophylaxis improve renal function preservation.
Abstract

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