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A Single-Center Experience With Kidney Transplantation in Patients Who Had Low Left Ventricular Ejection Fraction

Yucel Yuksel1,2, Ilker Tekin, Halil Erbis

  • 1From the Department of General Surgery and Transplantation, Sanko University, Gaziantep, Turkey.

Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation
|January 19, 2023
PubMed

Insights

Kidney transplant improves heart function in patients with low ejection fraction. Left ventricular ejection fraction below 50% is not a contraindication for kidney transplant in end-stage renal disease patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation

Background:

  • Left ventricular hypertrophy is common in end-stage renal disease.
  • Low left ventricular ejection fraction (LVEF) impacts survival in heart failure.
  • This study examines kidney transplant outcomes in patients with LVEF <50%.

Purpose of the Study:

  • To evaluate the safety and efficacy of living donor kidney transplant in patients with pre-existing low left ventricular ejection fraction.
  • To assess the impact of kidney transplantation on cardiac function and survival in this patient group.

Main Methods:

  • Retrospective analysis of 31 living donor kidney transplant recipients with pretransplant LVEF <50% (Nov 2008-Nov 2021).
  • Echocardiograms and New York Heart Association (NYHA) classification assessed pre- and post-transplant.
  • Graft survival and patient mortality data were analyzed.

Main Results:

  • Kidney transplant significantly improved NYHA classification (P = .001).
  • Mean LVEF increased from 32% pre-transplant to 52% at 6 months post-transplant (P < .001).
  • Graft loss and all-cause mortality rates were both 12.9%.

Conclusions:

  • Low LVEF (<50%) is not an absolute contraindication for kidney transplantation.
  • Myocardial scintigraphy is recommended for end-stage renal disease patients with low LVEF prior to transplant consideration.
  • Kidney transplant can be a viable option for selected patients without ischemic heart disease.
Abstract

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