Faculty Collaboration Database

Cardiac Surgery and Postoperative Renal Allograft Failure. Ann Thorac Surg 2020 Dec;110(6):1904-1908

Date

04/29/2020

Pubmed ID

32343950

DOI

10.1016/j.athoracsur.2020.03.066

Scopus ID

2-s2.0-85087890222 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Although cardiac surgery among renal allograft recipients is relatively safe, less is known about the impact of cardiac surgery on the functioning renal allograft. This study assessed postoperative renal failure among renal transplant recipients undergoing cardiac surgery.

METHODS: The study population was identified by matching medical record numbers from the United Network for Organ Sharing Kidney Transplant Database to a cardiovascular surgery database and The Society of Thoracic Surgeons Adult Cardiac Surgery Database for the authors' institution from January 1992 through August 2018.

RESULTS: One hundred seventy-nine renal transplant recipients with a functioning allograft underwent cardiac surgery a mean of 6.4 ± 5.6 years after renal transplantation. Thirty (17.6%) of the 170 patients either died or had allograft failure during the first postoperative year. Receiver-operating characteristics curve analysis using Cox regression demonstrated an optimal cutoff point for preoperative serum creatinine predicting postoperative allograft loss is 1.9 mg/dL (hazard ratio 3; 95% confidence interval, 1.5 to 6.9) with a model C statistic of 0.642.

CONCLUSIONS: The current study affirms findings in the literature that cardiac surgery in renal transplant recipients carries acceptable perioperative morbidity and mortality. Renal transplant recipients who underwent cardiac surgery had a constant hazard of renal allograft loss similar to that of the general transplant population. A preoperative serum creatinine value greater than 1.9 mg/dL increases the risk for long-term renal allograft loss after cardiac surgery.

Author List

Mace JE, Xie R, Deng L, Asban A, Kim W, Pereira SJ, Kirklin JK, Davies JE

Author

James E. Mace MD Adjunct Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Cardiac Surgical Procedures
Creatinine
Female
Graft Survival
Humans
Kidney Transplantation
Male
Middle Aged
Postoperative Complications
Predictive Value of Tests
ROC Curve
Renal Insufficiency
Survival Rate
Time Factors