Original articleGeneral thoracicAcute Kidney Injury Increases Mortality After Lung Transplantation
Section snippets
Data Source
For this study, we utilized the UNOS database from the UNOS registry, an open cohort of all patients undergoing LTx in the United States. The Johns Hopkins Medicine Institutional Review Board approved this study.
Study Design
This study is a retrospective cohort design of all adults (aged 18 years or older) who underwent LTx from 2000 to 2010. Patients undergoing retransplantation, combined heart-lung transplants, multiorgan transplants, patients on preoperative RRT, and patients missing preoperative
Cohort Statistics
From 2001 to 2010, 13,499 patients receiving a LTx were included in the UNOS database. After excluding pediatric patients (n = 533), redo LTx (n = 497), multiorgan transplants (n = 34), patients requiring preoperative RRT (n = 9), and patients missing preoperative creatinine (n = 318), the final cohort comprised 12,108 patients.
The mean age of the entire cohort was 52 ± 13 years, and 6,657 (55.0%) were male. By strata, 5,273 recipients (43.6%) had a GFR 90 or more, 5,476 recipients (45.2%) had
Comment
This analysis represents the largest study to date to examine the incidence, impact, and risk factors for requiring RRT in the perioperative period after LTx. In our study of 12,108 LTx, we found a 5.51% incidence of RRT. The need for RRT after LTx was associated with decreased survival at 30 days, 1 year, and 5 years on both univariate and multivariable analysis. Although much of the difference in mortality occurs early, the need for RRT is still associated with increased 5-year mortality
References (26)
- et al.
The modification of diet in renal disease (MDRD) and the prediction of kidney outcomes after lung transplantation
J Heart Lung Transplant
(2008) - et al.
Predictors of decline in renal function after lung transplantation
J Heart Lung Transplant
(2006) - et al.
Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality
Am J Transplant
(2005) - et al.
Severe acute kidney injury according to the RIFLE (risk, injury, failure, loss, end stage) criteria affects mortality in lung transplantation
J Heart Lung Transplant
(2011) - et al.
Dialysis after lung transplantation: prevalence, risk factors and outcome
J Heart Lung Transplant
(2007) - et al.
Independent association between acute renal failure and mortality following cardiac surgery
Am J Med
(1998) - et al.
Acute renal failure after cardiac surgery: evaluation of the RIFLE classification
Ann Thorac Surg
(2006) - et al.
RIFLE criteria for acute kidney injury in aortic arch surgery
J Thorac Cardiovasc Surg
(2007) - et al.
Clinical risk factors for primary graft failure following lung transplantation
Chest
(2003) - et al.
Implementation of a management guideline aimed at minimizing the severity of primary graft dysfunction after lung transplant
J Thorac Cardiovasc Surg
(2010)
The evolution of kidney function after lung transplantation: a retrospective cohort study
Transplant Proc
The impact of center volume on survival in lung transplantation: an analysis of more than 10,000 cases
Ann Thorac Surg
Acute renal failure following lung transplantation: risk factors, mortality, and long-term consequences
Eur J Cardiothorac Surg
Cited by (82)
Long-Term Survival Following Primary Graft Dysfunction Development in Lung Transplantation
2024, Journal of Surgical ResearchDonor respiratory multidrug-resistant bacteria and lung transplantation outcomes
2024, Journal of InfectionSimultaneous Lung-Kidney Transplantation in the United States
2023, Annals of Thoracic SurgeryPostoperative Acute Kidney Injury and Long-Term Outcomes After Lung Transplantation
2023, Annals of Thoracic SurgeryBenefit of Kidney Transplantation for Post Lung Transplantation Renal Failure
2023, Journal of Surgical ResearchConventional and Novel Approaches to Immunosuppression in Lung Transplantation
2023, Clinics in Chest Medicine