Journal article
Midterm outcomes of off-pump and on-pump coronary artery revascularization in renal transplant recipients
Journal of cardiac surgery, Vol.26(6), pp.591-595
11/2011
DOI: 10.1111/j.1540-8191.2011.01327.x
PMID: 21995559
Abstract
Renal transplant recipients have high mortality from cardiac causes and are frequently in need of coronary interventions. Surgical coronary revascularization is associated with significant morbidity and mortality in this patient population. This study was undertaken to evaluate outcomes of on-pump versus off-pump revascularization in renal transplant recipients.
We retrospectively reviewed 43 renal transplant recipients who underwent surgical coronary revascularization with functioning allografts. Revascularization was performed on-pump [coronary artery bypass grafting (CABG)] in 21 patients and off-pump [off-pump coronary artery bypass (OPCAB)] in 22 patients.
Preoperative characteristics did not differ between the two groups except for age and incidence of prior sternotomy. Total operative time and transfusion requirements were similar. The on-pump group received a higher number of bypass grafts (p = 0.03). Overall 30-day, one-year, five-year, and eight-year survival was 90%, 76%, 61%, and 32% for CABG group, and 95%, 86%, 62%, and 48% for OPCAB group (p = 0.53). The postoperative peak creatinine was higher in the CABG patients than in OPCAB patients (p = 0.04). At discharge, there was no difference in mean creatinine between the two groups. The rate of return to permanent dialysis after revascularization was similar (28% for CABG and 22% for OPCAB, p = 0.73). There was no difference in dialysis-free survival up to eight-years postrevascularization (p = 0.63).
Despite higher mortality risk, surgical coronary revascularization can be performed safely in renal transplant recipients. OPCAB resulted in no improvement in patient survival or renal allograft function compared to on-pump revascularization.
Details
- Title: Subtitle
- Midterm outcomes of off-pump and on-pump coronary artery revascularization in renal transplant recipients
- Creators
- Hossein Shayan - Department of Cardiothoracic Surgery, Thomas E. Starzl Transplantation Institute, and Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USARodolfo RochaLawrence WeiThomas GleasonDiana ZaldonisRonald PellegriniYoshiya ToyodaRon ShapiroFerhaan AhmadChristian Bermudez
- Resource Type
- Journal article
- Publication Details
- Journal of cardiac surgery, Vol.26(6), pp.591-595
- Publisher
- United States
- DOI
- 10.1111/j.1540-8191.2011.01327.x
- PMID
- 21995559
- ISSN
- 0886-0440
- eISSN
- 1540-8191
- Language
- English
- Date published
- 11/2011
- Academic Unit
- Radiology; Molecular Physiology and Biophysics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984025480602771
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