Journal article
Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction
Nephrology, dialysis, transplantation, Vol.25(9), pp.3090-3096
09/2010
DOI: 10.1093/ndt/gfq141
PMID: 20299337
Abstract
Background. Early graft dysfunction is a significant complication after renal transplantation and is a marker of adverse outcomes. Although multiple predictors of graft dysfunction have been previously described, the reported prevalence of pulmonary hypertension (pulmonary HTN) in the dialysis population (40–50%), along with biologic and physiologic principles, led us to hypothesize that pulmonary HTN might be an additional risk factor for early graft dysfunction. Methods. We performed a retrospective study that screened all adult renal transplants performed at our institution over a 3-year period and limited the evaluation to those subjects who had an estimated pulmonary artery systolic pressure on a preoperative echocardiogram report (n = 55). The primary outcome of this study was to investigate the impact of pulmonary HTN on early graft dysfunction using a combined endpoint of delayed graft function or slow graft function. Results. Among patients receiving a living donor kidney, early graft dysfunction was not observed regardless of pulmonary HTN status. However, among patients receiving a deceased donor kidney, pulmonary HTN was found to be associated with a significant increased risk of early graft dysfunction (56 vs 11.7%, P = 0.01). Univariate and multivariable logistic regression supported this observation as an independent risk factor beyond potential confounding recipient, donor and graft-based risk factors for early graft dysfunction (P < 0.05). Conclusion. Pulmonary HTN detected on non-invasive imaging prior to renal transplantation appears to be an independent predictor of early graft dysfunction among those patients who receive a deceased donor kidney.
Details
- Title: Subtitle
- Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction
- Creators
- David M. Zlotnick - Dartmouth–Hitchcock Medical CenterDavid A. Axelrod - Dartmouth–Hitchcock Medical CenterMichael C. Chobanian - Dartmouth–Hitchcock Medical CenterScott Friedman - Dartmouth–Hitchcock Medical CenterJeremiah Brown - Dartmouth–Hitchcock Medical CenterEdward Catherwood - Dartmouth–Hitchcock Medical CenterSalvatore P. Costa - Dartmouth–Hitchcock Medical Center
- Resource Type
- Journal article
- Publication Details
- Nephrology, dialysis, transplantation, Vol.25(9), pp.3090-3096
- Publisher
- Oxford University Press
- DOI
- 10.1093/ndt/gfq141
- PMID
- 20299337
- ISSN
- 0931-0509
- eISSN
- 1460-2385
- Language
- English
- Date published
- 09/2010
- Academic Unit
- Surgery
- Record Identifier
- 9984321860902771
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