• Geoffroy Hariri, Paul Henocq, Guillaume Coutance, Sehmi Mansouri, Joanna Tohme, Jérémie Guillemin, Shaida Varnous, Pauline Dureau, Baptiste Duceau, Pascal Leprince, Agnès Dechartres, and Adrien Bouglé.
• Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU DREAM, Département d'anesthésie et réanimation, Institut de Cardiologie, Hôpital La Pitié-Salpêtrière, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Paris, France. Electronic address: geoffroyhariri@hotmail.com.
• J. Cardiothorac. Vasc. Anesth. 2024 Mar 22.

ObjectivesThis study aimed to identify perioperative risk factors of acute kidney injury after heart transplantation and to evaluate 1-year clinical outcomes.DesignA retrospective single-center cohort study.SettingAt a university hospital.ParticipantsAll patients who underwent heart transplantation from January 2015 to December 2020.InterventionsNone.Measurements And Main ResultsThe authors recorded acute kidney injury after heart transplantation. One-year mortality and renal function also were recorded. Risk factors of acute kidney injury were evaluated using a multivariate logistic regression model. Long-term survival was compared between patients developing acute kidney injury and those who did not, using a log-rank test. Among 209 patients included in this study, 134 patients (64% [95% CI (58; 71)]) developed posttransplantation acute kidney injury. Factors independently associated with acute kidney injury were high body mass index (odds ratio [OR]: 1.18 [1.02-1.38] per kg/m2; p = 0.030), prolonged duration of cold ischemic period (OR: 1.11 [1.01-1.24] per 10 minutes; p = 0.039), and high dose of intraoperative dobutamine support (OR: 1.24 [1.06-1.46] per µg/kg/min; p = 0.008). At 1 year, patients who developed postoperative acute kidney injury had higher mortality rates (20% v 8%, p = 0.015). Among 172 survivors at 1 year, 82 survivors (48%) had worsened their renal function compared with preheart transplantation.ConclusionsThis study highlighted the high incidence of acute kidney injury after heart transplantation and its impact on patient outcomes. Risk factors such as body mass index, prolonged cold ischemic period duration, and level of inotropic support with dobutamine were identified, providing insights for preventive strategies.Copyright © 2024 Elsevier Inc. All rights reserved.

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