Pre- and Post Renal Dysfunction Predicts a Worst Outcome in Patients with Heart Transplantation

Introduction: It is the purpose of this study to review the renal function of the transplanted patients (P.) pre- and post-transplantation. Several reports have shown a poor prognosis in P. with heart transplantation who developed moderate renal dysfunction post transplantation. Methods: We reviewed our data and survival of 140 P. who underwent heart transplants in our institution. Results: 72% were males and 28% were females with a mean age of 46 years old. The ischemic period was 123 minutes. 62 P. developed moderate renal dysfunction (creatinine >2.5 mg%). We compared the pre-operative creatinine (1.83 mg%) with the creatinine at one year. There was an increase from 1.83 ± 10 to 3.35 mg% (P < 0.5). The survival rate was from 1 to 5 years. The deaths were multifactorial, but the renal dysfunction was the culprit. Conclusions: The preservation of the renal function during the first year is crucial due to the high comorbidities seen in this group like diabetes mellitus, hypertension and the sub-clinical rejection which was low proven by myocardial biopsies (1R). Strict control of these comorbidities or better selections of P. will improve total survival of our group.