TY - JOUR
T1 - Impact of Postoperative Continuous Renal Replacement Therapy in Lung Transplant Recipients
AU - Katahira, Masato
AU - Hirama, Takashi
AU - Eba, Shunsuke
AU - Suzuki, Takaya
AU - Notsuda, Hirotsugu
AU - Oishi, Hisashi
AU - Matsuda, Yasushi
AU - Sado, Tetsu
AU - Noda, Masafumi
AU - Sakurada, Akira
AU - Sidhu, Aman
AU - Okada, Yoshinori
N1 - Publisher Copyright:
© 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PY - 2020
Y1 - 2020
N2 - Background. Acute kidney injury (AKI) is a common complication after lung transplant (LTx), and continuous renal replacement therapy (CRRT) is increasingly of use to critically ill patients who have developed AKI. However, the optimal timing or threshold of kidney impairment for which to commence CRRT after LTx has been uncertain. There has also been limited information on the impact of CRRT among LTx recipients (LTRs) introduced in the early posttransplant period on survival, graft function, and renal function. We aimed to review LTRs who developed AKI requiring CRRT postoperatively and followed their long-term outcomes at Tohoku University Hospital (TUH). Methods. Medical records of consecutive patients who underwent LTx at TUH between 2000 and 2018 were reviewed, with follow-up to 2019 inclusive. Results. Although mortality in those who required CRRT (n = 21) was increased versus those who did not require CRRT (n = 85)(P = 0.024), conditional survival beyond 3-month posttransplant was not affected (P = 0.131). Additionally, the cumulative incidence of chronic lung allograft rejection (P = 0.160) and the development of chronic kidney disease (P = 0.757) were not significant between groups. Conclusions. The initiation of CRRT posttransplant may be a useful strategy to preserve cardiac and optimize volume management among critically ill patients.
AB - Background. Acute kidney injury (AKI) is a common complication after lung transplant (LTx), and continuous renal replacement therapy (CRRT) is increasingly of use to critically ill patients who have developed AKI. However, the optimal timing or threshold of kidney impairment for which to commence CRRT after LTx has been uncertain. There has also been limited information on the impact of CRRT among LTx recipients (LTRs) introduced in the early posttransplant period on survival, graft function, and renal function. We aimed to review LTRs who developed AKI requiring CRRT postoperatively and followed their long-term outcomes at Tohoku University Hospital (TUH). Methods. Medical records of consecutive patients who underwent LTx at TUH between 2000 and 2018 were reviewed, with follow-up to 2019 inclusive. Results. Although mortality in those who required CRRT (n = 21) was increased versus those who did not require CRRT (n = 85)(P = 0.024), conditional survival beyond 3-month posttransplant was not affected (P = 0.131). Additionally, the cumulative incidence of chronic lung allograft rejection (P = 0.160) and the development of chronic kidney disease (P = 0.757) were not significant between groups. Conclusions. The initiation of CRRT posttransplant may be a useful strategy to preserve cardiac and optimize volume management among critically ill patients.
UR - http://www.scopus.com/inward/record.url?scp=85086785566&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086785566&partnerID=8YFLogxK
U2 - 10.1097/TXD.0000000000001013
DO - 10.1097/TXD.0000000000001013
M3 - Article
AN - SCOPUS:85086785566
JO - Transplantation Direct
JF - Transplantation Direct
SN - 2373-8731
M1 - e562
ER -