Predictors of early renal dysfunction after heart transplantation: a report from the International Consortium on Primary Graft Dysfunction

Abstract Background Renal dysfunction is a common complication after heart transplantation (HT). replacement therapy (RRT) HT has been associated with increased risk of death. Long-term renal mainly to immunosuppressive but also strongly related post-transplant failure. Predictors early have not clearly identified. Purpose We aimed define predictors HT. Methods Our consortium includes 10 centers in the US, Canada and Europe. collected data on all consecutive single-organ recipients from 2010 2020. The primary outcome was (ERD), defined as composite need for RRT or creatinine ≥2.5 mg/dL 24 hours assessed incidence performed univariate multivariate analyses identify recipient transplant characteristics its development. Results included 2,764 recipients: 282 (10.2%) presented 2482 (89.8%) did not. Recipients who postoperative were more frequently male, Caucasian, previous sternotomy, higher baseline creatinine, longer ischemic time worse donor LVEF. They likely be under RRT, intravenous inotropes ECMO support there severe graft (PGD) (Table 1). Multi-variable logistic regression demonstrated that strongest development PGD (OR 5.26, 2.88–9.62, p<0,001) prior 5.80, 2.93–11.5, p<0.001). Other male sex, long Conclusions Early an around 10% large contemporary cohort. presence pre-transplant Interestingly, emergent MCS independently ERD. Further studies are needed patients at high late kidney may benefit combined transplantation. Funding Acknowledgement Type funding sources: None.