Results of HeartMate II left ventricular assist device implantation on renal function in patients requiring post-implant renal replacement therapy

Renal Failure in Patients with Left Ventricular Assist Devices

“…For example, Sandner et al reported in a population of continuous-flow LVAD recipients that survival rates at 1, 3, and 6 months post-LVAD implantation were 83% (25 of 30), 49% (14 of 29), and 29% (5 of 17), respectively, for patients who required postoperative CRRT versus 96% (54 of 56), 87% (41 of 47), and 78% (20 of 26) for patients who did not require postoperative CRRT (23). In more recent studies, mortality from AKI has decreased but still remains significantly elevated (47,58). As with most causes of AKI, it remains uncertain if the AKI itself is directly responsible for the increased mortality, or if sicker patients (i.e., patients in cardiogenic shock) are more likely to develop AKI and the increased mortality is really due to the greater comorbidities or associated multiorgan system failure in these patients.…”

“…The incidence of AKI after LVAD implantation has been reported to range from 7% to 56% (Table 1) (20,21,23,26,29,44,47,(49)(50)(51)(52)(53)(54)(55)(56)(57)(58). There are multiple reasons for the large variation in AKI incidence, which include varying definitions for AKI, the time period during which the study was performed, the baseline severity of heart failure (INTERMACS level), and the incidence and severity of pre-existing RD.…”

“…Even using RRT (usually CRRT) as a definition of AKI, the incidence of AKI has been reported to be as high as one-third of LVAD recipients (23,53). More recent studies using continuous-flow devices appear to be associated with a lower incidence (range, 7%-14%) of postimplantation AKI (Table 1) (20,21,29,47,57,58). Although several variables could be responsible for this reduction in AKI, it is unlikely that the choice of LVAD is critical because Sandner et al reported a similar incidence of AKI with both pulsatile and continuous devices (44).…”

Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model

“…All other US HMII single-centre studies (n = 12) included both BTT and DT patients in single analyses (i.e. results not separated according to therapy) or did not state if patients received BTT or DT (Demirozu 2011, 61 Martin 2010 69 and Kato 2012 66 ). The two studies of Topilsky 2011 79,80 investigated overlapping populations as also did the two studies by Schaffer 2009, 77 2011.…”

Perioperative Plasma Neutrophil Gelatinase-Associated Lipocalin Measurement in Patients Who Undergo Left Ventricular Assist Device Implantation Surgery

“…The doses of CHDF were comparable between these 2 cohorts (data not shown). Clearance calculation using blood and effluent fluid concentration revealed that Cre clearance by CHDF was virtually equal to Qd + Qr + Qnet, and that NGAL clearance was approximately 25% below the Cre clearance (NGAL/Cre clearance ratio: 26 [23][24][25][26][27][28][29][30][31][32][33][34]% at 3 h, 26 [18][19][20][21][22][23][24][25][26][27][28][29]% at 12 h, and 22 [18][19][20][21][22][23][24][25][26][27][28]% at 24 h; Figure 4).…”