The Influence of Pre-Left Ventricular Assist Device (LVAD) Implantation Glomerular Filtration Rate on Long-Term LVAD Outcomes

Mohamedali, Burhan; Bhat, Geetha

doi:10.1016/j.hlc.2017.01.002

Cited by 21 publications

(20 citation statements)

References 30 publications

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“…In the present study, we describe the derivation and validation of a novel risk score that can serve as an adjunct to clinical decision making for bridge to heart transplantation candidacy. The BTT-LVAD Score, derived from six recipient and two donor variables, risk categorizes BTT-LVAD patients into low (0-5), intermediate (6)(7)(8)(9)(10), and high based on a 33 point scoring system. Variables found to be predictive of 1-year mortality post-OHT were recipient age, body mass index, renal and hepatic dysfunction, inotrope dependence, and donor ischemic time and race-mismatch.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Moreover, even among non-LVAD heart failure studies, elevated BUN and low GFR have been identified as strong predictors of morbidity and mortality. 8,9 Similar to other scoring methods for MCS patients, the BTT-LVAD score incorporates a marker of renal dysfunction, but uniquely includes it at both listing and last follow-up thus accounting for changes in renal function while on LVAD support. Among patients with poor renal function prior to LVAD implantation, improvements in renal function are usually noted between the first and second months post-LVAD implantation.…”

Section: Discussionmentioning

confidence: 99%

“…In the validation cohort (n = 2328), complete data were available for 98% (n = 2279) of patients. Risk groups were classified as low (0 -5), intermediate (6)(7)(8)(9)(10), and high (>10) based on clinically meaningful differences in expected mortality. When examined as a continuous variable, each 1-point increase predicted an 11% increase in the odds of 1-year mortality (OR: 1.12%-95% CI: 1.09-1.13).…”

Section: Score Validationmentioning

confidence: 99%

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Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score

et al. 2022

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Background: To derive and validate a risk score that accurately predicts 1-year mortality after heart transplantation (HT) in patients bridged to transplant (BTT) with a left ventricular assist device (LVAD). Methods: The UNOS database was queried to identify patients BTT with an LVAD between 2008 and 2018. Patients with ⩾1-year follow up were randomly divided into derivation (70%) and validation (30%) cohorts. The primary endpoint was 1-year mortality. A simple additive risk score was developed based on the odds of 1-year mortality after HT. Risk groups were created, and survival was estimated and compared. Results: A total of 7759 patients were randomly assigned to derivation ( n = 5431) and validation ( n = 2328) cohorts. One-year post-transplant mortality was 9.8% ( n = 760). A 33-point scoring was created from six recipient variables and two donor variables. Risk groups were classified as low (0–5), intermediate (6–10), and high (>10). In the validation cohort, the predicted 1-year mortality was significantly higher in the high-risk group than the intermediate and low-risk groups, 14.7% versus 9% versus 6.1% respectively (log-rank test: p < 0.0001). Conclusion: The BTT-LVAD Score can serve as a clinical decision tool to guide therapeutic decisions in advanced heart failure patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Score Validationmentioning

confidence: 99%

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Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score

et al. 2022

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“…While some patients with high preoperative creatinine develop AKI postoperatively [18], others with CRS may have improvements in renal function following LVAD placement [7, 14, 19-21]. Many studies note these transient renal functional improvements, with return to baseline dysfunction after 1 or more years [6, 7].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Moderate-to-Severe Acute Kidney Injury following Left Ventricular Assist Device Implantation

et al. 2019

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Background: Although acute kidney injury (AKI) is a common complication following cardiac surgery, less is known about the occurrence and consequences of moderate/severe AKI following left ventricular assist device (LVAD) implantation. Methods: All patients who had an LVAD implanted at our center from 2008 to 2016 were reviewed to determine the incidence of, and risk factors for, moderate/severe (stage 2/3) AKI and to compare postoperative complications and mortality rates between those with and those without moderate/severe AKI. Results: Of 246 patients, 68 (28%) developed moderate/severe AKI. A multivariable logistic regression comprising body mass index and prior sternotomy had fair predictive ability (area under the curve = 0.71). A 1-unit increase in body mass index increased the risk of moderate/severe AKI by 7% (odds ratio = 1.07; 95% confidence interval: 1.03–1.11); a prior sternotomy increased the risk more than 3-fold (odds ratio = 3.4; 95% confidence interval: 1.84–6.43). The group of patients with moderate/severe AKI had higher rates of respiratory failure and death than the group of patients with mild/no AKI. Patients with moderate/severe AKI were at 3.2 (95% confidence interval: 1.2–8.2) times the risk of 30-day mortality compared to those without. Even after adjusting for age and Interagency Registry for Mechanically Assisted Circulatory Support profile, those with moderate/severe AKI had 1.75 (95% confidence interval: 1.03–3.0) times the risk of 1-year mortality compared to those without. Discussion: Risk-stratifying patients prior to LVAD placement in regard to AKI development may be a step toward improving surgical outcomes.

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“…Hasin T. и соавт. у пациентов, наблюдавшихся после имплантации HeartMate II, отметил развитие артериосклероза в посмертных почечных образцах, а также снижение СКФ через год от предимплантационного уровня [32].…”

Section: патологические измененияunclassified

Left Ventricular Assist Device (LVAD) Implantation and Renal Dysfunction

Nogaibayeva¹,

Sultanova

Makhmutov

2018

J Clin Med Kaz

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Pathophysiological, pathomorphological and functional changes in the kidneys after left ventricular assist device implantation have not yet been fully understood and represent an actual problem of our time. Changes in renal function following left ventricular assist device implantation have been disclosed in many studies with inconsistent results. Some studies have shown that patients with renal dysfunction after left ventricular assist device implantation had worse outcomes, despite stabilization or even improvement of kidney function during the postoperative period, other studies have shown the progression of chronic kidney disease requiring renal replacement therapy.

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The Influence of Pre-Left Ventricular Assist Device (LVAD) Implantation Glomerular Filtration Rate on Long-Term LVAD Outcomes

Cited by 21 publications

References 30 publications

Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score

Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score

Outcomes of Moderate-to-Severe Acute Kidney Injury following Left Ventricular Assist Device Implantation

Left Ventricular Assist Device (LVAD) Implantation and Renal Dysfunction

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