*Purpose: Acute Kidney Injury (AKI) is a frequent complication of heart transplantation. However, with recent allocation changes, we have increasingly complex patients with a higher incidence of AKI requiring renal replacement therapy. In this study, we evaluate the impact of AKI requiring dialysis on heart graft survival and overall mortality.

*Methods: We identified adult patients (≥ 18 years old) with a solitary heart transplant between 1/1/2000 and 9/04/2020 from the Organ Procurement Transplantation Network data. We excluded patients who were on hemodialysis prior to heart transplant. Multivariate Cox regression analysis was performed and adjusted for age, sex, Body Mass Index, length of stay, ischemic time, serum creatinine prior to transplant, previous heart transplant and rejection in the first year.

*Results: A total of 40910 solitary heart transplant recipients were identified. Of these, there were 3927 (9.6%) that required dialysis after transplantation. Our cohort’s mean age was 52.69 ±12.69 years, with a predominance of males (74.31%) and Caucasians (68.87%). Compared to patients without the need for dialysis, patients that developed AKI requiring dialysis had a significantly higher risk of graft failure [adjusted hazard ration (aHR 1.31 95% CI 1.095-1.57)] and patient death (aHR1.28 95% CI (1.17-1.40) over 5.82 ± 5.03 years of follow up

*Conclusions: There was a significant association between AKI requiring dialysis and the risk of overall mortality and heart graft failure. Large, prospective studies will be needed to identify how to prevent severe AKI in these patients in order to improve heart graft and patient survival.

« Back to 2021 American Transplant Congress