Key result
Renal transplantation in ESRD patients with nonischemic very low LVEF resulted in similar graft outcomes and mortality as normal LVEF recipients, whereas non-transplanted low LVEF patients had higher mortality (P<0.05).
Why the study?
Renal transplantation in ESRD patients with very low LVEF HF carries potential perioperative morbidity and mortality risks, but evidence on whether outcomes are worse in nonischemic HF was lacking.
Does renal transplantation improve survival and provide similar graft outcomes in ESRD patients with nonischemic very low LVEF heart failure compared to those without heart failure?
Cohort (n=110)
Does renal transplantation improve survival and provide similar graft outcomes in ESRD patients with nonischemic very low LVEF heart failure compared to those without heart failure?
p-value: p=<0.05
Renal transplantation in ESRD patients with nonischemic very low LVEF heart failure appears to offer similar graft and survival outcomes as in recipients with normal LVEF.
Renal transplant may be considered for nonischemic very low-LVEF ESRD; leaves open need for RCTs to confirm benefit.
Objective: Transplantation in end-stage renal disease (ESRD) patients with very low left ventricular ejection fraction (LVEF) heart failure (HF) is a challenging issue, owing to the potential risk of morbidity and mortality, perioperatively. Although patients’ survival and worse graft outcomes can be predicted, there is no evidence to claim worse outcomes, especially in patients with nonischemic heart failure. Materials and Methods: A total of 110 ESRD patients were enrolled in the study, and they were divided into 3 groups. Group 1 (n=10) included ESRD patients with very low LVEF (<45%) HF who could not undergo allograft transplantation (on the waitlist or with immunological barriers to receive a living-related graft), Group 2 (n=20) included ESRD patients with very low LVEF HF who underwent allograft transplantation, and Group 3 (n=80) included ESRD patients who received an allograft and had no history of HF. Patients with EF between 45-55% were excluded. Results: The mean follow-up period was 15.1±3.1 months. Two patients from Group 1 died (Group 1 vs Group 2 and 3; p<0.05). Delayed graft function rates, one-year graft functions, graft loss, and one-year mortality rates were similar in Group 2 and 3. Conclusion: ESRD patients with a nonischemic low LVEF HF can receive all advantages of an allograft transplantation as recipients with normal LVEF. Cite this article as: Demir ME, Merhametsiz Ö. Outcomes of Renal Transplantation in End-Stage Renal Disease Patients with Nonischemic Very Low Ejection Fraction Heart Failure. Turk J Nephrol 2021; 30(1): 70-6.
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Demir et al. (2021) conducted a cohort in End-Stage Renal Disease with Nonischemic Very Low Ejection Fraction Heart Failure (n=110). Renal allograft transplantation vs. No transplantation (waitlist/immunological barriers) or transplantation with normal LVEF was evaluated on Mortality (p=<0.05). Renal transplantation in ESRD patients with nonischemic very low LVEF resulted in similar graft outcomes and mortality as normal LVEF recipients, whereas non-transplanted low LVEF patients had higher mortality (P<0.05).
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