Influence of hemodialysis on clinical outcomes after lung transplantation

Sara A. Hennessy, Jacob R. Gillen, Tjasa Hranjec, Benjamin D. Kozower, David R. Jones, Irving L. Kron, Christine L. Lau

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Chronic renal failure after lung transplantation is associated with significant morbidity. However, the significance of acute kidney injury (AKI) after lung transplantation remains unclear and poorly studied. We hypothesized that hemodialysis (HD)-dependent AKI after lung transplantation is associated with significant mortality. Materials and methods: We performed a retrospective review of all patients undergoing lung transplantation from July 1991 to July 2009 at our institution. Recipients with AKI (creatinine > 3 mg/dL) were identified. We compared recipients without AKI versus recipients with and without HD-dependent AKI. Kaplan-Meier survival curves were compared by log rank test. Results: Of 352 lung transplant recipients reviewed at our institution, 17 developed non-HD-dependent AKI (5%) and 16 developed HD-dependent AKI (4.6%). Cardiopulmonary bypass was significantly higher in patients with HD-dependent AKI. None of the recipients who required HD had recovery of renal function. The 30-day mortality was significantly greater in recipients requiring HD (63% versus 0%; P < 0.0001). One-year mortality after transplantation was significantly increased in recipients with HD-dependent AKI compared with those with non-HD-dependent AKI (87.5% versus 17.6%; P < 0.001). Conclusions: Hemodialysis is associated with mortality after lung transplantation. Fortunately, AKI that does not progress to HD commonly resolves and has a better overall survival. Avoidance, if possible, of cardiopulmonary bypass may attenuate the incidence of AKI. Aggressive measures to identify and treat early postoperative renal dysfunction and prevent progression to HD may improve outcomes after lung transplantation.

Original languageEnglish (US)
Pages (from-to)916-921
Number of pages6
JournalJournal of Surgical Research
Volume183
Issue number2
DOIs
StatePublished - Aug 2013

Fingerprint

Lung Transplantation
Acute Kidney Injury
Renal Dialysis
Mortality
Cardiopulmonary Bypass
Kidney
Recovery of Function
Kaplan-Meier Estimate
Chronic Kidney Failure
Creatinine
Transplantation

Keywords

  • Acute kidney injury
  • Dialysis
  • Lung
  • Mortality
  • Outcomes
  • Transplantation

ASJC Scopus subject areas

  • Surgery

Cite this

Hennessy, S. A., Gillen, J. R., Hranjec, T., Kozower, B. D., Jones, D. R., Kron, I. L., & Lau, C. L. (2013). Influence of hemodialysis on clinical outcomes after lung transplantation. Journal of Surgical Research, 183(2), 916-921. https://doi.org/10.1016/j.jss.2013.02.008

Influence of hemodialysis on clinical outcomes after lung transplantation. / Hennessy, Sara A.; Gillen, Jacob R.; Hranjec, Tjasa; Kozower, Benjamin D.; Jones, David R.; Kron, Irving L.; Lau, Christine L.

In: Journal of Surgical Research, Vol. 183, No. 2, 08.2013, p. 916-921.

Research output: Contribution to journalArticle

Hennessy, SA, Gillen, JR, Hranjec, T, Kozower, BD, Jones, DR, Kron, IL & Lau, CL 2013, 'Influence of hemodialysis on clinical outcomes after lung transplantation', Journal of Surgical Research, vol. 183, no. 2, pp. 916-921. https://doi.org/10.1016/j.jss.2013.02.008
Hennessy, Sara A. ; Gillen, Jacob R. ; Hranjec, Tjasa ; Kozower, Benjamin D. ; Jones, David R. ; Kron, Irving L. ; Lau, Christine L. / Influence of hemodialysis on clinical outcomes after lung transplantation. In: Journal of Surgical Research. 2013 ; Vol. 183, No. 2. pp. 916-921.
@article{4b343836316d499faa10d3bd08e86d5b,
title = "Influence of hemodialysis on clinical outcomes after lung transplantation",
abstract = "Background: Chronic renal failure after lung transplantation is associated with significant morbidity. However, the significance of acute kidney injury (AKI) after lung transplantation remains unclear and poorly studied. We hypothesized that hemodialysis (HD)-dependent AKI after lung transplantation is associated with significant mortality. Materials and methods: We performed a retrospective review of all patients undergoing lung transplantation from July 1991 to July 2009 at our institution. Recipients with AKI (creatinine > 3 mg/dL) were identified. We compared recipients without AKI versus recipients with and without HD-dependent AKI. Kaplan-Meier survival curves were compared by log rank test. Results: Of 352 lung transplant recipients reviewed at our institution, 17 developed non-HD-dependent AKI (5{\%}) and 16 developed HD-dependent AKI (4.6{\%}). Cardiopulmonary bypass was significantly higher in patients with HD-dependent AKI. None of the recipients who required HD had recovery of renal function. The 30-day mortality was significantly greater in recipients requiring HD (63{\%} versus 0{\%}; P < 0.0001). One-year mortality after transplantation was significantly increased in recipients with HD-dependent AKI compared with those with non-HD-dependent AKI (87.5{\%} versus 17.6{\%}; P < 0.001). Conclusions: Hemodialysis is associated with mortality after lung transplantation. Fortunately, AKI that does not progress to HD commonly resolves and has a better overall survival. Avoidance, if possible, of cardiopulmonary bypass may attenuate the incidence of AKI. Aggressive measures to identify and treat early postoperative renal dysfunction and prevent progression to HD may improve outcomes after lung transplantation.",
keywords = "Acute kidney injury, Dialysis, Lung, Mortality, Outcomes, Transplantation",
author = "Hennessy, {Sara A.} and Gillen, {Jacob R.} and Tjasa Hranjec and Kozower, {Benjamin D.} and Jones, {David R.} and Kron, {Irving L.} and Lau, {Christine L.}",
year = "2013",
month = "8",
doi = "10.1016/j.jss.2013.02.008",
language = "English (US)",
volume = "183",
pages = "916--921",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Influence of hemodialysis on clinical outcomes after lung transplantation

AU - Hennessy, Sara A.

AU - Gillen, Jacob R.

AU - Hranjec, Tjasa

AU - Kozower, Benjamin D.

AU - Jones, David R.

AU - Kron, Irving L.

AU - Lau, Christine L.

PY - 2013/8

Y1 - 2013/8

N2 - Background: Chronic renal failure after lung transplantation is associated with significant morbidity. However, the significance of acute kidney injury (AKI) after lung transplantation remains unclear and poorly studied. We hypothesized that hemodialysis (HD)-dependent AKI after lung transplantation is associated with significant mortality. Materials and methods: We performed a retrospective review of all patients undergoing lung transplantation from July 1991 to July 2009 at our institution. Recipients with AKI (creatinine > 3 mg/dL) were identified. We compared recipients without AKI versus recipients with and without HD-dependent AKI. Kaplan-Meier survival curves were compared by log rank test. Results: Of 352 lung transplant recipients reviewed at our institution, 17 developed non-HD-dependent AKI (5%) and 16 developed HD-dependent AKI (4.6%). Cardiopulmonary bypass was significantly higher in patients with HD-dependent AKI. None of the recipients who required HD had recovery of renal function. The 30-day mortality was significantly greater in recipients requiring HD (63% versus 0%; P < 0.0001). One-year mortality after transplantation was significantly increased in recipients with HD-dependent AKI compared with those with non-HD-dependent AKI (87.5% versus 17.6%; P < 0.001). Conclusions: Hemodialysis is associated with mortality after lung transplantation. Fortunately, AKI that does not progress to HD commonly resolves and has a better overall survival. Avoidance, if possible, of cardiopulmonary bypass may attenuate the incidence of AKI. Aggressive measures to identify and treat early postoperative renal dysfunction and prevent progression to HD may improve outcomes after lung transplantation.

AB - Background: Chronic renal failure after lung transplantation is associated with significant morbidity. However, the significance of acute kidney injury (AKI) after lung transplantation remains unclear and poorly studied. We hypothesized that hemodialysis (HD)-dependent AKI after lung transplantation is associated with significant mortality. Materials and methods: We performed a retrospective review of all patients undergoing lung transplantation from July 1991 to July 2009 at our institution. Recipients with AKI (creatinine > 3 mg/dL) were identified. We compared recipients without AKI versus recipients with and without HD-dependent AKI. Kaplan-Meier survival curves were compared by log rank test. Results: Of 352 lung transplant recipients reviewed at our institution, 17 developed non-HD-dependent AKI (5%) and 16 developed HD-dependent AKI (4.6%). Cardiopulmonary bypass was significantly higher in patients with HD-dependent AKI. None of the recipients who required HD had recovery of renal function. The 30-day mortality was significantly greater in recipients requiring HD (63% versus 0%; P < 0.0001). One-year mortality after transplantation was significantly increased in recipients with HD-dependent AKI compared with those with non-HD-dependent AKI (87.5% versus 17.6%; P < 0.001). Conclusions: Hemodialysis is associated with mortality after lung transplantation. Fortunately, AKI that does not progress to HD commonly resolves and has a better overall survival. Avoidance, if possible, of cardiopulmonary bypass may attenuate the incidence of AKI. Aggressive measures to identify and treat early postoperative renal dysfunction and prevent progression to HD may improve outcomes after lung transplantation.

KW - Acute kidney injury

KW - Dialysis

KW - Lung

KW - Mortality

KW - Outcomes

KW - Transplantation

UR - http://www.scopus.com/inward/record.url?scp=84880268683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880268683&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2013.02.008

DO - 10.1016/j.jss.2013.02.008

M3 - Article

VL - 183

SP - 916

EP - 921

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -