Impact of Left Ventricular Assist Device on Renal Function Following Heart Transplantation.

PURPOSE: The difference in renal function between bridge-to-transplantation (BTT) and medically managed patients undergoing heart transplantation (HTx) is unknown. This study aimed to depict the difference in renal function between BTT and medically managed patients pre- and post-HTx.

METHODS: A retrospective single-center cohort study was conducted including all HTx patients that were transplanted since the introduction of left ventricular assist device (LVAD) therapy in our center in 2006. Patients were dichotomized according to BTT and medical management strategy.

RESULTS: In total, 164 patients were included, of whom 135 were medically managed (mean age 49.3±10.4), and 29 BTT patients (mean age 48.5±11.8). Median time on LVAD support pre-HTx was 551 days, interquartile range [230-863]. At 12 months prior to HTx, the BTT patients had higher mean eGFR compared to the medically managed patients (87 ml/min/1.73m2 vs 63 ml/min/1.73m2 , p<0.001). At the time of HTx, the BTT patients had higher mean (68 ml/min/1.73m2 vs 51 ml/min/1.73m2 , p=0.03). Finally, at 1-year follow-up, BTT patients had a higher eGFR compared to medically managed patients (63 ml/min/1.73m2 vs 52 ml/min/1.73m2 , p=0.01). Outcomes, including mortality and primary graft dysfunction, following HTx were not significantly different CONCLUSION: In conclusion, patients who are bridged with LVAD therapy had a higher mean renal function at the time of HTx. Additionally, patients who received BTT therapy preserved longer an improved renal function at 1-year pre- and post-HTx.