Impact of Postoperative Continuous Renal Replacement Therapy in Lung Transplant Recipients

Masato Katahira, MD; Takashi Hirama, MD, PhD; Shunsuke Eba, MD, PhD; Takaya Suzuki, MD, PhD; Hirotsugu Notsuda, MD, PhD; Hisashi Oishi, MD, PhD; Yasushi Matsuda, MD, PhD; Tetsu Sado, MD, PhD; Masafumi Noda, MD, PhD; Akira Sakurada, MD, PhD; Aman Sidhu, MSc, MD; Yoshinori Okada, MD, PhD

doi:10.1097/TXD.0000000000001013

Transplantation Direct (Jun 2020)

Impact of Postoperative Continuous Renal Replacement Therapy in Lung Transplant Recipients

Masato Katahira, MD,
Takashi Hirama, MD, PhD,
Shunsuke Eba, MD, PhD,
Takaya Suzuki, MD, PhD,
Hirotsugu Notsuda, MD, PhD,
Hisashi Oishi, MD, PhD,
Yasushi Matsuda, MD, PhD,
Tetsu Sado, MD, PhD,
Masafumi Noda, MD, PhD,
Akira Sakurada, MD, PhD,
Aman Sidhu, MSc, MD,
Yoshinori Okada, MD, PhD

Affiliations

Masato Katahira, MD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Takashi Hirama, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Shunsuke Eba, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Takaya Suzuki, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Hirotsugu Notsuda, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Hisashi Oishi, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Yasushi Matsuda, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Tetsu Sado, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Masafumi Noda, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Akira Sakurada, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
Aman Sidhu, MSc, MD: 4 Multi-Organ Transplant Program, Toronto General Hospital, Toronto, ON, Canada.
Yoshinori Okada, MD, PhD: 1 Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.

DOI: https://doi.org/10.1097/TXD.0000000000001013
Journal volume & issue: Vol. 6, no. 6
p. e562

Abstract

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Background. Acute kidney injury (AKI) is a common complication after lung transplant (LTx), and continuous renal replacement therapy (CRRT) is increasingly of use to critically ill patients who have developed AKI. However, the optimal timing or threshold of kidney impairment for which to commence CRRT after LTx has been uncertain. There has also been limited information on the impact of CRRT among LTx recipients (LTRs) introduced in the early posttransplant period on survival, graft function, and renal function. We aimed to review LTRs who developed AKI requiring CRRT postoperatively and followed their long-term outcomes at Tohoku University Hospital (TUH). Methods. Medical records of consecutive patients who underwent LTx at TUH between 2000 and 2018 were reviewed, with follow-up to 2019 inclusive. Results. Although mortality in those who required CRRT (n = 21) was increased versus those who did not require CRRT (n = 85)(P = 0.024), conditional survival beyond 3-month posttransplant was not affected (P = 0.131). Additionally, the cumulative incidence of chronic lung allograft rejection (P = 0.160) and the development of chronic kidney disease (P = 0.757) were not significant between groups. Conclusions. The initiation of CRRT posttransplant may be a useful strategy to preserve cardiac and optimize volume management among critically ill patients.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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