We evaluated the associations between pretransplant DM and posttransplant DM (PTDM) and outcomes among adults receiving HTx at a single center.METHODS: We performed a retrospective study (range 01/2008 - 07/2018), n = 244. PURPOSE: Diabetes mellitus (DM) is common among recipients of heart transplantation (HTx) but its impact on clinical outcomes is unclear. J., Wayda, B., Moayedi, Y., Lee, R., Han, J., Multani, A., Yang, W., Purewal, S., Puing, A. Impact of diabetes mellitus on clinical outcomes after heart transplantation.Baseline renal function, BMI, ischemic time, and DM can help identify LVAD patients at risk of ARF requiring HD or CKD following HT. Left ventricular assist device patients have a higher incidence of ARF requiring HD and CKD at 1 year after HT compared with non-LVAD patients, but incidence of CKD is similar by 3 years. Similarly, BMI (hazard ratio = 1.49, p < 0.001), baseline eGFR (HR = 0.41, p < 0.001), pre-HT diabetes mellitus (DM) (HR = 1.37, p = 0.011), and post-HT dialysis before discharge (HR = 3.93, p < 0.001) were significantly associated with CKD. Among LVAD patients, body mass index (BMI) (odds ratio = 1.79, p < 0.001), baseline estimated glomerular filtration rate (eGFR) (OR = 0.43, p < 0.001), and ischemic time (OR = 1.28, p = 0.014) were significantly associated with ARF requiring HD. Left ventricular assist device patients had higher incidence of ARF requiring HD and CKD at 1 year, but no significant difference in CKD at 3 years compared to non-LVAD patients. There were 18,738 patients, with 4,535 (24%) bridged with LVAD support. Primary outcomes were ARF requiring HD before discharge following HT and CKD (defined as creatinine >2.5 mg/dl, permanent dialysis, or renal transplant) within 3 years. We compared patients bridged with durable continuous-flow LVAD to those without LVAD support. We examined the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry for heart transplant patients between January 2000 and June 2015. We investigated the incidence and risk factors for developing ARF requiring hemodialysis (HD) and CKD following HT specifically in patients with a left ventricular assist device (LVAD). 2021Īcute renal failure (ARF) and chronic kidney disease (CKD) are associated with short- and long-term morbidity and mortality following heart transplantation (HT). ASAIO journal (American Society for Artificial Internal Organs : 1992) Tibrewala, A., Khush, K. Risk of Renal Dysfunction Following Heart Transplantation in Patients Bridged with a Left Ventricular Assist Device.View details for DOI 10.1093/eurheartj/ehab568 However, intravascular ultrasound-derived changes in maximal intimal thickness were not predictive of outcomes.CONCLUSION: Abnormal coronary physiology 1year after heart transplantation was common and was a significant predictor of death or re-transplantation at 10years. Invasive measures of coronary physiology improved the prognostic performance of clinical variables (chi2 improvement: 7.41, P=0.006). One-year reduced FFR (aHR 2.98, 95% CI 1.13-7.87 P=0.028) and microvascular dysfunction (aHR 2.33, 95% CI 1.19-4.59 P=0.015) were associated with significantly increased risk of death or re-transplantation at 10years. At 1year, 5.0% had reduced FFR 23.8% had microvascular dysfunction. Baseline reduced FFR and microvascular dysfunction (aHR 0.88, 95% CI 0.44-1.79 P=0.73) were not predictors of death and re-transplantation at 10years. At baseline, 5.5% had reduced FFR 36.6% had microvascular dysfunction. The primary outcome was the composite of death or re-transplantation at 10years. Patients were classified into those with normal physiology, reduced FFR (FFR≤0.80), and microvascular dysfunction (either IMR≥25 or CFR≤2.0 with FFR>0.80). Vice Provost for Undergraduate EducationĪIMS: We evaluated the long-term prognostic value of invasively assessing coronary physiology after heart transplantation in a large multicentre registry.METHODS AND RESULTS: Comprehensive intracoronary physiology assessment measuring fractional flow reserve (FFR), the index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) was performed in 254 patients at baseline (a median of 7.2weeks) and in 240 patients at 1year after transplantation (199 patients had both baseline and 1-year measurement).Office of Vice President for Business Affairs and Chief Financial Officer.Office of VP for University Human Resources.Stanford Woods Institute for the Environment.Stanford Institute for Economic Policy Research (SIEPR).Institute for Stem Cell Biology and Regenerative Medicine.Institute for Human-Centered Artificial Intelligence (HAI).Institute for Computational and Mathematical Engineering (ICME).Freeman Spogli Institute for International Studies.School of Earth, Energy and Environmental Sciences.