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BACKGROUND Five to 10% of heart-transplant recipients develop end-stage renal failure (ESRF). Little is known about the outcome of these patients under renal replacement therapy. METHODS We conducted a retrospective study in 16 men (mean age 52.8+/-7.4 years at heart transplantation) who developed ESRF 5.3+/-2.1 years later. Results. Haemodialysis (HD) was the first-line treatment (mean Kt/V 1.35+/-0.4). Vascular access was unsuccessful in six patients (37.5%) due to peripheral arteriopathy and they were treated with tunnelled catheters for an average 15 months without bacterial infection. Mean weight was 68.4+/-10 kg at onset of HD and 61.7+/-9 kg one month later. Despite this reduction in extracellular overload, one antihypertensive drug was required in 75% of patients and two drugs in 12.5%. One patient tolerated automated peritoneal dialysis (PD) for 16 months (weekly Kt/V 2.1) despite persistent anuria. Renal transplantation (RT) was contraindicated in eight patients because of aortoiliac arteriopathy (n=5), poor general status (n=2), or ischaemic heart disease (n=1). RT was performed in eight patients with no acute episode of heart or renal graft rejection. There were no serious infectious complications. Three months after RT, mean serum creatinine was 115 micromol/l. One patient developed post-transplant lymphoproliferative disorder 3.5 months after RT and was successfully treated with transplant nephrectomy. Sudden death occurred in two patients 18 and 33 months after RT. Overall patient survival was 100, 78, and 59%, 1, 2 and 3 years after HD onset respectively. Using a time-dependent variable, the Cox model analysis demonstrated that heart-transplant recipients with ESRF have a relative risk of death 3.2 times higher than those without ESRF (95% CI = 1.3-7.8). CONCLUSIONS HD, PD, and RT can be useful for the treatment of ESRF after heart transplantation. After initiating HD, patient survival is nearly the same as that reported in patients in Europe undergoing HD for other causes. But ESRF seems to reduce life expectancy in heart-transplant recipients.
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
February 2004,
Clinical transplantation,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
July 1992,
Journal of the American Veterinary Medical Association,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
December 1993,
Critical care nursing clinics of North America,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
June 1971,
Minnesota medicine,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
September 1974,
The Medical journal of Australia,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
December 1998,
Transplantation,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
December 2003,
Critical care nursing clinics of North America,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
January 2000,
Transplant international : official journal of the European Society for Organ Transplantation,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
May 2001,
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons,
L Frimat, and
J P Villemot, and
L Cormier, and
T Cao-Huu, and
E Renoult, and
D Hestin, and
C Dopff, and
S Mattéi, and
J Hubert, and
M Kessler
June 2010,
Kardiologia polska,
