Incidence, Risk Factors and Outcomes of Early Acute Kidney Injury After Heart Transplantation: An 18-year Experience

Background Little is known about the incidence of acute kidney injury (AKI), as defined using the Kidney Disease Improving Global Outcome (KDIGO) classification, after heart transplantation (HT). Objective. Our objective was to evaluate the impact of AKI in a cohort of HT recipients. (Setting: University Hospital.) Methods We studied 310 consecutive HT recipients from 1999 to 2017, with AKI being defined according to the KDIGO criteria. Risk factors were analyzed by multivariable analyses, and survival by Kaplan-Meier curves and a risk-adjusted Cox proportional hazards regression model. Results 125 patients (40.3%) developed AKI, with 73 (23.5%), 18 (5.8%) and 34 (11%) patients having AKI stage 1, 2 and 3, respectively. Cardiac tamponade (OR: 16.82; 95% CI: 1.06–138), acute right ventricular failure (OR: 3.54; 95% CI: 1.82–6.88), and major bleeding (OR: 2.46; 95% CI: 1.18–5.1) were the principal risk factors for AKI. Patients with AKI had a greater hospital mortality (3.8% vs. 16%, P

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