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J Heart Lung Transplant. 2011 Feb;30(2):182-7. doi: 10.1016/j.healun.2010.08.019.

Results of HeartMate II left ventricular assist device implantation on renal function in patients requiring post-implant renal replacement therapy.

Author information

1
Department of Cardiopulmonary Transplantation, Texas Heart Institute, St Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.

Abstract

BACKGROUND:

Renal function is often compromised in patients with advanced heart failure.

METHODS:

We evaluated renal function in heart failure patients supported by the HeartMate II (Thoratec Corporation, Pleasanton, CA) continuous-flow left ventricular assist device (LVAD) who required renal replacement therapy (RRT) by continuous venovenous hemofiltration dialysis (CVVHD) or hemodialysis, or both. Indications for RRT included oliguria (urine < 400 ml/day) unresponsive to diuretic therapy for > 24 hours with a creatinine level > 2.0 mg/dl or 1.5 times that of the pre-implant creatinine level, severe acidemia, and volume overload.

RESULTS:

Of 107 consecutive patients who underwent HeartMate II implantation at our center and had been supported for > 30 days, 15 (13 men and 2 women) required post-implant RRT. Of the 15 patients, 3 received CVVHD and 12 received CVVHD and hemodialysis. Renal function improved within 2 months of support compared with average values before support (creatinine clearance, 64 ± 39 vs 92 ± 55 ml/min, p = 0.041; glomerular filtration rate, 46.9 ± 20.7 vs 73.2 ± 38.9 ml/min/1.73 m(2); p = 0.032). Renal function improved after HeartMate II implantation in 10 patients, and RRT was removed. Of these 10 patients, 2 underwent heart transplantation 4 months after RRT was removed, 1 underwent heart and kidney transplantation 4 years later, 2 died at home of conditions unrelated to renal function 6 months after RRT was removed, and 5 are awaiting heart transplantation, with good quality of life.

CONCLUSIONS:

In this study, patients who experienced clinical recovery after the LVAD implant had subsequent recovery of renal function after continuous-flow LVAD support.

PMID:
20888256
DOI:
10.1016/j.healun.2010.08.019
[Indexed for MEDLINE]

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