TITLE:
Short- and Long-Term Outcomes of Cardiac Surgery in Kidney Transplant Recipients: A Review—Kidney Transplant and Cardiac Surgery
AUTHORS:
Nael Al-Sarraf
KEYWORDS:
Kidney Transplant, Cardiac Surgery, Graft Failure, Dialysis, Immunosuppression
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.13 No.12,
December
28,
2023
ABSTRACT: Background: Cardiovascular diseases remain the leading cause of
death in kidney transplant patients and increasing proportion of these patients
are referred to cardiac surgery. Data on short- and long-term outcomes of these
patients are limited to single center reports with no randomized trials and no
prospective studies published previously. The aim of this review was to report
both short- and long-term outcomes of these patients. Methods: Literature
review was conducted using three databases from inception to June 2022.
Multiple search terms were used and limited to English language. Thirty-one
relevant articles were included. Outcomes of interest were short-term
mortality, long-term survival, renal allograft failure and infection in kidney
transplant patients undergoing cardiac surgery. Results: Cardiac risk
factors (diabetes mellitus, hypertension, hyperlipidemia) were prevalent in
kidney transplant patients. 30-days mortality ranged across the studies from
zero to 18.8%. The 1-year survival ranged from 71% - 97% and
5-years survival ranged from 31% - 95.7%.
Commonest causes of death were cardiac and sepsis. Multiple predictors of
mortality were reported. Postoperative acute kidney injury ranged from 0 - 74% with most of them being transient. Kidney graft failure
ranged from 0 - 45% with 5-year kidney
graft survival rates ranged between 37% - 80%.
Post-operative infection rates ranged from 1% - 25% and
the most common sites were pneumonia followed by septicemia and surgical site
infections. Conclusion: Cardiac surgery can be performed in kidney
transplant patients with good short- and long-term results.