Acute kidney injury following left ventricular assist device implantation: Contemporary insights and future perspectives.

Abstract

Currently, an increasing number of patients with end-stage heart failure are being treated with left ventricular assist device (LVAD) therapy as bridge-to-transplantation, bridge-to-candidacy, or destination therapy (DT). Potential life-threatening complications may occur, specifically in the early post-operative phase, which positions LVAD implantation as a high-risk surgical procedure. Acute kidney injury (AKI) is a frequently observed complication after LVAD implantation and is associated with high morbidity and mortality. The rapidly growing number of LVAD implantations necessitates better approaches of identifying high-risk patients, optimizing peri-operative management, and preventing severe complications such as AKI. This holds especially true for those patients receiving an LVAD as DT, who are typically older (with higher burden of comorbidities) with impaired renal function and at increased post-operative risk. Herein we outline the definition, diagnosis, frequency, pathophysiology, and risk factors for AKI in patients with an LVAD. We also review possible strategies to prevent and manage AKI in this patient population.

• Authors: Yunus C Yalcin, Jeroen J H Bunge, Goksel Guven, Rahatullah Muslem, Mariusz Szymanski, Corstiaan A den Uil, Dennis A Hesselink, Veli K Topkara, Olivier C Manintveld, Paolo C Colombo, Ad J J C Bogers, Kadir Caliskan
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 38 Issue 8 Pg. 797-805 (08 2019) ISSN: 1557-3117 [Electronic] United States
• PMID: 31352996 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2019 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Topics

• Acute Kidney Injury (diagnosis, epidemiology, etiology)
• Forecasting
• Heart Failure (surgery)
• Heart-Assist Devices (adverse effects)
• Humans
• Postoperative Complications (etiology)
• Risk Factors