Acute Kidney Injury Requiring Dialysis After Pediatric Heart Transplant

ABSTRACT Background Acute kidney injury (AKI) is a common complication of pediatric heart transplant, with a subset of patients developing severe AKI requiring dialysis (AKI‐D). We aimed to identify the epidemiology, risk factors, and outcomes of postoperative AKI‐D in pediatric heart transplant rec...

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Bibliographic Details
Published in:Pediatric transplantation 2024-08, Vol.28 (5), p.e14829-n/a
Main Authors: Lipman, Amy R., Lytrivi, Irene D., Fernandez, Hilda E., Lynch, Aine M., Yu, Miko E., Stevens, Jacob S., Mohan, Sumit, Husain, Syed Ali
Format: Article
Language:English
Subjects:
acute kidney injury
Acute Kidney Injury - epidemiology
Acute Kidney Injury - etiology
Adolescent
Child
Child, Preschool
Dialysis
Epidemiology
Female
Heart rate
heart transplant
Heart Transplantation
Heart transplants
Hemodialysis
Humans
Infant
Kidney diseases
Male
Pediatrics
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Renal Dialysis
Renal failure
Retrospective Studies
Risk Factors
Survival
transplant outcomes
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Summary:ABSTRACT Background Acute kidney injury (AKI) is a common complication of pediatric heart transplant, with a subset of patients developing severe AKI requiring dialysis (AKI‐D). We aimed to identify the epidemiology, risk factors, and outcomes of postoperative AKI‐D in pediatric heart transplant recipients. Methods We retrospectively identified all pediatric first‐time, single‐organ heart transplants at our institution from 2014 to 2022. Postoperative AKI was defined as AKI within 2 weeks of transplant. Unadjusted and adjusted logistic regression were used to identify characteristics associated with AKI‐D, and unadjusted time‐to‐event analyses were used to determine the association between AKI‐D and survival free of kidney failure. Results Among 177 patients included, 116 (66%) developed postoperative AKI of any stage, including 13 (7%) who developed AKI‐D with median time from transplant to dialysis initiation of 6 days (IQR 3–13). In adjusted models, increased cardiopulmonary bypass time (OR 1.19, 95% CI 1.04–1.37, per 15 min increase in bypass time) and higher weight at transplant were associated with higher odds of AKI‐D, whereas patient demographics and pretransplant kidney function were not associated with AKI‐D. AKI‐D was associated with greater mortality during initial hospitalization (46% vs. 1%, p 
ISSN:1397-3142
1399-3046
1399-3046
DOI:10.1111/petr.14829