J. M. Tatum1, M. L. Barr1, B. Abt1, M. E. Bowdish1 1Keck School Of Medicine Of The University Of Southern California,Division Of Cardiothoracic Surgery,Los Angeles, CA, USA
Introduction:
Perioperative renal replacement therapy (RRT) is frequently required in patients undergoing implantation of a mechanical circulator support device. It is unknown how perioperative renal replacement therapy effects survival.
Methods:
Retrospective single center review of all patients receiving mechanical circulatory support devices between 2010 and 2015 with follow up until 2016. Patients on chronic preoperative hemodialysis were excluded. Patients were divided into two groups for analysis, those who received perioperative RRT and those who did not.
Results:
A total of 116 patients were included in the study, 46 required RRT. Of these 46 patients, 11 required pre-operative RRT, 45 required post-operative RRT and 10 required both. Mean age was 60 years, 77% were male and these characteristics were not significantly different between groups. Mean duration of RRT was 7 ± 3 days. Follow up survival data is complete for all patients. Mean follow up time was 721 days. Kaplan-Meier analyses were performed showing that the need for any peri-operative RRT significantly decreased post-operative survival, HR 2.4 (95% CI: 1.4-2.9), p = 0.001. The need for only post-operative RRT also significantly decreased survival, HR 2.2 (95% CI: 1.4-3.4), p = 0.001.
Conclusion:
Mechanical circulatory support devices should be used with caution in patients who require RRT in the pre-operative period and in patients where there is a strong clinical suspicion that post-operative RRT will be required. The use of mechanical circulator support devices as a destination therapy in these patients is cautioned against.
