Effect of acute renal injury on short-term prognosis after heart transplantation

Objective Acute kidney injury（AKI）is a common complication of heart transplantation（HT）. The effect of AKI on the prognosis of HT patients remains elusive. The purpose of this study was to examine the effect of AKI on short-term（90 days）prognosis of HT. Methods From January 2010 to October 2020，a total of 137 HT recipients were retrospectively reviewed at Guangdong Provincial People's Hospital. According to the KDIGO criteria for AKI diagnosis and classification，they were assigned into three groups of non-AKI（n=16），mild AKI（grade 1/2，n=67）and severe AKI （grade 3，n=54）. Primary endpoint was all-cause mortality at 90 days post-operation. Finally KaplanMeier survival and Cox regression analyses were performed for evaluating the risk factors of AKI on short-term prognosis （90 days） after HT. Results The mortality rate within 90 days post-HT was around 22. 6%（n=31）. Kaplan-Meier survival analysis indicated that 90-day mortality of patients with severe AKI was significantly higher than that of other groups（P<0. 001）. Multivariate Cox regression revealed an elevated risk of all-cause mortality at 90 days post-HT in severe AKI group（HR=8. 783，95% CI：11. 142-67. 557，P=0. 037）. Conclusion Patients with severe AKI have an elevated risk of morality at 90 days post-HT. Therefore early identification and timely intervention of severe AKI may improve patient prognosis.