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• W4362585114 abstract "PurposeRenal function trajectory is well described in patients supported with ventricular assist devices (VAD), however there are limited data on major adverse kidney events (MAKE) and their impact on survival to transplantation. We describe the relationship between MAKE and adverse events in patients supported with VAD.MethodsWe conducted a single-centre retrospective analysis of consecutive VAD implants between 2010-2019. Baseline demographics, INTERMACS profile, biochemistry and adverse events were collected for the duration of VAD support. MAKE was defined as the first event to occur of sustained drop in eGFR>50%, stage V chronic kidney disease, initiation of dialysis beyond index VAD implant admission, or death on dialysis at any time.Results173 patients were included, median age 56.8 years, 18.5% female, 75.1% INTERMACS 1 or 2. 46 patients did not survive to transplant. MAKE occurred in 37 patients. Survival to transplant was significantly reduced in patients with MAKE (p<0.001), shown in figure 1. All components of MAKE were associated with mortality on univariate analysis. In a multivariate Cox regression analysis, female gender and MAKE, but not age, INTERMACS profile, or pre-implant estimated glomerular filtration rate, were significantly associated with mortality. Gastrointestinal bleeding was more common in patients with MAKE (odds ratio 2.95, 95% CI 1.28-6.87, p=0.009). MAKE was not associated with other adverse hemocompatibility events.ConclusionMAKE is significantly associated with reduced survival to transplant in patients supported with VAD. Contributors to MAKE and means of preserving renal function should be identified in VAD supported patients to address this excess in mortality. Renal function trajectory is well described in patients supported with ventricular assist devices (VAD), however there are limited data on major adverse kidney events (MAKE) and their impact on survival to transplantation. We describe the relationship between MAKE and adverse events in patients supported with VAD. We conducted a single-centre retrospective analysis of consecutive VAD implants between 2010-2019. Baseline demographics, INTERMACS profile, biochemistry and adverse events were collected for the duration of VAD support. MAKE was defined as the first event to occur of sustained drop in eGFR>50%, stage V chronic kidney disease, initiation of dialysis beyond index VAD implant admission, or death on dialysis at any time. 173 patients were included, median age 56.8 years, 18.5% female, 75.1% INTERMACS 1 or 2. 46 patients did not survive to transplant. MAKE occurred in 37 patients. Survival to transplant was significantly reduced in patients with MAKE (p<0.001), shown in figure 1. All components of MAKE were associated with mortality on univariate analysis. In a multivariate Cox regression analysis, female gender and MAKE, but not age, INTERMACS profile, or pre-implant estimated glomerular filtration rate, were significantly associated with mortality. Gastrointestinal bleeding was more common in patients with MAKE (odds ratio 2.95, 95% CI 1.28-6.87, p=0.009). MAKE was not associated with other adverse hemocompatibility events. MAKE is significantly associated with reduced survival to transplant in patients supported with VAD. Contributors to MAKE and means of preserving renal function should be identified in VAD supported patients to address this excess in mortality." @default.
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• W4362585114 date "2023-04-01" @default.
• W4362585114 modified "2023-09-26" @default.
• W4362585114 title "(283) Major Adverse Kidney Events is a Predictor of Reduced Survival in Patients Supported with Ventricular Assist Devices" @default.
• W4362585114 doi "https://doi.org/10.1016/j.healun.2023.02.1587" @default.
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