Cardiac surgery in kidney and liver transplant recipients

Subrato J. Deb, Charles J. Mullany, Patrick Sequeira Kamath, Joseph A. Dearani, Richard C. Daly, Thomas A. Orszulak, Hartzell V Schaff

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To evaluate operative management, outcome, and long-term survival in patients with functioning renal and hepatic allografts who underwent cardiac surgery. PATIENTS AND METHODS: We studied all patients who had previously undergone either renal or hepatic transplantation and who subsequently (1936-2001) underwent: cardiac surgery at one institution. Data were obtained by retrospective medical record analysis. RESULTS: The study comprised 47 patients with renal (n=34) and hepatic (n=13) functioning allografts. Median time to cardiac surgery from transplantation was 79 months. The most common procedures were as follows: coronary artery bypass grafting, 22 (47%); aortic valve procedures, 11 (23%); and mitral valve procedures, 5 (11%). One patient (2%) died within 30 days of surgery Renal allograft dysfunction was noted in S renal patients (15%) Immediately after surgery. Two patients required dialysis postoperatively, 1 of whom required continued dialysis on dismissal. Transient allograft dysfunction, as determined by elevated liver enzyme levels, occurred In 6 hepatic patients (46%). However, all hepatic patients had functional allografts on dismissal. Two patients (4%) developed leg wound infections, and 9 (19%) had respiratory complications. No sternal or mediastinal infection occurred. One- and 5-year survival rates (mean ± SEM) for all patient, were 93%±4% and 76%±8%, respectively. Of the renal patients, 1- and 5-year survival rates (mean ± SEM) were 97%±3% and 82%±8%, respectively. One- and 5-year survival rates (mean ± SEM) for hepatic patients were 77%±12% and 69%±13%, respectively. CONCLUSION: Cardiac surgery can be performed safely in kidney and liver transplant recipients, with low early mortality and excellent medium-term survival. In almost all instances, allograft function is well preserved.

Original languageEnglish (US)
Pages (from-to)917-922
Number of pages6
JournalMayo Clinic Proceedings
Volume81
Issue number7
DOIs
StatePublished - 2006

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Thoracic Surgery
Kidney
Liver
Allografts
Survival Rate
Transplant Recipients
Dialysis
Survival
Wound Infection
Heart Transplantation
Ambulatory Surgical Procedures
Aortic Valve
Mitral Valve
Coronary Artery Bypass
Liver Transplantation
Kidney Transplantation
Medical Records
Leg
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Deb, S. J., Mullany, C. J., Kamath, P. S., Dearani, J. A., Daly, R. C., Orszulak, T. A., & Schaff, H. V. (2006). Cardiac surgery in kidney and liver transplant recipients. Mayo Clinic Proceedings, 81(7), 917-922. https://doi.org/10.4065/81.7.917

Cardiac surgery in kidney and liver transplant recipients. / Deb, Subrato J.; Mullany, Charles J.; Kamath, Patrick Sequeira; Dearani, Joseph A.; Daly, Richard C.; Orszulak, Thomas A.; Schaff, Hartzell V.

In: Mayo Clinic Proceedings, Vol. 81, No. 7, 2006, p. 917-922.

Research output: Contribution to journalArticle

Deb, SJ, Mullany, CJ, Kamath, PS, Dearani, JA, Daly, RC, Orszulak, TA & Schaff, HV 2006, 'Cardiac surgery in kidney and liver transplant recipients', Mayo Clinic Proceedings, vol. 81, no. 7, pp. 917-922. https://doi.org/10.4065/81.7.917
Deb SJ, Mullany CJ, Kamath PS, Dearani JA, Daly RC, Orszulak TA et al. Cardiac surgery in kidney and liver transplant recipients. Mayo Clinic Proceedings. 2006;81(7):917-922. https://doi.org/10.4065/81.7.917
Deb, Subrato J. ; Mullany, Charles J. ; Kamath, Patrick Sequeira ; Dearani, Joseph A. ; Daly, Richard C. ; Orszulak, Thomas A. ; Schaff, Hartzell V. / Cardiac surgery in kidney and liver transplant recipients. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 7. pp. 917-922.
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AU - Orszulak, Thomas A.

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N2 - OBJECTIVE: To evaluate operative management, outcome, and long-term survival in patients with functioning renal and hepatic allografts who underwent cardiac surgery. PATIENTS AND METHODS: We studied all patients who had previously undergone either renal or hepatic transplantation and who subsequently (1936-2001) underwent: cardiac surgery at one institution. Data were obtained by retrospective medical record analysis. RESULTS: The study comprised 47 patients with renal (n=34) and hepatic (n=13) functioning allografts. Median time to cardiac surgery from transplantation was 79 months. The most common procedures were as follows: coronary artery bypass grafting, 22 (47%); aortic valve procedures, 11 (23%); and mitral valve procedures, 5 (11%). One patient (2%) died within 30 days of surgery Renal allograft dysfunction was noted in S renal patients (15%) Immediately after surgery. Two patients required dialysis postoperatively, 1 of whom required continued dialysis on dismissal. Transient allograft dysfunction, as determined by elevated liver enzyme levels, occurred In 6 hepatic patients (46%). However, all hepatic patients had functional allografts on dismissal. Two patients (4%) developed leg wound infections, and 9 (19%) had respiratory complications. No sternal or mediastinal infection occurred. One- and 5-year survival rates (mean ± SEM) for all patient, were 93%±4% and 76%±8%, respectively. Of the renal patients, 1- and 5-year survival rates (mean ± SEM) were 97%±3% and 82%±8%, respectively. One- and 5-year survival rates (mean ± SEM) for hepatic patients were 77%±12% and 69%±13%, respectively. CONCLUSION: Cardiac surgery can be performed safely in kidney and liver transplant recipients, with low early mortality and excellent medium-term survival. In almost all instances, allograft function is well preserved.

AB - OBJECTIVE: To evaluate operative management, outcome, and long-term survival in patients with functioning renal and hepatic allografts who underwent cardiac surgery. PATIENTS AND METHODS: We studied all patients who had previously undergone either renal or hepatic transplantation and who subsequently (1936-2001) underwent: cardiac surgery at one institution. Data were obtained by retrospective medical record analysis. RESULTS: The study comprised 47 patients with renal (n=34) and hepatic (n=13) functioning allografts. Median time to cardiac surgery from transplantation was 79 months. The most common procedures were as follows: coronary artery bypass grafting, 22 (47%); aortic valve procedures, 11 (23%); and mitral valve procedures, 5 (11%). One patient (2%) died within 30 days of surgery Renal allograft dysfunction was noted in S renal patients (15%) Immediately after surgery. Two patients required dialysis postoperatively, 1 of whom required continued dialysis on dismissal. Transient allograft dysfunction, as determined by elevated liver enzyme levels, occurred In 6 hepatic patients (46%). However, all hepatic patients had functional allografts on dismissal. Two patients (4%) developed leg wound infections, and 9 (19%) had respiratory complications. No sternal or mediastinal infection occurred. One- and 5-year survival rates (mean ± SEM) for all patient, were 93%±4% and 76%±8%, respectively. Of the renal patients, 1- and 5-year survival rates (mean ± SEM) were 97%±3% and 82%±8%, respectively. One- and 5-year survival rates (mean ± SEM) for hepatic patients were 77%±12% and 69%±13%, respectively. CONCLUSION: Cardiac surgery can be performed safely in kidney and liver transplant recipients, with low early mortality and excellent medium-term survival. In almost all instances, allograft function is well preserved.

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