title: Impact of pre-existing left ventricular dysfunction on kidney transplantation outcomes: implications for patient selection.
abstract: BACKGROUND
  End-stage kidney disease patients with decreased left ventricular ejection fraction (EF) are often denied kidney transplantation (KT) for fear of poor graft and patient survival.
  
  
  METHODS
  We retrospectively studied all patients who underwent KT at our center between 2001 and 2005 to determine the impact of low EF on outcomes post KT. Low EF was defined as <50% EF by noninvasive cardiac imaging. Follow-up was for 1 year post KT. Outcomes assessed included hospitalization for congestive heart failure (CHF), cardiac events, and renal allograft and patient survival.
  
  
  RESULTS
  Among 254 patients, 37 had low EF (study group) and 217 had normal EF (≥50%; control group). Post KT, the low EF group had a significantly higher rate of hospitalization for CHF. No significant difference was noted in the rate of cardiac events, graft loss, GFR, and all cause death at 12 months post KT.
  
  
  CONCLUSIONS
  Patients with low EF should not be excluded from transplantation, given favorable outcomes.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA.
authors.forename: V
authors.initials: V
authors.lastname: Karthikeyan
authors.forename: J
authors.initials: J
authors.lastname: Chattahi
authors.forename: H
authors.initials: H
authors.lastname: Kanneh
authors.forename: J
authors.initials: J
authors.lastname: Koneru
authors.forename: S
authors.initials: S
authors.lastname: Hayek
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: M
authors.initials: M
authors.lastname: Goggins
authors.forename: K
authors.initials: K
authors.lastname: Ananthasubramaniam
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006085:Graft Survival; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008824:Michigan; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left