title: The effects of levosimendan on renal function early after heart transplantation: results from a pilot randomized trial.
abstract: BACKGROUND
  We evaluated the effects of a levosimendan (LS)-based strategy compared with standard inotropic therapy on renal function in heart transplantation.
  
  
  RESULTS
  Using a randomized study design, 94 patients were assigned to LS-based therapy or standard inotropic support. At the time of transplantation, the groups did not differ in age, gender, heart failure etiology, hemodynamic profile, LVEF, or comorbidities. While there were no differences in serum creatinine (sCr) or eGFR between groups at baseline, patients in the LS group had a greater increase in their relative eGFR (62% vs. 12%, p = 0.002) and a lower incidence of acute kidney injury (AKI) (28% vs. 6%, p = 0.01) during the first post-transplant week. On logistic regression analysis, correlates of AKI were randomization to LS therapy (OR = 0.21 [0.09-0.62], p = 0.01), baseline renal dysfunction (OR = 3.9 [1.1-13.6], p = 0.032), and diabetes mellitus (OR = 4.2 [1.1-16.5], p = 0.038). However, LS was associated with a greater need for additional norepinephrine therapy (40 [85%] vs. 15 [31%], p < 0.001) and a trend toward longer intensive care unit stay (9.5 ± 9.0 d vs. 7.0 ± 6.0 d, p = 0.13).
  
  
  CONCLUSIONS
  In patients undergoing heart transplantation, levosimendan-based strategy may be associated with better renal function when compared to standard therapy.
authors: Advanced Heart Failure and Transplantation Center, UMC, Ljubljana, Slovenia.
authors: Ivan
authors: I
authors: Knezevic
authors: Gregor
authors: G
authors: Poglajen
authors: Eva
authors: E
authors: Hrovat
authors: Anja
authors: A
authors: Oman
authors: Tatjana
authors: T
authors: Pintar
authors: Joseph C
authors: JC
authors: Wu
authors: Bojan
authors: B
authors: Vrtovec
authors: François
authors: F
authors: Haddad
mesh_terms: D000328:Adult; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival / Q000502:physiology; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006439:Hemodynamics; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011724:Pyridazines / Q000627:therapeutic use*; D012307:Risk Factors; D000077464:Simendan; D015996:Survival Rate
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan
keywords: heart transplantation; inotropes; levosimendan; renal function