title: Impact of left ventricular dysfunction on renal transplant survival: study of paired kidneys from the same donor.
abstract: BACKGROUND
  A significant number of patients with chronic kidney disease (CKD) have cardiac abnormalities, and left ventricular systolic dysfunction (LVSD) is a common manifestation. Our hypothesis is that a decrease in the left ventricular ejection fraction (LVEF) at the time of kidney transplantation is a factor of poor prognosis associated with poor graft evolution.
  
  
  RESULTS
  A total of 954 kidney transplantations were performed in our center between 2005 and 2012. Nineteen (2%) of these patients had been diagnosed with left ventricular dysfunction that was defined by the presence of LVEF <50% on echocardiography. This group of patients was compared with a control group of recipients without LVSD who had received the contralateral kidney from the same donor. During a mean follow-up of 52 ± 14 months, it was observed that the patients with LVSD had a higher incidence of delayed graft function (DGF) as well as a significantly longer renal function recovery period than in the control group until they became dialysis free (19.8 [range, 0-90] vs 12 [range, 0-36] days; P = .01). Furthermore, graft function achieved by the LVSD group was worse during the evolution (serum creatinine 2.3 ± 1.9 vs 1.4 ± 0.5 mg/dL; P = .01). Patients with LVSD showed worse kidney graft survival at the end of the follow-up when compared with the control group (79% vs 100%; P = .03).
  
  
  CONCLUSIONS
  Systolic dysfunction of the renal transplant recipient is associated with greater delay in graft function and worse graft survival with poorer renal function.
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain. Electronic address: montego_12@yahool.es.
authors: E
authors: E
authors: González Monte
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: M T
authors: MT
authors: Mora
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: N
authors: N
authors: Polanco
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: E
authors: E
authors: Morales
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: E
authors: E
authors: Gutiérrez
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: M
authors: M
authors: Molina
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: Á
authors: Á
authors: Sevillano
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: E
authors: E
authors: Hernández
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: M
authors: M
authors: Praga
authors: Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors: A
authors: A
authors: Andrés
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D051799:Delayed Graft Function / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology