title: Predictors of Acute Kidney Injury in Cardiac Transplantation.
abstract: BACKGROUND
  Acute kidney injury (AKI) is an outcome that represents a significant increase in morbidity and mortality rates; however, limited information exists about the incidence of AKI after cardiac transplantation.
  
  
  METHODS
  This single-center, retrospective study from 2009 to 2014 analyzed pre-, intra-, and post-operative characteristics of 111 patients who underwent orthotopic cardiac transplantation to identify risk factors for AKI and validate findings of existing literature.
  
  
  RESULTS
  AKI based on the RIFLE criteria (risk, injury, failure, loss, and end-stage) occurred in 65 patients (58.6%) during the hospitalization period, with 38 patients requiring early dialysis. Risk factors for AKI were longer cardiopulmonary bypass duration (P = .008), higher packed cell (P = .004) and cryoprecipitate (P = .022) transfusions, and post-operative bleeding with subsequent surgical re-exploration (P = .008). The development of AKI was also associated with longer inotropic (P ≤ .001) and ventilation duration (P ≤ .001) as well as higher mortality rates (P = .048).
  
  
  CONCLUSIONS
  AKI after cardiac transplantation is prevalent and prognostically significant. Although there is yet to be a strategy that conclusively demonstrated its ability to prevent AKI after cardiac surgery, therapies targeted at modifiable risk factors may offer protection against this outcome.
authors.affiliation: Faculty of Medicine, The University of New South Wales, Sydney, Australia. Electronic address: richardtjahjono@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Tjahjono
authors.affiliation: Department of Cardiothoracic Surgery, St. Vincent's Hospital, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Connellan
authors.affiliation: Faculty of Medicine, The University of New South Wales, Sydney, Australia; Department of Cardiothoracic Surgery, St. Vincent's Hospital, Sydney, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Granger
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors