Acuterenal failure(ARF)after cardiac transplantation is a common and serious complication. In this study we aimed to investigate the incidence and effect of ARF on survival in patients who underwent cardiac transplantation. Patients: Eight patients underwent cardiac and one patient underwent combined cardiac and renal transplantation. The mean age of the patients was 33±11.6 years (17-51). In the preoperative echocardiographic evaluation mean ejection fraction was calculated as 19±3.11% (16-24). One patient were with compansated renal failure and one patient with dialysis dependent renal failure. Hemofiltration was routinely used in the operations. Corticosteroid, cyclosporine (CsA) and mycophenolate mofetil were used for immunosuppresion. Early renal support was used in patients with ARF.
Results: The incidence of ARF was 55.5% (5 patients). In the early postoperative and follow up period, ejection fraction was 55±9.9% and 57±4.5% respectively. The mean follow up period was 18±9.46 (2-31) months. In the early initiation period the mean peak value of CsA was 479±201.8 ng/ml, in the first and third months were 250±95.3 and 195±43.7 ng/ml respectively. The mean creatinine level in the last follow up was 1.27±0.4. There was Grade III-A rejection in one patient. One patient died due to coronary artery occlusive diseae 31 months after transplantation. Comment: In our study we have found that acute renal failure has no negative effect on survival in our patients. This can be explained by improved cardiac performance, keeping CsA levels in low limits and maintaining early renal support treatment.