Management of heart failure and renal failure in end-stage heart failure patients is a main problem. Utilization of IABP is very limited, because of potential risks for the patient, especially when no donor is available. Low blood pressure makes convential hemodialysis impossible. Since 2006, 12 heart transplants is performed in our center. We have major problems in the management of 2 patients. Unfortunately VAD was not present in our center. CRRT was being utilized for them. In the first pateient, 24 hours after heart transplant due to very low blood pressure for a long time before and after the transplant ATN with anuria was developed. The heart was still stunned and no VAD was present. CRRT started for the patient for 72 hours during which this period the blood pressure was rasied, urination started and after 86 hours the creatinine declines. Another patient was a candidate of heart transplant with severe dsypena, ascitis and pitting edema in lower extremities. No VAD was present and no donor was found. The patient was undergone CRRT twice each time for 48 hours and each time 12 Liters of fluid was evacuated, which after every procedure the patient became better. 30 hours after the last CRRT the patient was undergone heart transplant and had an uneventful post operative course. We concluded that CRRT can be used effectively not only for the management of renal failure, but also heart failure after and even before surgery and has many potential effects in removing the oxygen free radicals.
Volume : 6
Issue : 4
Pages : 126
Departments of Nephrology, Cardiothoracic Surgery, Cardiology, of Massih Daneshvari Hospital, Shahid Beheshti University, Tehran, Iran