Introduction: Pulmonary hypertension is common among patients with end-stage renal disease, although data regarding the impact of right ventricular (RV) failure on postoperative outcomes remain limited. We hypothesized that echocardiographic findings of RV dilation and dysfunction are associated with adverse clinical outcomes after renal transplant. Methods: A retrospective review of adult renal transplant recipients at a single institution from January 2008 to June 2010 was conducted. Patients with transthoracic echocardiograms (TTEs) within 1 year leading up to transplant were included. The primary end point was a composite of delayed graft function, graft failure, and all-cause mortality. Results: Eighty patients were included. Mean follow-up time was 9.4 ± 0.8 years. Eight patients (100%) with qualitative RV dysfunction met the primary end point, while 39/65 patients (60.0%) without RV dysfunction met the end point (p = 0.026). Qualitative RV dilation was associated with a significantly shorter time to all-cause graft failure (p = 0.03) and death (p = 0.048). RV systolic pressure was not measurable in 45/80 patients (56%) and was not associated with outcomes in the remaining patients. Conclusion: RV dilation and dysfunction are associated with adverse outcomes after renal transplant. TTE assessment of RV size and function should be a standard part of the pre-kidney transplant cardiovascular risk assessment.
Cardiorenal Med

中文翻译：

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肾移植术后右心室功能障碍和不良结局

简介：肺动脉高压在终末期肾病患者中很常见，但关于右心室 (RV) 衰竭对术后结果的影响的数据仍然有限。我们假设 RV 扩张和功能障碍的超声心动图结果与肾移植后的不良临床结果相关。方法：对 2008 年 1 月至 2010 年 6 月在单一机构的成人肾移植受者进行回顾性研究。包括移植前 1 年内进行经胸超声心动图 (TTE) 的患者。主要终点是移植物功能延迟、移植物失败和全因死亡率的复合终点。结果：包括八十名患者。平均随访时间为 9.4 ± 0.8 年。8 名有定性 RV 功能障碍的患者 (100%) 达到了主要终点，而 39/65 名无 RV 功能障碍的患者 (60.0%) 达到了终点 ( p = 0.026)。定性 RV 扩张与全因移植物失败 ( p = 0.03) 和死亡 ( p = 0.048) 的时间显着缩短相关。45/80 名患者 (56%) 的 RV 收缩压无法测量，并且与其余患者的结局无关。结论：右心室扩张和功能障碍与肾移植后的不良结局相关。RV 大小和功能的 TTE 评估应该是肾移植前心血管风险评估的标准部分。
心肾医学