REnal TRansplant Outcomes After CARdiac Surgery (RETROCAR)

Long-term Renal Outcome After Cardiac Surgery : Impact of Previous Renal Transplantation

In this retrospective study, the authors assess long term renal outcome in renal transplant recipients after cardiac surgery with cardiopulmonary bypass, and research factors associated with poor long term renal outcome.

Post-operative mortality after cardiac surgery is increased in renal transplant recipients, compared with general population of cardiac surgery, or with kidney transplant recipients not undergoing cardiac surgery. If the survival of this specific population is now well studied, the long-term renal outcome is much less studied. Previous studies show a trend for increased risk of allograft dysfunction and need for permanent dialysis. This study proposes to compare long term renal outcome between renal transplant recipients and non-renal transplant recipients.

Inclusion Criteria for Renal Transplant Recipients group:

• Previous renal transplantation
• Who underwent cardiac surgery with CPB

Inclusion Criteria for Non Renal Transplant Récipients group:

• No previous renal transplantation
• Who underwent cardiac surgery with CPB
• Apparied with Renal Transplant récipients with the 5 following criteria : age, sex, previous diagnosis of diabete, type of cardiac surgery (isolated coronary artery bypass graft, valvular surgery, aorta surgery, combined surgery), best glomerular filtration rate with CKD-EPI formula at +/- 15 ml/min, in the 3 pre-operative months

Exclusion Criteria:

• Patients requiring mechanical circulatory support (Extracorporeal Membrane Oxygenation)
• Pre-operative permanent dialysis
• Aorta dissection extended to renal arteries
• Non-elective surgery for infective endocarditis
• Previous hepatic, pancreatic or cardiac transplantation
• Death in the 30 first days after cardiac surgery
• Patient not meeting the inclusion criteria