Acute kidney injury after implantation of a left ventricular assist device: a comparison of axial-flow (HeartMate II) and centrifugal-flow (HeartWare HVAD) devices

Azeen Anjum, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B. Civitello, Whitson B. Etheridge, Reynolds M. Delgado, Leo Simpson, Joggy K. George, Ajith P. Nair, O. H. Frazier, Jeffrey A. Morgan

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation. We compared the perioperative characteristics, postoperative complications, and survival rates of the patients with and without AKI and differentiated the outcomes based on device type (HM-II or HVAD). Seventy-five patients (14.4%) developed AKI postoperatively. Patients with AKI after LVAD implantation had significantly reduced survival compared to patients without AKI (p = 0.01). Cox proportional hazards models showed that AKI was a significant independent predictor of mortality (HR = 1.54, p = 0.03). Preoperative mechanical circulatory support and prolonged cardiopulmonary bypass time were independent predictors of AKI. The incidence of AKI was similar for HM-II and HVAD recipients (p = 0.25). There was no significant difference in AKI rates for the HM-II and HVAD recipients. Developing AKI adversely affected survival.

Original languageEnglish (US)
Pages (from-to)285-292
Number of pages8
JournalJournal of Artificial Organs
Volume21
Issue number3
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Keywords

  • Acute kidney injury
  • Heart failure
  • Left ventricular assist device

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering
  • Cardiology and Cardiovascular Medicine

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    Anjum, A., Kurihara, C., Critsinelis, A., Kawabori, M., Sugiura, T., Civitello, A. B., Etheridge, W. B., Delgado, R. M., Simpson, L., George, J. K., Nair, A. P., Frazier, O. H., & Morgan, J. A. (2018). Acute kidney injury after implantation of a left ventricular assist device: a comparison of axial-flow (HeartMate II) and centrifugal-flow (HeartWare HVAD) devices. Journal of Artificial Organs, 21(3), 285-292. https://doi.org/10.1007/s10047-018-1047-0