Abstract 12162: Changes in Renal Function Following Left Ventricular Assist Device Placement in Pediatric Patients: A PediMACS Analysis
Introduction: Renal dysfunction (RD) is prevalent among pediatric patients with advanced heart failure. Data are limited regarding changes in renal function following left ventricular assist device (LVAD) placement in this population.
Hypothesis: Renal function will improve following pediatric LVAD placement, but degree and durability of improvement may vary based upon patient and device characteristics.
Methods: Pediatric LVAD recipients enrolled in the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) between September 19, 2012 and December 31, 2015 were included. The Schwartz equation was used to calculate eGFR and longitudinal changes in renal function were analyzed for the entire cohort as well as subgroups stratified by patient and device characteristics.
Results: Data from 218 patients from 39 centers were analyzed. Mean age at implant was 9.2 years and total follow up time was 768 patient-months. There were 117 (54%) durable continuous flow LVADs, 60 (27%) durable pulsatile flow LVADs, and 41 (19%) temporary LVADs. The underlying diagnosis was cardiomyopathy in 162 (74%) patients and congenital heart disease in 47 (22%) patients. Baseline RD (eGFR < 90 mL/min/1.73 m2) was present in 140 (64%) patients. Overall, eGFR improved post-LVAD, peaking at 1 month post-implant (Figure 1). There was an inverse relationship between baseline eGFR and the degree of improvement at 1 month (mean increase in eGFR of 45 +/- 16 for patients with baseline RD vs. mean increase of 16 +/- 58 for patients with normal eGFR pre-LVAD, p=0.001). Degree of improvement in eGFR at 1 month did not appear impacted by device type, age, or diagnosis. There was a downward trend in eGFR after 1 month, although eGFR remained over baseline for patients with pre-implant RD.
Conclusions: Renal function improves post-LVAD placement in pediatric patients regardless of age, diagnosis or device type, with improvement most pronounced in patients with baseline RD.
Author Disclosures: J.M. Friedland-Little: None. B.J. Hong: None. J.G. Gossett: None. S.R. Deshpande: None. S. Law: None. K.A. Hollifield: None. R.S. Cantor: None. S.J. Kindel: None. M.W. Turrentine: None. R.R. Davies: None.
- © 2016 by American Heart Association, Inc.