Novel Multidisciplinary Management of Acute Kidney Injury After Infant Orthotopic Heart Transplantation.
Billy C WangBrent M GordonPeter ChauTimothy P MartensRichard P LionPublished in: World journal for pediatric & congenital heart surgery (2020)
Acute kidney injury following orthotopic heart transplantation in pediatric recipients is often multifactorial, requiring balance of immune suppression, nephrotoxic medication exposure, nutrition, and fluid status. Therapeutic options are often limited by patient size and hemodynamic stability. We describe a four-month, 4.9-kg female bridged by mechanical circulatory support to transplant after failed stage 1 palliation secondary to recurrent aortic stenosis and severe ventricular dysfunction. Posttransplant, kidney injury was managed by transcatheter relief of central obstruction from an anastomotic stricture and continuous renal replacement therapy, allowing uninterrupted immune suppression, medication, and nutrition delivery until sufficient recovery of renal function.
Keyphrases
- acute kidney injury
- aortic stenosis
- left ventricular
- cardiac surgery
- transcatheter aortic valve replacement
- ejection fraction
- aortic valve replacement
- transcatheter aortic valve implantation
- aortic valve
- physical activity
- healthcare
- adverse drug
- catheter ablation
- heart failure
- case report
- rectal cancer
- oxidative stress
- early onset
- coronary artery disease
- atrial fibrillation
- endoscopic submucosal dissection