Currently, an increasing number of patients with end-stage heart failure are being
treated with left ventricular assist device (LVAD) therapy as bridge-to-transplantation,
bridge-to-candidacy, or destination therapy (DT). Potential life-threatening complications
may occur, specifically in the early post-operative phase, which positions LVAD implantation
as a high-risk surgical procedure. Acute kidney injury (AKI) is a frequently observed
complication after LVAD implantation and is associated with high morbidity and mortality.
The rapidly growing number of LVAD implantations necessitates better approaches of
identifying high-risk patients, optimizing peri-operative management, and preventing
severe complications such as AKI. This holds especially true for those patients receiving
an LVAD as DT, who are typically older (with higher burden of comorbidities) with
impaired renal function and at increased post-operative risk. Herein we outline the
definition, diagnosis, frequency, pathophysiology, and risk factors for AKI in patients
with an LVAD. We also review possible strategies to prevent and manage AKI in this
patient population.
KEYWORDS
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Article info
Publication history
Published online: June 19, 2019
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© 2019 International Society for Heart and Lung Transplantation. All rights reserved.
