REnal TRansplant Outcomes After CARdiac Surgery (RETROCAR)

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Cardiac Surgery, Cardiopulmonary Bypass, Renal Transplant Recipient

Intervention / Treatment
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* Other: standard of care


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| RENAL TRANSPLANT RECIPIENTS<br>All patients with previous renal transplantation undergoing cardiac surgery with cardiopulmonary bypass | Other: standard of care<br>* retrospective study : standard of care<br>|
| NON RENAL TRANSPLANT RECIPIENTS<br>All patients without previous renal transplantation undergoing cardiac surgery with cardiopulmonary bypass | Other: standard of care<br>* retrospective study : standard of care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Long-term renal outcome | Proportion of patients meeting a composite criterion : death or permanent dialysis or doubling the baseline serum creatinine value | 12 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Glomerular Filtration Rate (GFR) | Glomerular Filtration Rate (GFR) calculated with CKD-EPI formula | 30 days after surgery | 
| Glomerular Filtration Rate (GFR) | Glomerular Filtration Rate (GFR) calculated with CKD-EPI formula | 12 months after surgery | 
| Vital status | Mortality after surgery | 12 months after surgery | 
| Major Adverse Kidney Events | Major Adverse Kidney Events defined by new receipt of Renal replacement therapy (RRT), or Acute Kidney Injury (AKI) episodes with persistent renal dysfunction and final serum creatinine value before hospital discharge ≥ 200 % of the baseline serum creatinine | Up to 12 months after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac surgery, renal transplant recipient, renal function, acute kidney injury, major adverse kidney events