Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study shows that a kidney transplant can reverse heart failure

06.04.2005


University of Maryland study may change traditional thinking about offering kidney transplants to dialysis patients whose hearts do not pump effectively



Doctors at the University of Maryland Medical Center say that contrary to conventional thinking, a kidney transplant can significantly improve the heart function of people on dialysis with a serious form of heart failure. In a study published in the April 5, 2005 issue of the Journal of the American College of Cardiology, the researchers found that a majority of patients who had systolic heart failure, in which the heart’s left ventricle was weak and not pumping blood efficiently, had a dramatic recovery after their kidney transplant.

"These findings are contrary to conventional thinking that a kidney transplant may put additional strain on the hearts of patients with systolic heart failure," says the lead author of the study, Ravinder K. Wali, M.D., a nephrologist at the University of Maryland Medical Center and assistant professor of medicine at the University of Maryland School of Medicine. "We were surprised to find that, in fact, many of those people with severe heart failure had striking improvement in terms of cardiac function after a kidney transplant."


Dr. Wali adds, "Our study also found that systolic heart failure was more likely to be reversed if patients received a transplant soon after they began dialysis to treat their kidney failure."

The study followed 103 patients between June 1998 and November 2002. Prior to their transplant, all of the patients had congestive heart failure with a left ventricular ejection fraction of 40 percent or less. The ejection fraction is a measure of the ability of the heart to pump blood. In the normal ejection fraction, the heart is capable of pumping more than 55 percent of the blood volume in the ventricle. The researchers assessed the heart’s pumping ability of the patients at six and 12 months and at a later follow-up visit after successful transplantation.

Overall, after a kidney transplant, the heart’s pumping ability improved in more than 86 percent of the patients. For 70 percent of the patients, pumping ability returned to normal or close to normal following the transplant. Even more dramatic, the majority of the patients with the worst heart failure (about 20 percent of those studied) regained significant cardiac function following the transplant, according to Dr. Wali.

The investigators also observed major recovery in patients whose heart failure included blocked or narrowed heart arteries, a condition known as ischemic heart failure. "We showed that the ejection fraction went up even among those who had undergone coronary artery bypass surgery," says Dr. Wali.

The most important factor that directly affected recovery of the heart function was the length of time the patient was on dialysis. The study was not large enough to determine how long a person can remain on dialysis and still receive a cardiac benefit from a kidney transplant.

"Our conclusion," says Dr. Wali, "is that your best chance of survival, if you have both kidney failure and heart failure, is to receive a kidney transplant as soon as possible." He says this group of patients should be encouraged to seek a living kidney donor since the national waiting time for a deceased donor kidney transplant can average three to five years, according to the United Network for Organ Sharing.

Dr. Wali says it is not clear why prolonged dialysis reduces the benefits of kidney transplantation for the heart, but he says there are several toxins associated with end-stage renal disease that have an adverse effect on the muscles of the heart. It may be that some of those toxins are not totally eliminated during the process of dialysis and that long-term exposure to those toxins increases the risk of death from cardiac causes.

In an editorial accompanying the article in the Journal of the American College of Cardiology, the authors underscore the complexity of heart-kidney interactions and point to the need for further study. "The clinical implications of the study lend credence to the notion that renal transplantation can be performed safely in patients with advanced stages of heart failure due to left ventricular dysfunction," says the editorial.

The editorial was written by Hector O. Ventura, M.D., F.A.C.C., of the Ochsner Clinic Foundation in New Orleans and Mandeep R. Mehra, M.D., F.A.C.C., formerly of Ochsner, who is now head of cardiology at the University of Maryland Medical Center and professor of medicine and head of the Division of Cardiology at the University of Maryland School of Medicine.

In an interview, Dr. Mehra said, "This is an amazing study. It reverses the usual sequence of scientific inquiry from laboratory bench to patient bedside. Instead, astute observation at the bedside is prompting investigators to the laboratory, where they can systematically seek to understand why kidney transplantation successfully treats heart failure."

Bill Seiler | EurekAlert!
Further information:
http://www.umm.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

 
Latest News

Scientists propose synestia, a new type of planetary object

23.05.2017 | Physics and Astronomy

Zap! Graphene is bad news for bacteria

23.05.2017 | Life Sciences

Medical gamma-ray camera is now palm-sized

23.05.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>