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Kidney Week

Abstract: SA-PO688

Case Report: Patient with a Total Artificial Heart Maintained on Outpatient Dialysis While Listed for Combined Organ Transplant: A Single Center Experience

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis

Authors

  • Hanna, Ramy Magdy, UCLA Health, Rolling Hills Estates, California, United States
  • Hasnain, Huma S., UCLA Nephrology, Los Angeles, California, United States
  • Kamgar, Mohammad, None, Manhattan Beach, California, United States
  • Minasian, Raffi R., None, Manhattan Beach, California, United States
  • Wilson, James, None, Manhattan Beach, California, United States
Background

Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH).

Methods

Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care. Protocols do exist for VAD implanted patients to be transitioned to outpatient dialysis care, but there are no reported cases of TAH patients with ESRD being successfully transitioned to outpatient dialysis care.

Results

In this report, we identify a patient with a TAH and ESRD transitioned successfully to outpatient Hemodialysis (HD) and maintained for more than two years, though he did not survive to transplant

Conclusion

It is hoped that this report will raise awareness of this possibility, and assist in the development of protocols for similar patients to be successfully transitioned to outpatient dialysis care.