Preoperative Levosimendan Administration in Heart Transplant Patients with Severe Hepatic and Renal Impairment: A Retrospective Study

Authors

  • Qiang Zheng Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Hongwen Lan Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Qiannan Guo Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Chenghao Li Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Tixiusi Xiong Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Jing Zhang Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Guohua Wang Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Nianguo Dong Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China
  • Jiawei Shi Department of Cardiovascular Surgery, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, 430022 Wuhan, Hubei, China

DOI:

https://doi.org/10.59958/hsf.5433

Keywords:

levosimendan, hepatic impairment, renal impairment, heart transplantation

Abstract

Background: The cardio-renal syndrome and hepatic impairment play a critical role in end-stage heart failure (HF). Levosimendan is an effective inotropic agent used to maintain cardiac output similar to classic cardiotonic like dobutamine/dopamine. This current research aims to investigate the clinical outcomes of levosimendan and dobutamine/dopamine in Chinese heart transplant awaiting patients with severe hepatic or renal impairment. Methods: We performed a retrospective analysis of 568 heart transplant awaiting individuals with severe hepatic or renal impairment who treated with levosimendan or dobutamine/dopamine in our institution between January 2015 and December 2020. Univariate Cox proportional hazard models and Kaplan-Meier survival curves were applied. The primary endpoint was defined as death included inhospital mortality and the mortality at 30 days, 90 days, 180 days and 1 year after heart transplantation. Results: There were no significant differences in mortality rate at 30, 90, 180 days and 1 years after heart transplantation between the levosimendan and non-levosimendan groups, or between subgroups of patients with severe hepatic impairment or renal impairment. The results were consistent before and after propensity score matching. Conclusions: In the population with advanced heart failure awaiting heart transplantation, levosimendan did not increase short- or long-term mortality rates after surgery compared to dobutamine/dopamine, regardless of their hepatic or renal function. Severe hepatic or renal impairment were not necessarily considered a contraindication for levosimendan in these patients.

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Published

2023-08-14

How to Cite

Zheng, Q., Lan, H., Guo, Q. . ., Li, C., Xiong, T. ., Zhang, J., Wang, G., Dong, N. ., & Shi, J. . (2023). Preoperative Levosimendan Administration in Heart Transplant Patients with Severe Hepatic and Renal Impairment: A Retrospective Study. The Heart Surgery Forum, 26(4), E346-E357. https://doi.org/10.59958/hsf.5433

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