Renal Impairment an Impediment to Heart Transplantation?

Abstract

Chronic kidney disease (CKD), especially when severe, is widely held as a contraindication to heart transplantation by many medical institutions. Given the widespread prevalence of CKD among heart transplant candidates, a nephrological assessment and management in potential heart transplant recipients is a key issue as renal impairment may potentially jeopardize the access of these patents to a life-saving procedure. Chronic heart and kidney diseases are intimately interconnected.  First, both conditions share a great number of etiological factors. Second, a steady stream of studies have highlighted the negative heart-kidney interaction in such a way that any acute or chronic dysfunction of the former may affect the latter- and reciprocally-, as part of the « cardiorenal syndromes ».