Outcomes of Renal Transplantation in End-Stage Renal Disease Patients with Nonischemic Very Low Ejection Fraction Heart Failure

Objective: Transplantation in end-stage renal disease (ESRD) patients with very low left ventricular ejection fraction (LVEF) heart failure (HF) is a challenging issue, owing to the potential risk of morbidity and mortality, perioperatively. Although patients' survival and worse graft outcomes can be predicted, there is no evidence to claim worse outcomes, especially in patients with nonischemic heart failure. Materials and Methods: A total of 110 ESRD patients were enrolled in the study, and they were divided into 3 groups. Group 1 (n=10) included ESRD patients with very low LVEF (<45%) HF who could not undergo allograft transplantation (on the waitlist or with immunological barriers to receive a living-related graft), Group 2 (n=20) included ESRD patients with very low LVEF HF who underwent allograft transplantation, and Group 3 (n=80) included ESRD patients who received an allograft and had no history of HF. Patients with EF between 45-55% were excluded. Results: The mean follow-up period was 15.1 +/- 3.1 months. Two patients from Group 1 died (Group 1 vs Group 2 and 3; p<0.05). Delayed graft function rates, one-year graft functions, graft loss, and one-year mortality rates were similar in Group 2 and 3. Conclusion: ESRD patients with a nonischemic low LVEF HF can receive all advantages of an allograft transplantation as recipients with normal LVEF.