ACUTE KIDNEY INJURY FOLLOWING LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: CONTEMPORARY INSIGHTS AND FUTURE PERSPECTIVES

Abstract Currently, an increasing number of patients with end-stage heart failure are being treated with left ventricular assist device (LVAD) therapy, as bridge-to-transplantation, bridge-to-candidacy or destination therapy (DT). Potential life-threatening complications may occur, specifically in the early postoperative phase, which positions LVAD implantation as a high-risk surgical procedure. Acute kidney injury (AKI) is a frequently observed complication after LVAD implantation and is associated with high morbidity and mortality. The rapidly growing number of LVAD implantations necessitates better approaches of identifying high risk patients, optimizing perioperative management and preventing severe complications such as AKI. This holds especially true for those patients receiving an LVAD as DT, who are typically older (with higher burden of co-morbidities) with impaired renal function and at increased postoperative risk. Herein we outline the definition, diagnosis, frequency, pathophysiology and risk factors for AKI in LVAD patients. We also review possible strategies to prevent and manage AKI in this patient population.