ACUTE-RENAL-FAILURE AFTER CARDIAC TRANSPLANTATION - A CASE-REPORT ANDREVIEW OF THE LITERATURE

Acute renal failure (ARF) is a relatively frequent complication associ ated with heart transplantation. It develops in the first few days pos toperatively and is characterized by oliguria with laboratory and urin ary indices typical of pre-renal azotemia. Cyclosporine, especially wi th higher doses, is one of the many factors which play an integral par t in the nephrotoxicity following cardiac transplant. Poor preoperativ e renal function and perioperative hemodynamic compromise may also con tribute to ARE The actual incidence of ARF now encountered by transpla nt centers may be lower than previously reported, the result of lower cyclosporine doses. Currently, management is entirely supportive, but novel therapeutic approaches with atrial natriuretic peptide-like subs tances are being explored. a case illustrating the typical clinical pr esentation of ARF after heart transplant will be presented and the cli nical features will be reviewed.