(925) - Incidence and Outcomes of Acute Kidney Injury Following Lung Transplantation in Pediatric Population: Retrospective Review

Abstract

s S333 also seen due to unloading from mechanical circulatory support. However, the response to therapy is heterogeneous. Cardiac complications can persist after LVAD implant, adversely affecting quality of life. The purpose of this study was to explore the relationship between unloading and quality of life after LVAD implant. Methods: Data was collected as part of “Profiling Biobehavioral Responses to Mechanical Support in Advanced Heart Failure (PREMISE)”, a prospective cohort study designed, in part, to quantify associations between symptoms and biomarkers of pathogenesis in adults undergoing VAD implant. Measures of myocardial wall stress (NT-proBNP) and quality of life (Kansas City Cardiomyopathy Questionnaire, KCCQ) were collected, prior to implant and 6 months after implant. Linear regression was used to explore the relationship between NT-proBNP levels/changes and KCCQ scores. The cohort was also divided into two groups based on BNP response (≥ 30% change vs. < 30% change). T-test was used to examine changes in KCCQ scores in these groups. Results: A total of 23 subjects had complete paired baseline and 6-month data for analysis. There was no relationship between 6-month NT-proBNP levels and KCCQ scores. However, the percent change in NT-proBNP correlated with KCCQ functional status score (r2 = 0.45, p < 0.001) and clinical summary score (r2 = 0.31, p = 0.006). Subjects with decrease in NT-proBNP of ≥ 30% had a mean reduction of 3945 pg/dL (58% of baseline), while subjects with < 30% decrease in NT-proBNP had a mean reduction of 445 pg/dL (3% of baseline). The group with ≥ 30% decrease in NT-proBNP had a significantly greater improvements in KCCQ clinical summary score after LVAD implant (37.2 vs. 11.5, p = 0.02) (Figure 1). Conclusion: Greater decreases in NT-proBNP are associated with better quality of life following LVAD implant.