Post-operative renal failure management in mechanical circulatory support patients

Danielle Austin*, Peter McCanny, Anders Aneman

*Corresponding author for this work

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Acute kidney injury (AKI) occurs commonly in patients requiring mechanical circulatory support (MCS) after cardiothoracic surgery. The prognostic implications of AKI in this patient group relate closely to the pathophysiology and risk factors associated with the underlying disease; pre-operative, intra-operative, and post-operative variables; hemodynamic factors; and type of support device used. General approaches to AKI management, including prevention strategies, medical management, and hemodynamic support, are also applicable in patients requiring MCS. Approaches to renal replacement therapy vary depend on patient factors, device-specific factors, and local preferences and experience. In this invited narrative review, we discuss the pathophysiology, risk factors, and prognostic implications of AKI in post-operative adult patients following institution of MCS. Management strategies for AKI are presented with a focus on those supported with either extracorporeal membrane oxygenation or a ventricular assist device.

Original languageEnglish
Article number833
Pages (from-to)1-15
Number of pages16
JournalAnnals of Translational Medicine
Issue number13
Publication statusPublished - Jul 2020

Bibliographical note

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  • Mechanical circulatory support (MCS)
  • acute kidney injury (AKI)
  • extracorporeal membrane oxygenation (ECMO)
  • left ventricular assist device (LVAD)

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