Renal Allograft Failure Due to Cardiorenal Syndrome.

Purpose: No relevant literature exists on cardiorenal syndrome (CRS) following renal transplantation. Methods: We investigated the incidence of renal allograft failure (RAF) due to CRS between 2006-2011 at our centre. We describe clinical course, pathophysiology and observed renal pathology in patients with graft loss due to CRS. Results: We found 7 cases of graft loss due to CRS (4.6% of all graft losses). CRS was diagnosed 25 (2-73) months after transplantation. Graft loss occurred 5 (1-62) months after diagnosis. 4/7 patients died. There was one case of CRS type I and 6 cases of CRS type II.Table: No Caption available.Histology revealed tubular injury as the most prominent pathology. Pathophysiology in CRS type II patients was heterogeneous, but left heart failure with subsequent right heart failure was predominant (4/6 patients). Pulmonary hypertension and moderate-to-severe tricuspid regurgitation were found in 5/6 patients. Conclusion: CRS may account for RAF. Thorough pre-/post-transplant cardiac investigation is necessary to identify patients at risk.