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NDT Plus Advance Access published online on August 23, 2009
NDT Plus, doi:10.1093/ndtplus/sfp110
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Improvement of cardiac function after kidney transplantation with dilated cardiomyopathy and long dialysis vintage

Imari Mimura1, Hiroo Kawarazaki1, Toshimitsu Momose2, Yugo Shibagaki3 and Toshiro Fujita1

1 Department of Nephrology and Endocrinology
2 Department of Radiology, University of Tokyo School of Medicine, Tokyo
3 Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan

Correspondence: Yugo Shibagaki; E-mail: eugo{at}wc4.so-net.ne.jp


  Abstract

Patients with long dialysis vintage have low cardiac output for various reasons. Although kidney transplantation is known to improve cardiac mortality, patients are sometimes evaluated as contraindicated for transplantation because of cardiac risk. We successfully performed kidney transplantation for a patient with a long dialysis vintage and dilated cardiomyopathy. Sequential 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy suggested that amelioration of uraemia improved cardiac function. Kidney transplantation for patients with severely impaired cardiac function is safe and effective under careful perioperative monitoring irrespective of dialysis vintage. Sequential 123I-MIBG scintigraphy can be used as an evaluation tool for the improvement in cardiac function.

Key Words: dilated cardiomyopathy • 123I-MIBG scintigraphy • kidney transplantation

Received for publication January 2, 2009. Accepted for publication July 24, 2009.


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