Continuous renal replacement therapy after heart transplantation.
Bibliographic record
Abstract
BACKGROUND: Renal failure following heart transplantation carries a poor prognosis. The objectives of this study were to determine risk factors for renal failure requiring continuous renal replacement therapy (CRRT), to describe the management strategies regarding immunosuppressive therapy and to examine the short-term prognosis. METHODS: Fifty-six patients who underwent heart transplantation from 1998 to 2002 at the Montreal Heart Institute were retrospectively analyzed. RESULTS: Six of 56 patients (11%) underwent CRRT after heart transplantation. Patients who underwent CRRT had lower preoperative creatinine clearance than those who did not (median 44 versus 59 mL/min, P=0.04) and lower first two-week postoperative creatinine clearance (median 23 versus 42 mL/min, P<0.01) compared with patients without CRRT. The total duration of CRRT ranged between two and 60 days (median 15 days). Cyclosporine was withheld for 12 days versus two days (P<0.01) and the time to achieve therapeutic levels of cyclosporine averaged 18 days versus nine days (P=0.01) among CRRT versus non-CRRT patients. Patients were administered thymoglobulin or basiliximab during cyclosporine withholding. The time to discharge from hospital after transplantation was longer in patients with CRRT (median 47 days versus 17 days, P<0.01). There was no mortality at three months in the CRRT group. CONCLUSION: Creatinine clearance is an important predictor of renal failure requiring renal replacement therapy. Although renal failure remains a serious complication after transplantation, the use of CRRT and antilymphocyte agents during cyclosporine A withholding is associated with a favourable short-term prognosis following heart transplantation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".