Professor of Surgery University of Pennsylvania Narberth, Pennsylvania
This study retrospectively evaluated preoperative historical, biochemical and cardiovascular screening data for predictors of survival to discharge and long-term survival in feline renal allograft recipients.One hundred and sixty-six cats that underwent renal transplantation at the University of Pennsylvania between 1998 and 2018 were included. Medical records were reviewed for preoperative historical information, biochemical data and cardiac assessment including auscultation findings, pre and post-operative systolic blood pressure measurements, thoracic radiograph evaluation and echocardiographic measurements. The need for hemodialysis, the number of surgical procedures, native kidney biopsy diagnosis and survival time was also recorded. Kaplan-Meier analysis was used to generate survival plots and estimate median survival times with a 95% confidence interval. Univariable and multivariable analysis were performed to determine variables that were independently associated with survival to discharge and long-term survival. The patient population primarily consisted of adult male DSH cats (70%) diagnosed with IRIS stage 4 CKD (66.3%). Abnormalities identified on preoperative cardiac assessment including hypertension, the presence of a murmur, echocardiographic changes and radiographic signs of congestive heart failure, were not associated with survival to discharge or long-term survival. Age was the only single significant variable associated with survival with the risk of death increased by 11% (95% CI, 6-17%) for every 1 year in patient age. The presence of cardiac abnormalities identified during the screening process of cats presenting for transplantation should not immediately exclude a potential candidate for the procedure. Owners considering transplantation should be educated on the impact of age on survival following surgery.
