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Acute Kidney Injury and Mid-term Outcomes After Extra-Cardiac Fontan Conversion

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Abstract

The aim of this study was to investigate the association of postoperative acute kidney injury and unplanned re-admission rate due to heart failure at 2 years follow-up in patients who had extra-cardiac Fontan conversion. This was a retrospective single-center study of patients who underwent conversion from classic Fontan to extra-cardiac Fontan between January 2014 and December 2021. Acute kidney injury was defined using the Kidney Disease Improving Global Outcomes criteria. A total of 47 patients underwent Fontan conversion. Acute kidney injury occurred in 22 patients (46.8%) and 5 patients with acute kidney injury needed renal replacement therapy. Unplanned re-admission rate at 2-year follow-up was significantly higher in patients with acute kidney injury even when renal function returned to baseline (8 [36.4%] vs. 3 [12.0%], p = 0.026 by the log-rank test). In conclusion, postoperative acute kidney injury after extra-cardiac Fontan conversion was associated with unplanned re-admission due to heart failure at 2-year follow-up even though renal function was recovered.

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Data Availability

The datasets that support the findings of this study are available from the corresponding author, T. K., on reasonable request.

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Acknowledgements

We would like to thank SES translation and proofreading service for English language editing. Moreover, we wish to thank Dr Yasuko Nagasaka, Professor of Department of Anesthesiology, Tokyo Women’s Medical University, for her support in our study.

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Authors and Affiliations

  1. Department of Anesthesiology, Sapporo Medical University, School of Medicine, 291 South 1 West 16, Chuo-Ku, Sapporo-Shi, Hokkaido, 060-8543, Japan

    Tatsuya Kunigo

  2. Department of Anesthesiology, Tokyo Women’s Medical University, School of Medicine, 8-1, Kawada-Cho, Shinjuku-Ku, Tokyo, 162-8666, Japan

    Tatsuya Kunigo, Risa Oikawa & Minoru Nomura

Authors
  1. Tatsuya Kunigo
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  2. Risa Oikawa
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  3. Minoru Nomura
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Contributions

TK: This author helped in the study design, study conduct, data analysis, and manuscript preparation. RO: This author helped in the study conduct and manuscript review. MN: This author helped in the study conduct, data interpretation, and manuscript review.

Corresponding author

Correspondence to Tatsuya Kunigo.

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Conflict of interest

The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This study was approved by the Institutional Review Board of Tokyo Women’s Medical University, School of Medicine, Tokyo, Japan (No. 2022-0008) on May 6, 2022.

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Kunigo, T., Oikawa, R. & Nomura, M. Acute Kidney Injury and Mid-term Outcomes After Extra-Cardiac Fontan Conversion. Pediatr Cardiol (2023). https://doi.org/10.1007/s00246-023-03220-y

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