Effect of continuous hemofiltration in preoperative management for heart transplantation——one case report

Objectives To discuss the effect of continuous veno-venous hemofiltration (CVVH) in preparation for heart transplantation.Methods We retrospectively analyzed a case who performed CVVH before heart transplantation ,focused on the methods and curative effect of CVVH.The case was with restrictive cardiomyopathy ,New York heart association heart function Ⅳ,appeared obstinate heart failure and perennial inadequacy.He improved heart function by CVVH ( treated 12 hours per day,for 3 days,ultrafiltrated 2 000～2 200 mL / d,25 days before heart transplantation ).Results After the treatment of CVVH,the case relieved from nausea,vomit and abdominal distention.Urinary production was recovered.The sign of bubble and ascites was disappeared.The biochemistry analysis was normal.The vital sign was stable.The dose of vasoactive agent was decreased obviously.After the heart transplantation ,the urinary production maintain 2 800 mL / d in the first 5 days.The patient returned to isolation ward on the 6th day,without serious right heart failure and infection.Conclusions The renal insufficiency before heart transplantation is prerenal insufficiency usually.It is reversible,so we should adopt active measure just as CVVH.CVVH is used for the preparation of heart transplantation not only in patients with serious renal insufficiency.