Myocardial remodeling after kidney transplantation: a case r
According to current therapeutic standards, kidney transplantation is the treatment of choice in patients with renal failure in course of Lupus nephritis (LN). On the contrary, a kidney transplantation in a patient with an additional heart disease poses a serious clinical challenge.

Published in the Journal of Medical Case Reports, the authors present a case of a 49-year-old woman with renal and heart failure following a long-term SLE prepared for kidney transplantation. During the SLE course, the function of the heart and kidneys gradually deteriorated.

The patient required the initiation of renal replacement therapy and was dialyzed until a kidney transplantation for 4 years. In the preparation of the patient for the surgical procedure, due to the extremely low ejection fraction, it was decided to include cardioprotective treatment with Levosimendan.

The postoperative period was not straightforward but successful. In the monthly and five-month follow-up, a continuous improvement of heart function with normal renal function was noted.

Lessons Learnt:-

-Kidney transplantation in patients with lupus suffering from heart failure requires the involvement of a team of specialists.

- Patients with extremely low ejection fraction in the perioperative period should undergo careful hemodynamic supervision in the intensive care unit.

- Cardioprotective and thus nephroprotective Levosimendan therapy together with optimal fluid and hemodynamic therapy in the peri-transplant period may be a bridge for heart remodeling after kidney transplantation.

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