Novel composite right heart hemodynamic parameter pulmonary artery pulsatility index (PAPi), may outperform currently assessed parameters like transpulmonary gradient, diastolic pulmonary gradient and pulmonary vascular resistance. PAPi and right atrial pressure can be used as predictors for early AKI in patients undergoing heart transplantation, and early prediction of AKI could be used to timely treat high-risk patients.