Journal article
Outcomes in Patients With LVADs Undergoing Simultaneous Heart-Kidney Transplantation
Journal of cardiac failure, v 28(11), pp 1584-1592
01 Nov 2022
PMID: 35597511
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Multiple studies have shown better outcomes for simultaneous heart-kidney transplant (sHKT) than for isolated orthotopic heart transplant (iOHT) in recipients with chronic kidney disease (CKD). However, outcomes in patients supported by durable left ventricular assist devices (LVADs) have not been well studied.
Patients with durable LVADs and stage 3 or higher CKD (eGFR < 60 mL/min/1.73 m
) undergoing iOHT or sHKT between 2008 and 2020 were identified from the United Network for Organ Sharing registry. A Kaplan-Meier survival analysis with associated log-rank test was conducted to compare post-transplant survival rates. Multivariable modeling was used to identify risk-adjusted predictors of 1 year post-transplant mortality.
We identified 4375 patients; 366 underwent sHKT, and 4009 underwent iOHT. The frequency of sHKT increased during the study period. The 1-year post-transplant survival rate was worse in patients after sHKT than in patients after iOHT (80.3% vs 88.3%; P < 0.001) and persisted up to 5 years post-transplant (P = 0.001). sHKT recipients were more likely to require dialysis after transplantation and had longer hospital lengths of stay (P < 0.001). Multivariable analysis showed that sHKT remained an independent risk factor for mortality at 1 year (OR 1.58; P = 0.002).
sHKT is becoming more common in patients with durable LVADs. Compared with iOHT, patients with sHKTs have worse short- and long-term survival rates and are more likely to require post-transplant dialysis.
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Details
- Title
- Outcomes in Patients With LVADs Undergoing Simultaneous Heart-Kidney Transplantation
- Creators
- Jessica Atkins - Medical University of South CarolinaNicholas R Hess - University of Pittsburgh Medical CenterSheng Fu - Medical University of South CarolinaJacob M Read - Medical University of South CarolinaJennifer M Hajj - Medical University of South CarolinaBhavadharini Ramu - Medical University of South CarolinaDaniel N Silverman - Medical University of South CarolinaChakradhari Inampudi - Medical University of South CarolinaAdrian B Vanbakel - Medical University of South CarolinaZ A Hashmi - Medical University of South CarolinaNicholas H Pope - Medical University of South CarolinaLucas P Witer - Medical University of South CarolinaManreet K Kanwar - Allegheny Health NetworkAndrew J Sauer - University of KansasBrian A Houston - Medical University of South CarolinaArman Kilic - Medical University of South CarolinaRyan J Tedford - Medical University of South Carolina
- Publication Details
- Journal of cardiac failure, v 28(11), pp 1584-1592
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:000904582400003
- Scopus ID
- 2-s2.0-85132743793
- Other Identifier
- 991021932097604721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems