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Heart Retransplant Recipients Have Better Survival With Concurrent Kidney
Transplant Than With Heart Retransplant Alone
#MMPMID26656863
Savla J
; Lin KY
; Pradhan M
; Ruebner RL
; Rogers RS
; Haskins SS
; Owens AT
; Abt P
; Gaynor JW
; Shaddy RE
; Rossano JW
J Am Heart Assoc
2015[Dec]; 4
(12
): ? PMID26656863
show ga
BACKGROUND: Heart retransplant (HRT) recipients represent a growing number of
transplant patients. The impact of concurrent kidney transplants (KTs) in this
population has not been well studied. We tested the hypothesis that recipients of
HRT with concurrent KT (HRT-KT) would have worse survival than recipients of HRT
alone. METHODS AND RESULTS: A retrospective analysis of the United Network of
Organ Sharing database was performed for all patients undergoing HRT from 1987 to
2011. There were 1660 HRT patients, of which 116 (7%) received concurrent KT.
Those who received HRT-KT had older age, longer wait-list time, worse kidney
function, and more known diabetes. Survival among recipients of HRT-KT was
significantly better than that of recipients of HRT alone (P=0.005). A subgroup
of 323 HRT patients with severe kidney dysfunction (estimated glomerular
filtration rate <30 mL/min per 1.73 m(2) or on dialysis) was studied in more
detail, and 76 (24%) received concurrent KT. Those on dialysis at the time of HRT
had better survival with versus without concurrent KT (P<0.0001). On
multivariable analysis, concurrent KT was independently associated with better
outcomes for all patients with HRT and for the subgroup of patients with severe
kidney dysfunction. CONCLUSIONS: Recipients of HRT-KT have better survival than
recipients of HRT alone. Further research is needed to determine which HRT
patients may benefit the most from concurrent KT.
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