TY - JOUR
T1 - Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate
T2 - Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database
AU - Karamlou, Tara
AU - Welke, Karl F.
AU - McMullan, D. Michael
AU - Cohen, Gordon A.
AU - Gelow, Jill
AU - Tibayan, Frederick A.
AU - Mudd, James M.
AU - Slater, Matthew S.
AU - Song, Howard K.
PY - 2014/1
Y1 - 2014/1
N2 - Objective: Criteria for simultaneous heart-kidney transplant (HKTx) recipients are unclear. We characterized the evolution of combined HKTx in the United States over time compared with isolated heart transplantation (HTx) and determined factors maximizing post-transplant survival. We focused on whether a threshold estimated glomerular filtration rate (eGFR) could be identified that justified combined transplantation. Methods: A supplemented United Network Organ Sharing Dataset identified HTx and HKTx recipients from 2000 to 2010. eGFR was calculated for HTx and recipients were grouped into eGFR quintiles. Time-related mortality was compared among recipients, with multivariable factors sought using Cox proportional hazard regression models. Results: We identified 26,183 HTx recipients, of whom 593 were HKTx recipients. HTx increased modestly over time (3.6%), whereas prevalence of HKTx increased dramatically (147%). Risk-unadjusted survival was similar among HTx recipients (8.4 ± 0.04 years) and HKTx recipients (7.7 ± 0.2 years) (P =.76). Isolated HTx recipients in the lowest eGFR quintile had decreased survival (P
AB - Objective: Criteria for simultaneous heart-kidney transplant (HKTx) recipients are unclear. We characterized the evolution of combined HKTx in the United States over time compared with isolated heart transplantation (HTx) and determined factors maximizing post-transplant survival. We focused on whether a threshold estimated glomerular filtration rate (eGFR) could be identified that justified combined transplantation. Methods: A supplemented United Network Organ Sharing Dataset identified HTx and HKTx recipients from 2000 to 2010. eGFR was calculated for HTx and recipients were grouped into eGFR quintiles. Time-related mortality was compared among recipients, with multivariable factors sought using Cox proportional hazard regression models. Results: We identified 26,183 HTx recipients, of whom 593 were HKTx recipients. HTx increased modestly over time (3.6%), whereas prevalence of HKTx increased dramatically (147%). Risk-unadjusted survival was similar among HTx recipients (8.4 ± 0.04 years) and HKTx recipients (7.7 ± 0.2 years) (P =.76). Isolated HTx recipients in the lowest eGFR quintile had decreased survival (P
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U2 - 10.1016/j.jtcvs.2013.09.017
DO - 10.1016/j.jtcvs.2013.09.017
M3 - Article
C2 - 24183335
AN - SCOPUS:84890549937
SN - 0022-5223
VL - 147
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 1
ER -