Subsequent kidney transplant after pediatric heart transplant: Prevalence and risk factors.
Am J Transplant
; 24(7): 1267-1278, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-38431077
ABSTRACT
Pediatric heart failure and transplantation carry associated risks for kidney failure and potential need for kidney transplant following pediatric heart transplantation (KT/pHT). This retrospective, United Network of Organ Sharing study of 10,030 pediatric heart transplants (pHTs) from 1987 to 2020 aimed to determine the incidence of waitlisting for and completion of KT/pHT, risk factors for KT/pHT, and risk factors for nonreceipt of a KT/pHT. Among pHT recipients, 3.4% were waitlisted for KT/pHT (median time of 14 years after pHT). Among those waitlisted, 70% received a KT/pHT, and 18% died on the waitlist at a median time of 0.8 years from KT/pHT waitlisting (median age of 20 years). Moderate-high sensitization at KT/pHT waitlisting (calculated panel reactive antibody, ≥ 20%) was associated with a lower likelihood of KT/pHT (adjusted hazard ratio, 0.67; 95% confidence interval, 0.47-0.95). Waitlisting for heart transplantation simultaneously with kidney transplant (adjusted hazard ratio, 3.73; 95% confidence interval, 2.01-6.92) was associated with increased risk of death on the KT/pHT waitlist. While the prevalence of KT/pHT is low, there is substantial mortality among those waitlisted for KT/pHT. These findings suggest a need to consider novel risk factors for nonreceipt of KT/pHT and death on the waitlist in prioritizing criteria/guidelines for simultaneous heart-kidney transplantation.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Waiting Lists
/
Heart Transplantation
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Kidney Transplantation
/
Heart Failure
Limits:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
/
Male
Language:
En
Journal:
Am J Transplant
Journal subject:
TRANSPLANTE
Year:
2024
Type:
Article
Affiliation country:
United States