| Autor: |
Noah Weingarten, Amit Iyengar, David Alan Herbst, Mark Helmers, David Rekhtman, Cindy Song, Samuel T Kim, Pavan Atluri |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 63(1) |
| ISSN: |
1873-734X |
| Popis: |
OBJECTIVES The decision to perform simultaneous heart–kidney transplant (HKT) rather than isolated heart transplant (IHT) for patients with advanced kidney disease is challenging. Limited data exist to guide this decision in obese patients. We sought to compare mortality after HKT and IHT in obese patients with non-dialysis-dependent kidney disease. METHODS The United Network for Organ Sharing was queried for data on adult heart transplant recipients from 2000 to 2022. Inclusion criteria were obesity, estimated glomerular filtration rate RESULTS A total of 289 HKT and 1920 IHT recipients met inclusion criteria. Heart–kidney recipients had higher baseline creatinine and rates of intensive care unit disposition than IHT recipients (both standardized mean differences >0.10). Propensity matching resulted in 239 pairs of HKT and IHT recipients with minimal differences in baseline characteristics. Heart–kidney recipients had higher 5- and 10-year survival than IHT recipients on unmatched (77% vs 69%, P = 0.011 and 58% vs 48%, P = 0.008) and propensity matched analyses (77% vs 68%, P = 0.026 and 57% vs 39%, P = 0.007). Heart–kidney transplantation was protective against 10-year mortality on multivariable regression (hazard ratio 0.585, P = 0.002). CONCLUSIONS In obese patients with non-dialysis-dependent kidney disease, HKT may decrease long-term mortality relative to IHT and should be strongly considered as a preferred treatment. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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