Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database

Tara Karamlou, Karl F. Welke, D. Michael McMullan, Gordon A. Cohen, Jill Gelow, Frederick (Fred) Tibayan, James Mudd, Matthew Slater, Howard Song

    Research output: Contribution to journalArticle

    42 Citations (Scopus)

    Abstract

    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

    Original languageEnglish (US)
    JournalJournal of Thoracic and Cardiovascular Surgery
    Volume147
    Issue number1
    DOIs
    StatePublished - Jan 2014

    Fingerprint

    Glomerular Filtration Rate
    Databases
    Transplants
    Kidney
    Survival
    Heart Transplantation
    Proportional Hazards Models
    Transplantation
    Mortality
    Transplant Recipients

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Surgery
    • Pulmonary and Respiratory Medicine

    Cite this

    @article{e16c1475271b4c9cb8b8f3aeb292de2d,
    title = "Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database",
    abstract = "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",
    author = "Tara Karamlou and Welke, {Karl F.} and McMullan, {D. Michael} and Cohen, {Gordon A.} and Jill Gelow and Tibayan, {Frederick (Fred)} and James Mudd and Matthew Slater and Howard Song",
    year = "2014",
    month = "1",
    doi = "10.1016/j.jtcvs.2013.09.017",
    language = "English (US)",
    volume = "147",
    journal = "Journal of Thoracic and Cardiovascular Surgery",
    issn = "0022-5223",
    publisher = "Mosby Inc.",
    number = "1",

    }

    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 (Fred)

    AU - Mudd, James

    AU - Slater, Matthew

    AU - Song, Howard

    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

    UR - http://www.scopus.com/inward/record.url?scp=84890549937&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84890549937&partnerID=8YFLogxK

    U2 - 10.1016/j.jtcvs.2013.09.017

    DO - 10.1016/j.jtcvs.2013.09.017

    M3 - Article

    C2 - 24183335

    AN - SCOPUS:84890549937

    VL - 147

    JO - Journal of Thoracic and Cardiovascular Surgery

    JF - Journal of Thoracic and Cardiovascular Surgery

    SN - 0022-5223

    IS - 1

    ER -