Your browser doesn't support javascript.
loading
Heart-kidney transplant versus heart transplant in the obese: a propensity-matched analysis.
Weingarten, Noah; Iyengar, Amit; Herbst, David Alan; Helmers, Mark; Rekhtman, David; Song, Cindy; Kim, Samuel T; Atluri, Pavan.
Afiliación
  • Weingarten N; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Iyengar A; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Herbst DA; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Helmers M; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Rekhtman D; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Song C; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Kim ST; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
  • Atluri P; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Eur J Cardiothorac Surg ; 63(1)2022 12 02.
Article en En | MEDLINE | ID: mdl-36534819
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 <45 ml/min/1.73 m2 and no pretransplant dialysis. HKT and IHT recipients were propensity matched. Morbidity was compared using chi-squared, Fisher's exact and McNemar's tests. Survival was assessed with Kaplan-Meier estimation. Risk factors for mortality were examined with Cox regression. 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.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Corazón / Trasplante de Riñón / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Corazón / Trasplante de Riñón / Insuficiencia Cardíaca Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania