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Kidney transplant outcomes in children with simultaneous versus sequential heart-kidney transplants.
Mahajan, Ruchi Gupta; Evans, Michael; Kizilbash, Sarah.
Afiliación
  • Mahajan RG; University of Minnesota Medical Center Fairview: M Health Fairview University of Minnesota Medical Center, Minneapolis, USA. ruchigupta.md@gmail.com.
  • Evans M; CTSI: University of Minnesota Twin Cities Clinical and Translational Science Institute, Minneapolis, USA.
  • Kizilbash S; University of Minnesota Medical Center Fairview: M Health Fairview University of Minnesota Medical Center, Minneapolis, USA.
Pediatr Nephrol ; 39(10): 3095-3102, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38822859
ABSTRACT

BACKGROUND:

Heart transplant recipients frequently require kidney transplantation for concomitant advanced chronic kidney disease. Data on simultaneous (heart and kidney transplants performed simultaneously) versus sequential (heart transplant performed before kidney) heart-kidney transplants in children are limited. Herein, we compare kidney transplant outcomes between the two groups.

METHOD:

We used the Scientific Registry of Transplant Recipients to identify all pediatric (age <21 years) heart transplant recipients who also received a kidney transplant within 10 years of the heart transplant. We divided the study cohort into simultaneous heart-kidney and sequential heart-kidney recipients. We compared patient and death-censored graft survival using the Cox regression, adjusting for age at kidney transplant, sex, race, pre-transplant dialysis, donor type, and prior kidney transplant. We evaluated delayed graft function (defined as dialysis within the first week posttransplant) using logistic regression.

RESULTS:

Our analysis cohort included 165 recipients (86 simultaneous and 79 sequential). The incidence of delayed graft function was higher in simultaneous recipients (22.4 vs. 7.7%, p=0.017), but the difference lost statistical significance on multivariable analysis. We found no difference in patient survival (aHR 0.97; 95% CI 0.39, 2.41; p=0.95) after kidney transplant but higher death-censored kidney graft survival in sequential heart-kidney recipients compared with simultaneous heart-kidney recipients (aHR 4.26; 95% CI 1.21, 14.9; p=0.02).

CONCLUSION:

Sequential heart-kidney transplants are associated with higher death-censored kidney allograft survival in children compared with simultaneous heart-kidney transplants.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema de Registros / Trasplante de Corazón / Trasplante de Riñón / Supervivencia de Injerto Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2024 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: Sistema de Registros / Trasplante de Corazón / Trasplante de Riñón / Supervivencia de Injerto Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania