Journal article
Subsequent Kidney Transplant after Pediatric Heart Transplant: Prevalence and Risk Factors
American journal of transplantation, Vol.24(7), pp.1267-1278
02/29/2024
DOI: 10.1016/j.ajt.2024.02.027
PMCID: PMC11816832
PMID: 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 (pHT) from 1987-2020 aimed to determine the incidence of waitlisting for and completion of KT/pHT, risk factors for KT/pHT, and risk factors for non-receipt of a KT/pHT. Among pHT recipients, 3.4% were waitlisted for KT/pHT (median time of 14 years post-pHT). Among those waitlisted, 70% received a KT/pHT and 18% died on the waitlist at median time 0.8 years from KT/pHT waitlisting (median age of 20 years). Moderate-high sensitization at KT/pHT waitlisting (calculated panel reactive antibody (cPRA) ≥ 20%) was associated with lower likelihood of KT/pHT (adjusted hazard ratio (aHR)=0.67; 95% CI=0.47, 0.95). Waitlisting for HT simultaneous with KT (aHR = 3.73; 95% CI = 2.01, 6.92) was associated with increased risk of death on the KT/pHT waitlist. While 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 non-receipt of KT/pHT and death on the waitlist in prioritization criteria/guidelines for simultaneous heart-kidney transplantation.
Details
- Title: Subtitle
- Subsequent Kidney Transplant after Pediatric Heart Transplant: Prevalence and Risk Factors
- Creators
- Lucas D. G. Barrett - University of Iowa Carver College of Medicine, Medical Scientist Training Program, Iowa City, IAKelli K Ryckman - University of IowaAmber M Goedken - University of Iowa College of Pharmacy, Iowa City, IAEmily Jane S Steinbach - University of Iowa Stead Family Children’s Hospital, Iowa City, IAEllen van der Plas - Psychiatry Department, University of Iowa Hospitals & Clinics, Iowa City, IAGary Beasley - University of Iowa Stead Family Children’s Hospital, Iowa City, IARabia S Khan - University of Iowa Stead Family Children’s Hospital, Iowa City, IAVernat Exil - Division of Pediatrics, Cardiology, Saint Louis University, St. Louis, MODavid A Axelrod - Department of Surgery, University of Iowa, Iowa City, IALyndsay A Harshman - University of Iowa Stead Family Children’s Hospital, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.24(7), pp.1267-1278
- DOI
- 10.1016/j.ajt.2024.02.027
- PMID
- 38431077
- PMCID
- PMC11816832
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: R18HS029292; DOI: 10.13039/100000062, name: National Institute of Diabetes and Digestive and Kidney Diseases, award: R01DK128835; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000054, name: National Cancer Institute, award: 1R37CA266135-01A1, T32DK007690-29, T32 GM139776
- Language
- English
- Electronic publication date
- 02/29/2024
- Academic Unit
- Pharmacy; Psychiatry; Cardiology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Epidemiology; Iowa Neuroscience Institute; Surgery; Biology; Radiation Oncology; Pharmacy Practice and Science
- Record Identifier
- 9984568065502771
Metrics
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