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Choudhry S, Denfield SW, Dharnidharka VR, et al. Simultaneous pediatric heart-kidney transplant outcomes in the US: A-25 year National Cohort Study. Pediatr Transplant. 2021;e14149doi: 10.1111/petr.14149.
Choudhry, S., Denfield, S. W., Dharnidharka, V. R., Wang, Y., Tunuguntla, H. P., Cabrera, A. G., Price, J. F., & Dreyer, W. J. (2021). Simultaneous pediatric heart-kidney transplant outcomes in the US: A-25 year National Cohort Study. Pediatric transplantation, e14149. https://doi.org/10.1111/petr.14149
Choudhry, Swati, et al. "Simultaneous pediatric heart-kidney transplant outcomes in the US: A-25 year National Cohort Study." Pediatric transplantation vol. (2021): e14149. doi: https://doi.org/10.1111/petr.14149
Choudhry S, Denfield SW, Dharnidharka VR, Wang Y, Tunuguntla HP, Cabrera AG, Price JF, Dreyer WJ. Simultaneous pediatric heart-kidney transplant outcomes in the US: A-25 year National Cohort Study. Pediatr Transplant. 2021 Sep 28;e14149. doi: 10.1111/petr.14149. Epub 2021 Sep 28. PMID: 34585490.
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Pediatr Transplant. 2021 Sep 28;e14149. doi: 10.1111/petr.14149. Epub 2021 Sep 28.

Simultaneous pediatric heart-kidney transplant outcomes in the US: A-25 year National Cohort Study.

Pediatric transplantation

Swati Choudhry, Susan W Denfield, Vikas R Dharnidharka, Yunfei Wang, Hari P Tunuguntla, Antonio G Cabrera, Jack F Price, William J Dreyer

Affiliations

  1. Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
  2. Division of Pediatric Nephrology, Hypertension and Pheresis, Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri, USA.
  3. Section of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.

PMID: 34585490 DOI: 10.1111/petr.14149

Abstract

BACKGROUND: Pediatric sHKTx remains uncommon in the US. We examined outcomes of pediatric sHKTx compared to PHTx alone. Our objective was to identify a threshold eGFR that justified pediatric sHKTx.

METHODS: Data from the SRTR heart and kidney databases were used to identify 9245 PHTx, and 63 pediatric sHKTx performed between 1992 and 2017 (age ≤21 years).

RESULTS: The median age for sHKTx was 16 years, and included 31 males (31/63 = 49%). Over half of sHKTx (36/63 = 57%) were performed in cases where pretransplant dialysis was initiated. Among patients who required pretransplant dialysis, the risk of death in sHKTx recipients was significantly lower than PHTx alone (sHKTx vs. PHTx: HR 0.4, 95% CI [0.2, 0.9], p = .01). In those without pretransplant dialysis, there was no improvement in survival between sHKTx and PHTx (p = .2). When stratified by eGFR, PHTx alone recipients had worse survival than sHKTx in the group with eGFR ≤35 ml/min/1.73 m

CONCLUSION: Pediatric sHKTx should be considered in HTx candidates with kidney failure requiring dialysis or eGFR ≤35 ml/min/1.73 m

© 2021 Wiley Periodicals LLC.

Keywords: heart transplant; heart-kidney transplant; kidney transplant

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