The outcome of heart transplant recipients following the development of end-stage renal disease: analysis of the Canadian Organ Replacement Register (CORR).

Full Abstract

End-stage renal disease is a significant complication of heart transplantation (HTx), but our understanding of dialysis outcomes in HTx recipients remains limited. We performed a retrospective analysis looking at dialysis mortality in HTx recipients as compared to a matched dialysis cohort. We also examined outcomes with respect to kidney transplantation (KTx) in these cohorts. 2709 incident HTx recipients were captured from the Canadian Organ Replacement Register between 1981 and 2002. The incidence of dialysis after HTx was 3.9% (n = 105) and carried a greater crude mortality compared to HTx recipients not requiring dialysis (56.2% vs. 35.9%, p < 0.001). Compared to the matched dialysis cohort, survival of HTx patients on dialysis was also significantly worse (19% vs. 40%, p = 0.003). In those receiving a KTx, survival did not differ between the two cohorts; however, in those that did not receive a KTx the survival was significantly lower in the dialysis post-HTx group compared to the matched dialysis cohort (15.7% vs. 35.2%, p < 0.025). Our analysis suggests mortality on dialysis following HTx is greater than would be expected from a similar dialysis population, and KTx may abrogate some of this increased risk. Attention should be placed on preventing chronic kidney disease progression following HTx.

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Author information

Author/s: Alam, A (A); Badovinac, K (K); Ivis, F (F); Trpeski, L (L); Cantarovich, M (M);

Affiliation: Multiorgan Transplant Program, Department of Medicine, Royal Victoria Hospital, McGill University Health Centre, Montreal, Québec, Canada.

Journal and publication information

Publication Type: Journal Article

Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant), published in Denmark. (Language: eng)

Reference: 2007-Feb; vol 7 (issue 2) : pp 461-5

Dates: Created 2007/02/05; Completed 2007/03/20;

PMID: 17283490, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Canada - epidemiology
Cohort Studies
Disease Progression
Female
Heart Transplantation - adverse effects; mortality
Humans
Kidney Failure, Chronic - etiology; mortality; surgery

Kidney Transplantation - adverse effects; mortality
Male
Middle Aged
Registries - statistics & numerical data
Renal Dialysis - adverse effects; mortality
Retrospective Studies
Risk Factors
Survival Rate

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