Kidney Transplantation Confers Survival Benefit for Candidates With Pulmonary Hypertension

Overview

Journal Transplant Direct

Publisher Wolters Kluwer

Specialty General Surgery

Date 2022 Jul 15

PMID 35836668

Authors

Michelle C Nguyen

Teresa Po-Yu Chiang

Allan B Massie

Sunjae Bae

Jennifer D Motter

Daniel C Brennan

Niraj M Desai

Dorry L Segev

Jacqueline M Garonzik-Wang

Affiliations

Soon will be listed here.

Abstract

Methods: Using UR Renal Data System (2000-2018), we studied 90 819 adult KT recipients. Delayed graft function, death-censored graft failure, and mortality were compared between recipients with and without PtPH using inverse probability weighted logistic and Cox regression. Survival benefit of KT was determined using stochastic matching and stabilized inverse probability treatment Cox regression.

Results: Among 90 819 KT recipients, 2641 (2.9%) had PtPH. PtPH was associated with higher risk of delayed graft function (odds ratio, 1.23; 95% CI, 1.10-1.36; < 0.01), death-censored graft failure (hazard ratio [HR], 1.23; 95% CI, 1.11-1.38; < 0.01), and mortality (HR, 1.56; 95% CI, 1.44-1.69; < 0.01). However, patients with PtPH who received a KT had a 46% reduction in mortality (HR, 0.54; 95% CI, 0.48-0.61; < 0.01) compared with those who remained on the waitlist.

Conclusions: Although PtPH is associated with inferior post-KT outcomes, KT is associated with better survival compared with remaining on the waitlist. Therefore, KT is a viable treatment modality for appropriately selected patients with PtPH.

Citing Articles

Kidney transplantation in the presence of pulmonary hypertension: A clinical dilemma.

Farshbafnadi M, Ghannadzadeh Kermani Pour R, Sattarzadeh Badkoubeh R, Geraiely B, Mehrpooya M, Larti F Heliyon. 2024; 10(20):e39074.

PMID: 39640609 PMC: 11620137. DOI: 10.1016/j.heliyon.2024.e39074.

Association of Cardiopulmonary Hemodynamics and Outcomes in Pulmonary Hypertension Following Kidney Transplantation: A Multicenter Retrospective Cohort Study.

Jose A, Kumar S, Gorelik L, Friedman S, Flores A, Sese D Chest. 2024; 166(6):1499-1510.

PMID: 39181378 PMC: 11638545. DOI: 10.1016/j.chest.2024.08.013.

Complexities and outcomes of pulmonary hypertension in kidney transplant patients: a comprehensive review.

Lentine K, Levine D, Runo J, Caliskan Y, Costa S, Lam N Turkish J Nephrol. 2024; 33(1):8-26.

PMID: 38213512 PMC: 10783548.

Erratum: Kidney Transplantation Confers Survival Benefit for Candidates With Pulmonary Hypertension: Erratum.

Transplant Direct. 2023; 9(2):e1444.

PMID: 36700063 PMC: 9851685. DOI: 10.1097/TXD.0000000000001444.

Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis.

Brinza C, Covic A, Stefan A, Floria M, Popa I, Scripcariu D J Clin Med. 2022; 11(7).

PMID: 35407552 PMC: 8999673. DOI: 10.3390/jcm11071944.

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