Comparison of cardiac allograft vasculopathy incidence between simultaneous multiorgan and isolated heart transplant recipients in the United States
Prior studies have shown reduced development of cardiac allograft vasculopathy (CAV) in multiorgan transplant recipients. The aim of this study was to compare the incidence of CAV between isolated heart transplants and simultaneous multiorgan heart transplants in the contemporary era. We utilized th...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2024-10, Vol.43 (10), p.1737-1746 |
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| container_title | The Journal of heart and lung transplantation |
| container_volume | 43 |
| creator | Shahandeh, Negeen Kim, Juka S. Klomhaus, Alexandra M. Tehrani, David M. Hsu, Jeffrey J. Nsair, Ali Khush, Kiran K. Fearon, William F. Parikh, Rushi V. |
| description | Prior studies have shown reduced development of cardiac allograft vasculopathy (CAV) in multiorgan transplant recipients. The aim of this study was to compare the incidence of CAV between isolated heart transplants and simultaneous multiorgan heart transplants in the contemporary era.
We utilized the Scientific Registry of Transplant Recipients to perform a retrospective analysis of first-time adult heart transplant recipients between January 1, 2010 and December 31, 2019 in the United States. The primary end-point was the development of angiographic CAV within 5 years of follow-up.
Among 20,591 patients included in the analysis, 1,279 (6%) underwent multiorgan heart transplantation (70% heart-kidney, 16% heart-liver, 13% heart-lung, and 1% triple-organ), and 19,312 (94%) were isolated heart transplant recipients. The average age was 53 years, and 74% were male. There were no significant between-group differences in cold ischemic time. The incidence of acute rejection during the first year after transplant was significantly lower in the multiorgan group (18% vs 33%, p |
| doi_str_mv | 10.1016/j.healun.2024.06.014 |
| format | Article |
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We utilized the Scientific Registry of Transplant Recipients to perform a retrospective analysis of first-time adult heart transplant recipients between January 1, 2010 and December 31, 2019 in the United States. The primary end-point was the development of angiographic CAV within 5 years of follow-up.
Among 20,591 patients included in the analysis, 1,279 (6%) underwent multiorgan heart transplantation (70% heart-kidney, 16% heart-liver, 13% heart-lung, and 1% triple-organ), and 19,312 (94%) were isolated heart transplant recipients. The average age was 53 years, and 74% were male. There were no significant between-group differences in cold ischemic time. The incidence of acute rejection during the first year after transplant was significantly lower in the multiorgan group (18% vs 33%, p < 0.01). The 5-year incidence of CAV was 33% in the isolated heart group and 27% in the multiorgan group (p < 0.0001); differences in CAV incidence were seen as early as 1 year after transplant and persisted over time. In multivariable analysis, multiorgan heart transplant recipients had a significantly lower likelihood of CAV at 5 years (hazard ratio = 0.76, 95% confidence interval: 0.66-0.88, p < 0.01).
Simultaneous multiorgan heart transplantation is associated with a significantly lower long-term risk of angiographic CAV compared with isolated heart transplantation in the contemporary era.</description><identifier>ISSN: 1053-2498</identifier><identifier>ISSN: 1557-3117</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2024.06.014</identifier><identifier>PMID: 38950666</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute rejection ; Adult ; Allografts ; cardiac allograft vasculopathy ; coronary angiography ; Female ; Follow-Up Studies ; Graft Rejection - epidemiology ; heart transplantation ; Heart Transplantation - adverse effects ; Humans ; Incidence ; Male ; Middle Aged ; multiorgan transplantation ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Registries ; Retrospective Studies ; United States - epidemiology</subject><ispartof>The Journal of heart and lung transplantation, 2024-10, Vol.43 (10), p.1737-1746</ispartof><rights>2024 International Society for the Heart and Lung Transplantation</rights><rights>Copyright © 2024 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-1f01037ee93fe1167f259d88f1bc93f5491125ad0ac0fee86e19665e5c6b51053</cites><orcidid>0000-0002-7811-8063</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249824017066$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38950666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shahandeh, Negeen</creatorcontrib><creatorcontrib>Kim, Juka S.</creatorcontrib><creatorcontrib>Klomhaus, Alexandra M.</creatorcontrib><creatorcontrib>Tehrani, David M.</creatorcontrib><creatorcontrib>Hsu, Jeffrey J.</creatorcontrib><creatorcontrib>Nsair, Ali</creatorcontrib><creatorcontrib>Khush, Kiran K.</creatorcontrib><creatorcontrib>Fearon, William F.</creatorcontrib><creatorcontrib>Parikh, Rushi V.</creatorcontrib><title>Comparison of cardiac allograft vasculopathy incidence between simultaneous multiorgan and isolated heart transplant recipients in the United States</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>Prior studies have shown reduced development of cardiac allograft vasculopathy (CAV) in multiorgan transplant recipients. The aim of this study was to compare the incidence of CAV between isolated heart transplants and simultaneous multiorgan heart transplants in the contemporary era.
We utilized the Scientific Registry of Transplant Recipients to perform a retrospective analysis of first-time adult heart transplant recipients between January 1, 2010 and December 31, 2019 in the United States. The primary end-point was the development of angiographic CAV within 5 years of follow-up.
Among 20,591 patients included in the analysis, 1,279 (6%) underwent multiorgan heart transplantation (70% heart-kidney, 16% heart-liver, 13% heart-lung, and 1% triple-organ), and 19,312 (94%) were isolated heart transplant recipients. The average age was 53 years, and 74% were male. There were no significant between-group differences in cold ischemic time. The incidence of acute rejection during the first year after transplant was significantly lower in the multiorgan group (18% vs 33%, p < 0.01). The 5-year incidence of CAV was 33% in the isolated heart group and 27% in the multiorgan group (p < 0.0001); differences in CAV incidence were seen as early as 1 year after transplant and persisted over time. In multivariable analysis, multiorgan heart transplant recipients had a significantly lower likelihood of CAV at 5 years (hazard ratio = 0.76, 95% confidence interval: 0.66-0.88, p < 0.01).
Simultaneous multiorgan heart transplantation is associated with a significantly lower long-term risk of angiographic CAV compared with isolated heart transplantation in the contemporary era.</description><subject>acute rejection</subject><subject>Adult</subject><subject>Allografts</subject><subject>cardiac allograft vasculopathy</subject><subject>coronary angiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Rejection - epidemiology</subject><subject>heart transplantation</subject><subject>Heart Transplantation - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multiorgan transplantation</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>United States - epidemiology</subject><issn>1053-2498</issn><issn>1557-3117</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1TAQtBCIlsI_QMhHLgm2EzvJBQk98VGpEgfo2fKz131-cuxgO636P_jBOErhyGlXq5nZ3RmE3lLSUkLFh3N7AuXX0DLC-paIltD-GbqknA9NR-nwvPaEdw3rp_ECvcr5TAhhHWcv0UU3TpwIIS7R70OcF5VcjgFHi7VKximNlffxLilb8L3KevVxUeX0iF3QzkDQgI9QHgACzm5efVEB4prx1rqY7lTAKhhcRb0qYHA9NBVckgp58SoUnEC7xUEouUricgJ8G9yG_FEqIb9GL6zyGd481St0--Xzz8O35ub71-vDp5tGs56WhlpCSTcATJ0FSsVgGZ_MOFp61HXE-4lSxpUhShMLMAqgkxAcuBZHvnlzhd7vukuKv1bIRc4ua_B-_0d2ZOgHJkg3Vmi_Q3WKOSewckluVulRUiK3PORZ7nnILQ9JhKx5VNq7pw3rcQbzj_Q3gAr4uAOg_nnvIMms3eawcdWkIk10_9_wB6pVodo</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Shahandeh, Negeen</creator><creator>Kim, Juka S.</creator><creator>Klomhaus, Alexandra M.</creator><creator>Tehrani, David M.</creator><creator>Hsu, Jeffrey J.</creator><creator>Nsair, Ali</creator><creator>Khush, Kiran K.</creator><creator>Fearon, William F.</creator><creator>Parikh, Rushi V.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7811-8063</orcidid></search><sort><creationdate>202410</creationdate><title>Comparison of cardiac allograft vasculopathy incidence between simultaneous multiorgan and isolated heart transplant recipients in the United States</title><author>Shahandeh, Negeen ; Kim, Juka S. ; Klomhaus, Alexandra M. ; Tehrani, David M. ; Hsu, Jeffrey J. ; Nsair, Ali ; Khush, Kiran K. ; Fearon, William F. ; Parikh, Rushi V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-1f01037ee93fe1167f259d88f1bc93f5491125ad0ac0fee86e19665e5c6b51053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>acute rejection</topic><topic>Adult</topic><topic>Allografts</topic><topic>cardiac allograft vasculopathy</topic><topic>coronary angiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Rejection - epidemiology</topic><topic>heart transplantation</topic><topic>Heart Transplantation - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multiorgan transplantation</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shahandeh, Negeen</creatorcontrib><creatorcontrib>Kim, Juka S.</creatorcontrib><creatorcontrib>Klomhaus, Alexandra M.</creatorcontrib><creatorcontrib>Tehrani, David M.</creatorcontrib><creatorcontrib>Hsu, Jeffrey J.</creatorcontrib><creatorcontrib>Nsair, Ali</creatorcontrib><creatorcontrib>Khush, Kiran K.</creatorcontrib><creatorcontrib>Fearon, William F.</creatorcontrib><creatorcontrib>Parikh, Rushi V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shahandeh, Negeen</au><au>Kim, Juka S.</au><au>Klomhaus, Alexandra M.</au><au>Tehrani, David M.</au><au>Hsu, Jeffrey J.</au><au>Nsair, Ali</au><au>Khush, Kiran K.</au><au>Fearon, William F.</au><au>Parikh, Rushi V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of cardiac allograft vasculopathy incidence between simultaneous multiorgan and isolated heart transplant recipients in the United States</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2024-10</date><risdate>2024</risdate><volume>43</volume><issue>10</issue><spage>1737</spage><epage>1746</epage><pages>1737-1746</pages><issn>1053-2498</issn><issn>1557-3117</issn><eissn>1557-3117</eissn><abstract>Prior studies have shown reduced development of cardiac allograft vasculopathy (CAV) in multiorgan transplant recipients. The aim of this study was to compare the incidence of CAV between isolated heart transplants and simultaneous multiorgan heart transplants in the contemporary era.
We utilized the Scientific Registry of Transplant Recipients to perform a retrospective analysis of first-time adult heart transplant recipients between January 1, 2010 and December 31, 2019 in the United States. The primary end-point was the development of angiographic CAV within 5 years of follow-up.
Among 20,591 patients included in the analysis, 1,279 (6%) underwent multiorgan heart transplantation (70% heart-kidney, 16% heart-liver, 13% heart-lung, and 1% triple-organ), and 19,312 (94%) were isolated heart transplant recipients. The average age was 53 years, and 74% were male. There were no significant between-group differences in cold ischemic time. The incidence of acute rejection during the first year after transplant was significantly lower in the multiorgan group (18% vs 33%, p < 0.01). The 5-year incidence of CAV was 33% in the isolated heart group and 27% in the multiorgan group (p < 0.0001); differences in CAV incidence were seen as early as 1 year after transplant and persisted over time. In multivariable analysis, multiorgan heart transplant recipients had a significantly lower likelihood of CAV at 5 years (hazard ratio = 0.76, 95% confidence interval: 0.66-0.88, p < 0.01).
Simultaneous multiorgan heart transplantation is associated with a significantly lower long-term risk of angiographic CAV compared with isolated heart transplantation in the contemporary era.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38950666</pmid><doi>10.1016/j.healun.2024.06.014</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7811-8063</orcidid></addata></record> |
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| ispartof | The Journal of heart and lung transplantation, 2024-10, Vol.43 (10), p.1737-1746 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | acute rejection Adult Allografts cardiac allograft vasculopathy coronary angiography Female Follow-Up Studies Graft Rejection - epidemiology heart transplantation Heart Transplantation - adverse effects Humans Incidence Male Middle Aged multiorgan transplantation Postoperative Complications - epidemiology Postoperative Complications - etiology Registries Retrospective Studies United States - epidemiology |
| title | Comparison of cardiac allograft vasculopathy incidence between simultaneous multiorgan and isolated heart transplant recipients in the United States |
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