Post-Kidney Transplant Mortality Linked to Pre-Existing Heart Disease
Coronary artery disease before transplantation increases death risk by 77%, study finds.
Pre-existing coronary artery disease (CAD) and diabetes mellitus (DM) are independent risk factors for mortality in kidney transplant recipients, data presented at the 2016 American Transplant Congress in Boston suggest.
In a retrospective study of 878 patients who received deceased-donor kidneys from 1996 to 2014, Fabian Helleck, MD, of Charité University, Berlin, Germany, and colleagues found that CAD and DM are associated with a significant 77% and 53% increased risk of death after adjusting for all relevant factors and comorbidities. The study also identified HLA-mismatch and cold ischemia time as independent risk factors, increasing the risk of death by a significant 12% and 34%, respectively.
In addition, congestive heart failure (CHF) and peripheral artery disease (PAD) independently predicted a 2.2 times and 1.7 times increased risk for death-censored graft loss, respectively. Other independent risk factors included donor age and HLA-match.
The patients had a mean age of 53 years and a mean follow-up of 5.8 years. At the time of transplantation, the prevalence of CAD, DM, PAD, and CHF was 25%, 16%, 11%, and 8%, respectively.
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