Researchers presenting at the American Transplant Congress 2020 virtual scientific program reported that pre-existing pulmonary hypertension may increase the risk for graft failure and early patient death after kidney transplantation.
Of 92,721 kidney transplant recipients within the US Renal Data System, 2570 (2.8%) had pulmonary hypertension prior to surgery. Patients with the condition had worse survival than those without it: a median 9.0 vs 12.8 years after transplant, Michelle Chi Nguyen, MD, MPH, and colleagues from Johns Hopkins University in Baltimore, reported. The presence of pulmonary hypertension, compared with its absence, was significantly associated with 28%, 18%, and 54% higher risks for delayed graft function (DGF), death-censored graft failure, and patient mortality, respectively.
Among the subset of patients with pulmonary hypertension, recipients of living donor kidneys had a significant 88% lower risk of DGF than recipients of deceased-donor kidneys. Living-donor kidney transplant recipients also tended to have better patient survival than deceased-donor kidney recipients whether or not they had pulmonary hypertension.
These data can inform risk stratification and the transplant selection process, Dr Nguyen and colleagues concluded.
Nguyen MC, Chiang P, Motter J, et al. Pulmonary hypertension is associated with inferior graft and patient survival after kidney transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). Abstract 341. Presented at the ATC 2020 virtual congress.