Survival in Transplant Patients Hinges on Key Risk Factors

Only low-risk patients with both kidney and heart failure have survival benefit from double transplant

TUESDAY, March 17 (HealthDay News) -- Low-risk combined heart and kidney transplantation recipients with a low estimated glomerular filtration rate (eGFR) have improved survival after the transplantation when compared with isolated heart transplant recipients, according to research published in the March issue of the Archives of Surgery.

Mark J. Russo, M.D., of the Columbia University College of Physicians and Surgeons in New York City, and colleagues obtained United Network for Organ Sharing data on 19,373 heart transplant recipients from 1995 through 2005, including 19,109 patient who received a heart and 264 who received both a heart and a kidney. The researchers performed regression analysis to identify characteristics associated with long-term survival and also stratified risk based on kidney function (using eGFR).

For heart and kidney transplantation patients, one-year survival was 93.2 percent in the lowest risk group and 61.9 percent in the highest, the investigators found. Only low-risk patients with an eGFR less than 33 mL/min undergoing heart and kidney transplantation showed a significant survival benefit over isolated patients undergoing orthotopic heart transplantation who had similar eGFRs and risk scores.

"This study is important because, given the critical scarcity of donor organs, achieving maximal benefit from transplantation is predicated on understanding the risks and benefits associated with allocating organs to various populations of transplant candidates, especially for those who are candidates for simultaneous multiorgan transplantation in which two or more organs are allocated to a single recipient," the authors write.

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