Heart failure & cardiomyopathiesCohort study
10-Year Survival and Renal Outcomes After Simultaneous Heart-Kidney Transplantation in Heart Retransplant Recipients
- Retrospective cohort study
- registry-based (UNOS)
- multivariable Cox regression
- Fine-Gray competing risk models
Authors' conclusion
In re-HT recipients, SHKT was associated with sustained 10-year survival benefit and favorable renal trajectories, particularly in patients with moderate to severe renal dysfunction.
Study context
- Population
- Adults undergoing heart retransplantation, UNOS registry, 2000–2024304 (22%) re-SHKT
- Participants
- 1,378 adults
- Exposure
- re-SHKT vs Isolated re-HT
- re-SHKTn = 304
- Outcome
- Survival
- Follow-up
- 10 years
Main finding
10-year survival
Adjusted hazard ratio
0.51
95% CI 0.38–0.70
P < 0.001
By group
re-SHKT vs Isolated re-HT
adjusted HR 0.51 (95% CI 0.38–0.70); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Survival by pretransplant estimated glomerular filtration rate (eGFR) (subgroup)
- Survival benefit with eGFR <45 mL/min/1.73 m² but not with eGFR ≥45 mL/min/1.73 m²
Subsequent kidney transplantation
- re-SHKT associated with reduction in subsequent kidney transplantation
- 84%
Treated rejection episodes
- Fewer treated rejection episodes with re-SHKT
Isolated re-HT with baseline eGFR <45 mL/min/1.73 m²
- Graded increase in subsequent kidney transplantation and death before rescue transplantation
Original publication
10-Year Survival and Renal Outcomes After Simultaneous Heart-Kidney Transplantation in Heart Retransplant Recipients. JACC Heart Fail. Published 27 April 2026. doi:10.1016/j.jchf.2026.103115
Summarised from the published abstract; every number is checked against it