Heart failure & cardiomyopathies
Outcomes of Combined Heart and Kidney Transplantation Under the New Heart Allocation Policy: A United Organ Network for Organ Sharing Database Analysis
Authors' conclusion
The new heart allocation policy was associated with worse overall survival and decreased freedom from heart and kidney graft failure in HKT recipients.
Study context
- Population
- Combined heart and kidney transplantation (HKT) recipients, UNOS data283 matched pairs
- Participants
- 370 vs 533
- Exposure
- New vs old heart allocation policy
- NEWn = 370
- OLDn = 533reference
- Outcome
- Overall survival and freedom from heart and kidney graft failure
- Follow-up
- 1 year
Methodological detailspropensity-score matched, UNOS registry, Median follow-up 1099 days
- Propensity-score matched
- UNOS registry
- Median follow-up 1099 days
Main finding
As reported in the abstract
1-year overall survival
Hazard ratio
1.81
P = 0.007
mortality, multivariate Cox
Hazard ratio
1.81
P = 0.007
heart graft failure, multivariate Cox
Hazard ratio
1.83
P = 0.002
kidney graft failure, multivariate Cox
Observational data: associations, not effects.
Further findings
| Outcome | OLD | NEW |
|---|---|---|
| Ischemic time and travel distance | ||
| Heart ischemic time | 2.94 hours | 3.37 hours |
| Kidney ischemic time | 14.1 hours | 16.0 hours |
| Travel distance | 47 miles | 183 miles |
- Ischemic time and travel distance: all P<0.001
Annual HKT volume
- HKT in 2015
- 117
- HKT in 2020
- 237
- Increased ≈2-fold, mainly among patients not on hemodialysis
Survival and kidney graft failure, patients not on hemodialysis (subgroup)
- Worse survival and higher risk of kidney graft failure under new policy
Original publication
Outcomes of Combined Heart and Kidney Transplantation Under the New Heart Allocation Policy: A United Organ Network for Organ Sharing Database Analysis. Circ Heart Fail. Published 22 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →