Heart failure & cardiomyopathiesCohort study
Prevalence and Impact of Recurrent Rejection on Pediatric Heart Transplant Recipients
- Retrospective cohort study
- registry (Pediatric Heart Transplant Society database)
Authors' conclusion
Although prevalence of RR has decreased, children experiencing RR are at greatly increased risk for losing their graft, particularly those who have recurrent mixed or antibody-mediated rejection.
Study context
- Population
- Pediatric heart transplant recipients, Pediatric Heart Transplant Society database, January 2000–June 20201,035 (17%) with RR
- Participants
- 6,342 recipients
- Exposure
- Recurrent rejection vs 0 or 1 rejection episodes, and by type of recurrent rejection
- RRn = 1,035
- Outcome
- Prevalence of RR and its impact on CAV and graft loss
Main finding
As reported in the abstract
Freedom from CAV and from graft loss, by number of rejection episodes
| Outcome | RR | 0 episodes | 1 episode |
|---|---|---|---|
| Freedom from CAV | 96.6% | Not reported in the abstract | Not reported in the abstract |
| Freedom from graft loss | 56.3% | Not reported in the abstract | Not reported in the abstract |
Observational data: associations, not effects.
Further findings
Outcomes by type of RR (AMR, ACR, mixed)
Freedom from CAV
Freedom from graft loss
- Outcomes by type of RR (AMR, ACR, mixed) — Freedom from cardiac allograft vasculopathy (CAV) similar regardless of RR type
- P > 0.05
Outcomes by type of RR (AMR, ACR, mixed)
- Freedom from graft loss lower with recurrent mixed or AMR vs recurrent ACR
Black vs White children with RR
- Black children with RR had lower freedom from CAV and graft loss than White children
- P < 0.05 for all
Original publication
Prevalence and Impact of Recurrent Rejection on Pediatric Heart Transplant Recipients. J Am Coll Cardiol. Published 2 October 2024. doi:10.1016/j.jacc.2024.08.010
Summarised from the published abstract; every number is checked against it