Is Renal Function after Heart Transplantation an Issue for Patients with Cardiac Amyloidosis?
Cedars Sinai Medical Center, Los Angeles.
Meeting: 2018 American Transplant Congress
Abstract number: B54
Keywords: Heart transplant patients, Outcome
Session Information
Session Name: Poster Session B: Heart and VADs: All Topics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: Cardiac amyloidosis (CA) (AL and ATTR) is an expanding indication for transplantation. Post-transplant renal function may be affected numerous factors including pre-transplant cardiorenal syndrome, renal involvement from amyloid, patient age, allograft rejection and immunosuppression. We sought to determine 1-yr post-transplant renal function by amyloid type in patients(pts) with CA who underwent heart transplant (HTx) alone.
Methods: Between 2008-16, 27 pts (6 AL, 9 ATTR-wildtype (wt), 12 ATTR-mutant (m)) underwent HTx for CA at our center. We evaluated change in creatinine and eGFR (MDRD) in the first post transplant year and compared with a control group (18 pts) transplanted for non-amyloid restrictive cardiomyopathy. We assessed 1-yr survival, and freedom from any treated rejection and cardiac allograft vasculopathy (CAV).
Results: Pts with ATTR were significantly older than AL pts or control at HTx (see table). Despite comparable renal function at baseline, AL and control pts had significantly better renal function at 1 year compared to ATTR and control pts, which may reflect younger age of AL and control pts at HTx. ATTR pts however maintained eGFR>50ml/min. 1 year survival, freedom from CAV and any treated rejection was comparable in all groups.
Conclusions: Despite potential for renal challenges in pts with CA, renal function appears preserved at 1-yr after HTx in appropriately selected pts.
| Endpoints | AL (n=6) | TTR wt senile (n=9) | TTR mutant (n=12) | Non-Amyloid Restrictive Control (n=18) | Log-Rank P-Value |
| Recipient Age ,mean ± SD | 60.1 ± 7.7 | 72.1 ± 2.5 | 67.2 ± 4.8 | 47.8 ± 14.3 | 0.0001 |
| 1-Yr Survival | 83.3% | 100% | 91.7% | 94.4% | 0.653 |
| 1-Yr Freedom from CAV | 100% | 77.8% | 91.7% | 88.9% | 0.659 |
| 1-Yr Freedom from Any-Treated Rejection | 100% | 100% | 100% | 100% | 1 |
| Baseline Cr, mean±SD | 1.10±0.46 | 1.29±0.25 | 1.5±0.45 | 1.19±1.11 | 0.7173 |
| Baseline eGFR, mean±SD | 65.6±33.2 | 57.1±11.7 | 55.5±15.5 | 61.7±35.1 | 0.8976 |
| 1-yr Cr, mean±SD | 0.90±0.2 | 1.46± 0.3 | 1.62±0.6 | 0.54±0.5 | <0.0001 |
| 1-yr eGFR, mean±SD | 75.4±16.1 | 50.1±12.57 | 53.7±17.8 | 81.2±39.7 | 0.0439 |
CITATION INFORMATION: Patel J., Kittleson M., Kransdorf E., Levine R., Dimbil S., Geft D., Chang D., Czer L., Kobashigawa J. Is Renal Function after Heart Transplantation an Issue for Patients with Cardiac Amyloidosis? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Patel J, Kittleson M, Kransdorf E, Levine R, Dimbil S, Geft D, Chang D, Czer L, Kobashigawa J. Is Renal Function after Heart Transplantation an Issue for Patients with Cardiac Amyloidosis? [abstract]. https://atcmeetingabstracts.com/abstract/is-renal-function-after-heart-transplantation-an-issue-for-patients-with-cardiac-amyloidosis/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress