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Age-Specific Graft Failure Rates in Pediatric Heart Transplant Recipients

B. Foster,1 M. Dahhou,1 X. Zhang,1 V. Dharnidharka,2 V. Ng,3 J. Conway.4

1Pediatrics, Research Institute of the McGill Univ. Health Centre, Montreal, QC, Canada
2Pediatrics, Washington Univ., St. Louis, MO
3Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
4Pediatrics, Stollery Children's Hospital, Edmonton, AB, Canada.

Meeting: 2015 American Transplant Congress

Abstract number: B11

Keywords: Age factors, Graft failure, Mortality, Pediatric

Session Information

Date: Sunday, May 3, 2015

Session Name: Poster Session B: "A Descent into the Maelstrom": Complications After Heart Transplantation

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

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Graft failure risk has been shown to peak during emerging adulthood (18-25 y) among kidney transplant recipients. The association between age and graft failure risk in heart transplant recipients is unknown; important differences may exist between organ types. We sought to estimate age-specific graft failure rates in young heart transplant recipients who had at least 6 months of graft function, and to estimate the relative hazards of graft failure at different ages, compared with at 21-24 years of age. We evaluated 11,473 patients recorded in the Scientific Registry of Transplant Recipients (SRTR) database who received a first heart transplant at <40 years old (1988-2012) and had at least 6 months of graft function; 6926 (60%) were <25 years at transplant. Time-dependent Cox models with time-varying covariates were used to estimate the association between age (time-dependent) and the risk of graft failure (defined as death after graft failure or re-transplant). Models included sex, race, era, socioeconomic status, insurer, comorbidity, and primary diagnosis. There were 2567 graft failures over a median follow-up of 5.9 years (IQR 2.7 – 10.6) years. Crude age-specific graft failure rates were highest in 21-24 year-olds (4.2 per 100 person-years). Compared to 21-24 year-olds with the same time since transplant, graft failure rates were significantly lower in 2-16 year-olds and in those ≥30 years old; failure rates were not significantly different in 17-20 year olds or 25-29 year-olds (HR 0.92 [95% CI 0.77, 1.09] for 17-20 year-olds and 0.86 [0.73, 1.03] for 25-29 year-olds). Among first heart transplant recipients <40 years old, older adolescents and young adults (17-29 years old) have the highest risk of graft failure, irrespective of age at transplant.

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To cite this abstract in AMA style:

Foster B, Dahhou M, Zhang X, Dharnidharka V, Ng V, Conway J. Age-Specific Graft Failure Rates in Pediatric Heart Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/age-specific-graft-failure-rates-in-pediatric-heart-transplant-recipients/. Accessed January 25, 2021.

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