Cardiovascular (CV) disease is the leading cause of mortality in ESRD patients. A prolonged QTc interval on EKG is a predictor of adverse CV outcomes. Successful kidney transplantation confers a significant protection from CV death through unclear mechanisms. The purpose of our study was to assess the change in QTc intervals after kidney transplant.

Retrospective chart review was done on 309 kidney transplant recipients from 2014-2015 at Houston Methodist Hospital. QTc intervals were recorded on EKGs done 1 day pre-transplant, and 2 days, 2 weeks, 1 month, 3 months, and 6 months post-transplant. Linear mixed models were used to examine the change of QTc over time. Post hoc marginal pairwise comparisons were performed to create the adjusted means with p-values of QTc changes from baseline up to 6 months post-transplant. We further stratified patients into those with pre-op QTc prolongation and those without pre-op QTc prolongation.

Our population had a median age of 49 years, 61% were male, 40% Caucasian, 53% received deceased donor kidneys and 37% had pre-op prolonged QTc. With respect to all recipients, post-transplant mean QTc shortening was rapid and evident as early as 2 days post-op with a peak QTc decrease of 31.9 ms (p < 0.001) at 1 month post-op. This QTc shortening remained stable up to 6 months follow-up. For patients with pre-op prolonged QTc, they had a greater mean QTc shortening at 2 days post-op as compared to patients without pre-op prolonged QTc. Otherwise, a similar pattern of peak QTc shortening at 1 month follow-up which remained stable up to 6 months follow-up was noted in the 2 groups.

^ = p 0.004

* = p < 0.001

Our study demonstrates that there is rapid and long-lasting QTc interval shortening in patients receiving kidney transplants. The reduction in CV risk conferred by successful kidney transplantation may be partly explained by the QTc shortening seen in our cohort. The improved uremic milieu and stabilization of electrolytes that kidney transplantation provides could contribute to the rapid QTc shortening we observed.

CITATION INFORMATION: Lai E, Acharya V, Nguyen D, Graviss E, Suki W. Change in QTC Interval After Kidney Transplant. Am J Transplant. 2017;17 (suppl 3).

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