Impact of Kidney Transplant on Post-Operative Morbidity and Mortality in Patients with Pre-Existing Cardiac Conditions (Low Ejection Fraction): A Case Series
Abdominal Transplant Surgery, UNC School of Medicine, Chapel Hill, NC
Meeting: 2022 American Transplant Congress
Abstract number: 216
Keywords: Echocardiography, Kidney transplantation, Morbidity, Mortality
Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications
Session Information
Session Name: Kidney: Cardiovascular and Metabolic Complications II
Session Type: Rapid Fire Oral Abstract
Date: Monday, June 6, 2022
Session Time: 3:30pm-5:00pm
Presentation Time: 3:30pm-3:40pm
Location: Hynes Veterans Auditorium
*Purpose: Patients with underlying cardiac diseases have higher morbidity and mortality as compared to the patients without any cardiac diseases. There has been a number of studies showing increased rates of complications, both cardiac and non-cardiac, and higher mortality in patients undergoing elective surgery. However, similar study done in kidney transplant patients showed different results. Aim of our study was to compare the morbidity and mortality after kidney transplant surgery in patients with and without cardiac disease.
*Methods: A retrospective analysis was done including 582 patients who underwent kidney transplant at a tertiary care center between 2014 and 2019. Participants for this study categorized into two groups: normal EF (n=540) and low EF (n=42). 9 patients in low EF group underwent heart/kidney transplant, so they were excluded, low EF (n= 33). Characteristics and outcomes of patients were compared before and after transplant using chi-square test (categorical measures), Kruskal-Wallis test and paired Student’s t test (continuous measures). Survival between groups was assessed using Kaplan-Meier test.
*Results: There was no significant difference in survival rates between low EF (EF<40%) and normal EF(p-value 0.33). Among patients with low EF, mean EF after transplant was significantly higher (mean: 55.83%, SD:5.75%) compared to their mean EF before transplant (mean: 38.28%, SD: 7.35%), p= <.0001. 21.21% of the patients with low EF before transplant had history of CAD, compared to 9.44% among those with normal EF, p= 0.0657. Post-transplant complications, especially MI was 0.56% in normal EF group as compared to 0 in low EF group. Graft survival was 93.89% at the end of 5 years in normal EF group as compared to 90.91% in low EF group. (Table 1)
*Conclusions: Patients with low ejection fraction do have significantly improved EF after kidney transplant. They do not show increased morbidity or mortality around or after the transplant as compared to people undergoing other elective surgeries. Cardiac events post-transplant is comparable to the normal EF group secondary to improved cardiac function.
|
Patient Characteristics |
Normal EF Group |
Low EF Group |
p-value |
| Observations, N (%) | 540, (94.24) | 33 (5.76) | <.0001 |
| Age (median, IQR) | 50 (22) | 46 (15) | 0.2054 |
| Hypertension | 83.70 | 96.97 | 0.0411 |
| History of Coronary Artery disease | 9.44 | 21.21 | 0.0657 |
| Patient survival, median (IQR) | 3.07 (2.32) | 3.51 (2.60) | 0.3357 |
| Pre-Transplant EF (mean, SD) | N/A | 38.28% (7.35%) | <.0001 |
| Post-Transplant EF (mean, SD) | N/A | 55.83% (5.75%) |
To cite this abstract in AMA style:
Kumar A, Naso C, Bacon D, Gerber D. Impact of Kidney Transplant on Post-Operative Morbidity and Mortality in Patients with Pre-Existing Cardiac Conditions (Low Ejection Fraction): A Case Series [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-kidney-transplant-on-post-operative-morbidity-and-mortality-in-patients-with-pre-existing-cardiac-conditions-low-ejection-fraction-a-case-series/. Accessed November 23, 2024.« Back to 2022 American Transplant Congress