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Pre-Transplant Cardiac Troponin T (cTT) Is a Strong Predictor of Post Kidney Transplant Hospitalizations

H. Amer, P. Geerdes, T. Fettes, R. Walker, E. Lorenz, F. Cosio.

The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.

Meeting: 2015 American Transplant Congress

Abstract number: 204

Keywords: Outcome, Outpatients, Risk factors, Safety

Session Information

Session Name: Concurrent Session: Kidney: Hospitalization/Readmission

Session Type: Concurrent Session

Date: Monday, May 4, 2015

Session Time: 2:15pm-3:45pm

 Presentation Time: 3:15pm-3:27pm

Location: Room 118-AB

Identifying patients at risk of re-hospitalization will permit improved monitoring and may decrease morbidity.

We examined nine objective variables at the time of transplant and their relationship with any hospitalization within the first year from transplant, within the first 30 days, between 30 days and one-year as well as those patients admitted > 2 times within the first year. Data was collected as part of routine clinical care and, in addition, a dedicated manual chart review was performed. In addition to demographics of; age, gender, race, BMI, first transplant, diabetes, donor source, dialysis status we measured total 25-hydroxy vitamin D (Vit D) and cTT.

From 2009 to 2012 609 patients received kidney transplants. Males 58%, Caucasian 90%, live donor source 83%, first transplant 80% and 41% were preemptive i.e. not on dialysis. Recipient age was 52 ± 14 years and BMI 28.5 ± 5.9 with 37% obese. Vit D was <30 ng/ml in 50% and cTT elevated in 51%. 25% > 0.01 < 0.04, 17 % >0.04 < 0.1 and 9% > 0.1 ng/ml. Within the first year of transplant 44% of patients were readmitted, 24 % off addmission occured within 30 days and 28 % beyond 30 days. Eight percent of patients had > 2 admissions within the first year. See table for the relationships.

Pre-transplant cTT is a strong independent predictor of post-kidney transplant re-hospitalizations.

Table 1
  Any Admission <30 days >30 days <365 days > 2 Admissions
Age (per year) 1.01 [0.99 – 1.02, 0.19] 1.00 [0.99- 1.01, 0.99] 1.02 [1.00- 1.03, 0.01] 1.02 [0.99- 1.04, 0.12]
Caucasian 1.52 [0.88- 2.62, 0.13] 1.21 [0.64- 2.3, 0.55] 1.52 [0.81- 2.89, 0.20] 1.71 [0.51- 5.68, 0.88]
Male 1.12 [0.86- 1.5, 0.28] 1.22 [0.84- 1.78, 0.30] 1.24 [0.87- 1.78, 0.23] 1.76 [0.96- 3.22, 0.07]
First Transplant 0.75 [0.50- 1.12, 0.16] 0.56 [0.36- 0.87, 0.01] 1.04 [0.67- 1.64, 0.9] 0.76 [0.37- 1.53, 0.44]
Pre-Emptive 0.67 [0.48- 0.9, 0.02] * 0.73 [0.50- 1.09, 0.13] 0.77 [0.53- 1.12, 0.18] 0.70 [0.36- 1.35, 0.29]
Live Donor 0.82 [0.53- 1.2, 0.35] 0.67 [0.43- 1.12, 0.13] 0.90 [0.56- 1.43, 0.65] 1.13 [0.49- 2.60, 0.77]
BMI 1.05 [1.02- 1.08, 0.001] * 1.03 [0.99- 1.06, 0.10] 1.04 [1.01- 1.08, 0.006] * 1.01 [0.96- 1.07, 0.63]
Diabetes 1.78 [1.23- 2.58, 0.002] 1.33 [0.87- 2.02, 0.183] 1.87 [1.26- 2.77, 0.002] 2.06 [1.10- 3.84, 0.02]
Vit D 0.99 [0.98- 1.01, 0.40] 0.99 [0.98- 1.01, 0.40] 1.00 [0.98- 1.01, 0.78] 0.99 [0.97- 1.02, 0.86]
Troponin T 15.4 [ 1.15- 207.44, 0.04] 0.77 [0.46- 12.91, 0.86] 23.44 [1.93- 284.9, 0.01] * 78.23 [4.99- 1226.26, <0.01] *
Odds ratio [CI, p]. * p<0.05 in Multivariate Analysis
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To cite this abstract in AMA style:

Amer H, Geerdes P, Fettes T, Walker R, Lorenz E, Cosio F. Pre-Transplant Cardiac Troponin T (cTT) Is a Strong Predictor of Post Kidney Transplant Hospitalizations [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-transplant-cardiac-troponin-t-ctt-is-a-strong-predictor-of-post-kidney-transplant-hospitalizations/. Accessed May 12, 2025.

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