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Incidence and magnitude of post-transplant cardiovascular disease after pediatric kidney transplantation: Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota. Pediatr Transplant 2018 Nov;22(7):e13283

Date

08/29/2018

Pubmed ID

30151948

DOI

10.1111/petr.13283

Scopus ID

2-s2.0-85052837780 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: KT recipients have increased the risk of CVD. The incidence of post-transplant CVEs among pediatric recipients has not been well-characterized.

PATIENTS AND METHODS: Between 1963 and 2015, 884 pediatric (age: 0-17 years old) recipients received 1058 KTs at our institution. The cumulative incidence of CVEs was analyzed. Statistical models were used to estimate risk factors for developing post-transplant CVEs.

RESULTS: Overall median patient survival was 33 years (IQR: 18.7-47). A total of 362 CVEs occurred in 161 (18.3%) patients at a median age of 20.5 years. Arrhythmias (18%) were most common. Cumulative risk of post-transplant CVEs was 9% at 10 years, 17% at 20 years, 25% at 30 years, and 36% at 40 years. Development of post-transplant CVEs was associated with increased mortality (HR 2.25 [95% CI 1.61-3.14]); of those who developed a CVE and died, 22/51 (43.1%) died of CVD. Multivariable risk factors for post-transplant CVEs included a history of pretransplant CVD (aHR 1.92 [1.18-3.13] and graft failure (4.57 [3.13-6.67]).

DISCUSSION: A pretransplant history of CVD and a failed graft are significant risk factors for the development of post-transplant CVE. CVD increases the risk of post-transplant death or graft loss.

Author List

Serrano OK, Bangdiwala AS, Vock DM, Chinnakotla S, Dunn TB, Finger EB, Kandaswamy R, Pruett TL, Najarian JS, Matas AJ, Chavers B

Author

Ty Blink Dunn MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Cardiovascular Diseases
Child
Child, Preschool
Female
Follow-Up Studies
Hospitals, University
Humans
Incidence
Infant
Infant, Newborn
Kaplan-Meier Estimate
Kidney Transplantation
Male
Minnesota
Postoperative Complications
Proportional Hazards Models
Retrospective Studies
Risk Factors