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

Oscar K. Serrano, Ananta S. Bangdiwala, David M. Vock, Srinath Chinnakotla, Ty B. Dunn, Erik B. Finger, Raja Kandaswamy, Timothy L. Pruett, John S. Najarian, Arthur J. Matas, Blanche Chavers

Research output: Contribution to journalArticlepeer-review

3 Scopus 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.

Original languageEnglish (US)
Article numbere13283
JournalPediatric transplantation
Volume22
Issue number7
DOIs
StatePublished - Nov 2018

Keywords

  • cardiovascular disease
  • kidney transplant
  • long-term outcomes
  • pediatric

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