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

Research output: Contribution to journalArticle

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 1 2018

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Kidney Transplantation
Statistical Factor Analysis
Cardiovascular Diseases
Pediatrics
Transplants
Kidney
Incidence
Statistical Models
Cardiac Arrhythmias
Survival
Mortality

Keywords

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

PubMed: MeSH publication types

  • Journal Article

Cite this

@article{addacaba5bc64eeb960dc34d7741b9f0,
title = "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",
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.",
keywords = "cardiovascular disease, kidney transplant, long-term outcomes, pediatric",
author = "Serrano, {Oscar K.} and Bangdiwala, {Ananta S} and Vock, {David M} and Srinath Chinnakotla and Dunn, {Ty B} and Finger, {Erik B} and Raja Kandaswamy and Pruett, {Timothy L} and Najarian, {John S.} and Matas, {Arthur J} and Chavers, {Blanche M}",
year = "2018",
month = "11",
day = "1",
doi = "10.1111/petr.13283",
language = "English (US)",
volume = "22",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Incidence and magnitude of post-transplant cardiovascular disease after pediatric kidney transplantation

T2 - Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota

AU - Serrano, Oscar K.

AU - Bangdiwala, Ananta S

AU - Vock, David M

AU - Chinnakotla, Srinath

AU - Dunn, Ty B

AU - Finger, Erik B

AU - Kandaswamy, Raja

AU - Pruett, Timothy L

AU - Najarian, John S.

AU - Matas, Arthur J

AU - Chavers, Blanche M

PY - 2018/11/1

Y1 - 2018/11/1

N2 - 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.

AB - 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.

KW - cardiovascular disease

KW - kidney transplant

KW - long-term outcomes

KW - pediatric

UR - http://www.scopus.com/inward/record.url?scp=85052837780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052837780&partnerID=8YFLogxK

U2 - 10.1111/petr.13283

DO - 10.1111/petr.13283

M3 - Article

C2 - 30151948

AN - SCOPUS:85052837780

VL - 22

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 7

M1 - e13283

ER -