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Kidney Week

Abstract: TH-PO171

Epidemiology and Prognostic Importance of Atrial Fibrillation in Kidney Transplant (KT): A Meta-Analysis

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Khoury, Nadeen J., Henry Ford Health, Detroit, Michigan, United States
  • Thongprayoon, Charat, Bassett Medical Center, Cooperstown, New York, United States
  • Bathini, Tarun J., Bassett medical center, Cooperstown, New York, United States
  • Chokesuwattanaskul, Ronpichai, King Chulalongkorn Memorial Hospital, Lansing, Michigan, United States
  • Cheungpasitporn, Wisit, University of Mississippi, Mississippi, Mississippi, United States
Background

This meta-analysis was conducted with aims to summarize all available evidence on prevalence of pre-existing atrial fibrillation (AF) and/or incidence of AF following kidney transplantation and the outcomes of KT recipients with AF.

Methods

A literature search was conducted utilizing MEDLINE, EMBASE and Cochrane Database from inception through March 2018. We included studies that reported 1) prevalence of pre-existing AF or incidence of AF following kidney transplantation or 2) outcomes of KT recipients with AF. Effect estimates from the individual study were extracted and combined utilizing random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018086192).

Results

8 cohort studies with 137,709 kidney transplant recipients were enrolled. Overall, the pooled estimated prevalence of pre-existing AF in patients undergoing kidney transplantation was 7.0% (95%CI: 5.6%-8.8%) and pooled estimated incidence of AF following kidney transplantation was 4.9% (95%CI: 1.7%-13.0%). Meta-regression analyses were performed and showed no significant correlations between year of study and either prevalence of pre-existing AF (p =0.93) or post-operative AF after kidney transplantation (p =0.16). The pooled OR of mortality among KT recipients with AF was 1.86 (3 studies; 95%CI: 1.03-3.35). In addition, AF is also associated with death-censored allograft loss (2 studies; OR: 1.55, 95%CI: 1.02-2.35) and stroke (3 studies; OR: 2.54, 95%CI: 1.11-5.78) among KT recipients.

Conclusion

The overall estimated incidence of AF following kidney transplantation is 4.9%. Despite advances in medicine, incidence of AF following KT doesn't seem to decrease over time. In addition, there is a significant association of AF with increased mortality, allograft loss, and stroke after kidney transplantation.