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Abstract: FR-PO851

Cardiovascular Outcomes in Kidney Transplant Recipients With Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Chedid, Maroun, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kaidbay, Hasan-Daniel Nabil, Lebanese American University, Beirut, Beirut, Lebanon
  • Wigerinck, Stijn, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Zubidat, Dalia, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Reddy, Prajwal, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Duriseti, Parikshit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Issa, Naim S., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Zoghby, Ziad, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Hanna, Christian, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Senum, Sarah R., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Harris, Peter C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Nkomo, Vuyisile T., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Chebib, Fouad T., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Cardiovascular disease leads to high morbidity and mortality in patients with kidney failure who undergo kidney transplantation. Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a systemic disease with various cardiac abnormalities. However, details on the cardiovascular profile in ADPKD patients undergoing kidney transplantation (KT) and its progression following transplantation are limited

Methods

Echocardiographic data within 2 years prior to kidney transplantation (1993-2020), and MACE (major adverse cardiovascular events) post transplantation were retrieved. The primary outcome was to assess cardiovascular abnormalities on echocardiography at time of transplant in ADPKD as compared to diabetic (DN) and nondiabetic non-ADPKD (NDNA) (n=217 each group) patients, matched by gender (male, 59.4%) and age at transplantation (57.2 + 8.8 years) (Table 1)

Results

Compared with DN and NDNA patients at time of transplantation, patients with ADPKD had lower rates of left ventricular hypertrophy (39.4% vs 66.4% vs 48.6%), mitral (2.7% vs 6.3% vs 7.45) and tricuspid regurgitations (1.8% vs 6.6%, 7.2%) (Table 1). ADPKD patients had less diastolic (25.3%) and systolic (5.6%) dysfunction at time of transplantation. ADPKD patients had the most favorable post-KT survival (median survival 18.7 years vs 12.0 for DN and 13.8 years for NDNA; P<0.01) and the most favorable MACE-free survival rate (HR=0.51, P<0.001). Finally, ADPKD patients showed an improvement of systolic function post-KT compared to pre-transplantation (7.96 vs 6.20%, P=0.53); however, ADPKD patients had worsening of their valvular function and an increase in the sinus of Valsalva diameter (38.2 vs 39.9 mm, P<0.01).

Conclusion

ADPKD transplant recipients had the most favorable cardiac profile pre-transplantation with better patient survival and MACE-free survival rates but worsening valvular function and increasing sinus of Valsalva diameter, as compared to those with other kidney diseases.