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Abstract: SA-PO805

Racial Differences in Trends and Survival After Simultaneous Heart and Kidney Transplantation in the United States

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Okoh, Alexis K., Emory University School of Medicine, Atlanta, Georgia, United States
  • Ruberwa, Joseph, University of North Carolina System, Chapel Hill, North Carolina, United States
Background

Among patients with chronic kidney disease listed for Heart Transplantation (HT), survival outcomes are better after simultaneous heart and kidney transplantation (sHKT) than isolated HT. However, racial differences in utilization of sHKT and post sHKT survival are unknown.

Methods

The United Network for Organ sharing database was queried for data on all adult patients who underwent sHKT between January 1990 and December 2019. Recipients were classified based on self-reported race and ethnicity, including non- Hispanic White, non-Hispanic Black, Hispanic, and Asian. Trends in sHKT over five eras (1990-1995, 1996-2001, 2002-2007, 2008-2013, 2014-2019) were examined. Kaplan- Meier analysis was used to examine one- and five-year post-transplant survival over the eras and by race-ethnic groups. Median survival rates were estimated from Cox proportional Hazard modelling.

Results

During the study period, a total of 1872 patients (non-Hispanic White (n=1082), non-Hispanic Black (n=556), Hispanic (n=157), and Asian (n=77) underwent sHKT in the United States. A significant increase in utilization of sHKT from 3.9% in 1990 to 51.9% in 2019 was seen overall and proportionally by race-ethnic group. Both one- and five-year survival post-sHKT were comparable by race. 1-year [Log rank test; p=0.623], 5-year [Log rank test: p=0.063] with no observed differences. Risk adjusted median survival rates by race were estimated as: [Race; Years] Non-Hispanic White:11.9 non-Hispanic Black: 12.5, Hispanic:16.8, Asian: 13.2.

Conclusion

There has been an increasing trend in the utilization of sHKT over the past 3 decades. There were no differences in post-transplant survival at both one- and five years by race-ethnic groups. Estimated median survival after sHKT is 12-years and remains comparable by race-ethnic groups.