Abstract: SA-PO0673
Subsequent Kidney Transplantation in Heart-Only Transplant Recipients with Advanced Nondialysis-Dependent CKD at the Time of Heart Transplant
Session Information
- Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Mahajan, Ruchi Gupta, Atrium Health, Charlotte, North Carolina, United States
- Evans, Michael David, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background
Chronic kidney disease (CKD) is common in children and young adults with heart failure. There is limited data on subsequent kidney transplantation (SKTX) in heart-only recipients with advanced kidney disease. Herein, we present the incidence of SKTX within 10 years of heart transplant (HTX) in heart-only recipients with non-dialysis-dependent advanced CKD (estimated glomerular filtration rate [eGFR] < 45 mL/min/1.73 m2) at the time of HTX.
Methods
We used the Scientific Registry of Transplant Recipients to identify recipients aged < 25 years who underwent HTX between 1989 and 2022. The study cohort was divided into two groups based on eGFR at the time of HTX: eGFR <30 mL/min/1.73 m2 but not on dialysis, with eGFR 30-45 mL/min/1.73 m2. We used Kaplan-Meier methods to evaluate 10-year patient survival following the HTX.
Results
Our analysis cohort comprised of 386 heart-only transplants with non-dialysis-dependent advanced CKD and an eGFR of <30 ml/min/1.73 m2 (group A) and 651 recipients with an eGFR of 30-45 ml/min/1.73 m2 (group B). Twelve patients in group A and 10 patients in group B received a subsequent deceased/living donor kidney transplant within 10 years of the HTX. Table 1 shows the baseline characteristics of both groups. The 10-year patient survival for recipients in group A was 49.9% (95% CI 44.8–55.5) and for those in group B was 54.7% (95% CI 50.6–59.1)
Conclusion
The incidence of subsequent kidney transplantation was low within 10 years of heart-only transplants in children and young adults with non-dialysis-dependent advanced CKD. The high mortality in the HTX population could be contributing to it.
Baseline characteristics of patients (<25 years) receiving a subsequent kidney transplant within 10 years after a heart transplant.
| Heart transplant, eGFR<30 no dialysis | Heart transplant, eGFR 30-45 | |
| Number | 386 | 651 |
| Females n (%) | 164 (42.5) | 248 (38.1) |
| White | 306 (79.3) | 487 (74.8) |
| Age at heart Transplant (years) Median (IQR) | 0.50 [0.00, 15.00] | 2.00 [0.00, 17.00] |
| eGFR mL/min/1.73 m2 Median IQR) | 22.05 [14.90, 26.33] | 38.88 [35.10, 41.96] |
| Kidney Transplant | ||
| Number of transplants Living donor Deceased donor | 12 3 (25.0) 9 (75.0) | 10 6 (60.0) 4 (40.0) |
| Age at kidney transplant (years) Median (IQR) | 21.00 [19.50, 25.25] | 17.50 [13.50, 22.50] |
| Females (%) | 5 (41.7) | 2 (20.0) |
| White (%) | 9 (75.0) | 7 (70.0) |