Abstract: FR-PO1019
Simultaneous Heart-Kidney vs. Isolated Heart Transplantation in Advanced Heart Failure with CKD: Insights from a National Inpatient Sample Study
Session Information
- Transplantation: Clinical - Pharmacology and Nonkidney Solid Organ Transplants
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Ghimire, Manoj, St Barnabas Hospital, New York, New York, United States
- Poudel, Sajana, John H Stroger Jr Hospital of Cook County, Chicago, Illinois, United States
- Ghimire, Kalpana, St Barnabas Hospital, New York, New York, United States
- Dandamudi, Mrunalini, St Barnabas Hospital, New York, New York, United States
- Shrestha, Karun, St Barnabas Hospital, New York, New York, United States
- Subedi, Prakriti, St Barnabas Hospital, New York, New York, United States
- Sangam, Sangam, St Barnabas Hospital, New York, New York, United States
- Bhatta, Gaurab, St George University, Grenada, Grenada
- Mundhra, Gunjan, HCA Florida Orange Park Hospital, Orange Park, Florida, United States
- Madera, Irvianny, St Barnabas Hospital, New York, New York, United States
- Chaudhary, Sanjay, Mayo Clinic in Florida, Jacksonville, Florida, United States
- Flores Chang, Bessy Suyin, St Barnabas Hospital, New York, New York, United States
Background
Chronic kidney disease (CKD) is common in end-stage heart failure and worsens outcomes after heart transplantation (HT). Some patients develop new or worsening kidney dysfunction post-HT, leading to increased use of simultaneous heart-kidney transplants (SHKT). However, comparative data on SHKT versus HT alone remain limited. This study examines the clinical characteristics and in-hospital outcomes of patients with advanced heart and kidney failure undergoing SHKT versus HT alone.
Methods
We conducted a retrospective analysis of adult patients (≥18 years) in the National Inpatient Sample (NIS) database from 2016 to 2021 who underwent heart transplantation and had CKD, with an eGFR ≤45 mL/min/1.73 m2. Patients who were dialysis-dependent at the time of transplant were excluded. Using ICD-10 codes, we identified patients who received either HT alone or SHKT and compared their demographics, hospital outcomes, and complications.
Results
A total of 1775 patients met the inclusion criteria, with 380 undergoing SHKT and 1,395 undergoing HT alone. The mean age of the cohort was 55.5 ± 5.77 years, and 24% were female. There was an increasing trend of total HT and SHKT during the study period. Patients in the SHKT group had significantly shorter hospital stays than those in the HT-only group (mean, 66 vs. 58 days, p = 0.04). The incidence of cardiac arrest was significantly lower in the SHKT group (1.32% vs. 2.51%, p = 0.01). Other complications, including acute myocardial infarction (3.95% vs. 4.66%) and arrhythmia (72% vs. 75%), were also lower in the SHKT group, though not statistically significant. There was no significant difference in in-hospital mortality between the groups (11.8% vs. 10.3%, p = 0.72). Similarly, total hospital charges were comparable between SHKT and HT-only recipients.
Conclusion
SHKT is associated with shorter hospital stays and lower in hospital complications compared to heart transplant alone, with similar mortality and costs, supporting its use in patients with CKD. This study highlights the need for deeper investigation into long-term outcomes and the impact of transplantation on patients' quality of life.