Abstract: TH-PO1024
Improvement of Functional Mitral Regurgitation After Living Donor Kidney Transplantation: The VINTAGE Study
Session Information
- Transplantation: Clinical - Outcomes, Malignancy, and Pathology
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Hidaka, Sumi, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Tsukahara, Tomoki, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Mochida, Yasuhiro, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Ishioka, Kunihiro, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Ohtake, Takayasu, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Tanabe, Kazunari, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
- Kobayashi, Shuzo, Shonan Kamakura General Hospital, Kidney Disease and Transplant Center, Kamakura, Japan
Group or Team Name
- Shonan Kamakura General Hospital, Kidney Disease and Transplant Center
Background
Functional mitral regurgitation (FMR) is common in patients with kidney failure and may reflect left atrial and ventricular remodeling caused by volume overload, pressure overload, and uremic cardiomyopathy. Kidney transplantation (KT) can induce cardiac reverse remodeling, but its effect on FMR remains unclear.
Methods
We analyzed 115 adult living donor KT recipients enrolled in the VINTAGE Study who underwent echocardiography before KT and at 1 year after KT. Patients with definite organic valvular disease, graft loss, or death within 1 year were excluded. The primary outcome was change in FMR severity, categorized as none, trivial, mild, moderate, or severe. Aortic regurgitation (AR) was evaluated as a comparator valvular lesion. Changes in left atrial diameter (LAD), left ventricular end-diastolic dimension (LVDd), atrial natriuretic peptide (ANP), and brain natriuretic peptide (BNP) were also assessed. Factors associated with worsening FMR and AR were examined using multivariable logistic regression.
Results
The mean recipient age was 54.1 years, 60.0% were male, and 42.6% underwent preemptive KT. Before KT, 76.5% had trivial FMR and 22.6% had mild, moderate, or severe FMR. At 1 year after KT, moderate and severe FMR had disappeared. Overall, FMR improved in 22 patients (19.1%), remained unchanged in 84 (73.1%), and worsened in 9 (7.8%), with a significant shift in FMR severity distribution (P=0.004). In contrast, AR did not significantly improve after KT (P=0.377). LAD decreased from 36.6 to 35.1 mm, LVDd from 48.6 to 44.0 mm, ANP from 74 to 35 pg/mL, and BNP from 61 to 20 pg/mL, all with P<0.001. Acute antibody-mediated rejection was independently associated with worsening FMR (OR 4.02, 95% CI 1.81–8.91, P<0.001). A history of arrhythmia and stroke was associated with worsening AR.
Conclusion
Successful living donor KT was associated with significant improvement of FMR, but not AR, in patients with kidney failure. The improvement of FMR was accompanied by reductions in LAD, LVDd, ANP, and BNP, suggesting left atrial and ventricular reverse remodeling after relief of cardiorenal overload. Acute rejection may attenuate this cardioprotective effect. These findings highlight FMR improvement as another important cardiovascular benefit of successful KT.
Acknowledgment
We appreciate the support provided by Katsunori Shimada, PhD (STATZ Institute Inc.,Japan), who provided expert assistance with statistical analysis.
Funding
- Clinical Revenue Support