ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2022
Optimal patient selection for simultaneous heart-kidney transplant: A modified cost-effectiveness analysis.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Survival Benefit of Heart-Kidney Versus Heart Transplant With or Without Delayed Kidney Transplant.Journal of the American Heart Association · 2026Article
- Simultaneous Heart and Kidney Transplantation Using Circulatory Death Donors: Are Kidney Graft Outcomes Comparable With Brain Death Donors?Transplantation direct · 2025Article
- A Paired Kidney Analysis of Simultaneous Heart-Kidney Transplantation and Kidney Transplantation After Heart Transplantation.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Clinical Outcomes for Heart-Alone and Multiorgan Transplant Under the New Heart Allocation Policy Era.Journal of the American Heart Association · 2025Article
- Charting the future of cardiorenal medicine: a vision for integration, innovation, and impact.Frontiers in nephrology · 2025Article
- Outcomes of Combined Heart-Kidney Transplantation in Older Recipients.Cardiology research and practice · 2023Article
- Current considerations for heart-kidney transplantation.Frontiers in transplantation · 2022Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
Increasing rates of simultaneous heart-kidney (SHK) transplant in the United States exacerbate the overall shortage of deceased donor kidneys (DDK). Current allocation policy does not impose constraints on SHK eligibility, and how best to do so remains unknown. We apply a decision-analytic model to evaluate options for heart transplant (HT) candidates with comorbid kidney dysfunction. We compare SHK with a "Safety Net" strategy, in which DDK transplant is performed 6 months after HT, only if native kidneys do not recover. We identify patient subsets for whom SHK using a DDK is efficient, considering the quality-adjusted life year (QALY) gains from DDKs instead allocated for kidney transplant-only. For an average-aged candidate with a 50% probability of kidney recovery after HT-only, SHK produces 0.64 more QALYs than Safety Net at a cost of 0.58 more kidneys used. SHK is inefficient in this scenario, producing fewer QALYs per DDK used (1.1) than a DDK allocated for KT-only (2.2). SHK is preferred to Safety Net only for candidates with a lower probability of native kidney recovery (24%-38%, varying by recipient age). This finding favors the implementation of a Safety Net provision and should inform the establishment of objective criteria for SHK transplant eligibility.
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Registered trials
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