ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2023
Clinical trends, risk factors, and temporal effects of post-transplant dialysis on outcomes following orthotopic heart transplantation in the 2018 United States heart allocation system.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- Temporal trends and post-transplant outcomes in anthracycline-induced cardiomyopathy: A contemporary United Network for Organ Sharing analysis.JHLT open · 2026Article
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- Mitigating Risk of Kidney Dysfunction After Heart Transplantation and Therapeutic Approaches.Circulation. Heart failure · 2026Review
- Extended Criteria Donor Use in Heart Transplantation: A Promising Strategy to Expand the Donor Pool.Journal of clinical medicine · 2026Article
- Impact of Prolonged Impella 5.5 Support on Post-Transplant Outcomes: An Institutional Study.Clinical transplantation · 2026Article
- Impact of 2018 allocation system change on heart transplantation outcomes in china: a retrospective analysis.European journal of medical research · 2025Article
- Article
- Impact of post-transplant stroke and subsequent functional independence on outcomes following heart transplantation under the 2018 United States heart allocation system.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Improved waitlist and comparable post-transplant outcomes in simultaneous heart-kidney transplantation under the 2018 heart allocation system.The Journal of thoracic and cardiovascular surgery · 2024Article
- Heart Transplantation.Journal of clinical medicine · 2024Review
- Assessment of periodontal status in patients undergoing renal dialysis - A hospital-based study.Journal of Indian Society of PeriodontologyArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThis study evaluated the current clinical trends, risk factors, and temporal effects of post-transplant dialysis on outcomes following orthotopic heart transplantation after the 2018 United States adult heart allocation policy change.
methodsThe United Network for Organ Sharing (UNOS) registry was queried to analyze adult orthotopic heart transplant recipients after the October 18, 2018 heart allocation policy change. The cohort was stratified according to the need for post-transplant de novo dialysis. The primary outcome was survival. Propensity score-matching was performed to compare the outcomes between 2 similar cohorts with and without post-transplant de novo dialysis. The impact of post-transplant dialysis chronicity was evaluated. Multivariable logistic regression was performed to identify risk factors for post-transplant dialysis.
resultsA total of 7,223 patients were included in this study. Out of these, 968 patients (13.4%) developed post-transplant renal failure requiring de novo dialysis. Both 1-year (73.2% vs 94.8%) and 2-year (66.3% vs 90.6%) survival rates were lower in the dialysis cohort (p < 0.001), and the lower survival rates persisted in a propensity-matched comparison. Recipients requiring only temporary post-transplant dialysis had significantly improved 1-year (92.5% vs 71.6%) and 2-year (86.6 % vs 52.2%) survival rates compared to the chronic post-transplant dialysis group (p < 0.001). Multivariable analysis demonstrated low pretransplant estimated glomerular filtration (eGFR) and bridge with extracorporeal membrane oxygenation (ECMO) were strong predictors of post-transplant dialysis.
conclusionsThis study demonstrates that post-transplant dialysis is associated with significantly increased morbidity and mortality in the new allocation system. Post-transplant survival is affected by the chronicity of post-transplant dialysis. Low pretransplant eGFR and ECMO are strong risk factors for post-transplant dialysis.
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