ArticleJHLT open2025
Corticosteroid use beyond 1-year post heart transplantation is associated with worse outcomes: A contemporary analysis of the ISHLT registry.
Article in JHLT open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Short-Term Care Burden After Left Ventricular Assist Device Implantation and Heart Transplant in the United States.Journal of the American Heart Association · 2026Article
- The impact of different immunosuppressants and acute immune rejection on clinical outcomes in diverse solid organ transplant recipients.Frontiers in immunology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Immunosuppressive drugs ensure graft survival in heart transplantation (HT). However, prolonged use can lead to significant morbidity and mortality, and the optimal immunosuppressive regimen is unknown. We compared outcomes in adult HT recipients with or without steroid use in the large, international ISHLT Registry. Methods: We included adults who underwent their first heart-only transplant between January 2010 and June 2018. We compared the risk-adjusted 2-, 3-, and 5-year survival as well as coronary allograft vasculopathy (CAV), treated rejection within 2 years, severe renal dysfunction, diabetes and malignancy rates between those with and without steroids by 1-year post-HT follow-up. Results: We included 17,483 HT recipients, steroids were discontinued in 8750 (50.0%) recipients beyond 1-year post-HT. Unadjusted survival rates (conditional upon 1-year survival) were significantly lower in the cohort receiving steroids at 2-years (96.2% vs. 98.0%, p<0.001), 3-years (93.3% vs. 96.5% p<0.001), and 5-years (89.8% vs. 94.0%, p<0.001). After adjustment, continued steroid use remained associated with a significantly higher risk of 2-year (HR 1.92, 95% CI 1.60-2.31), 3-year (HR 1.88, 95% CI 1.63-2.16), and 5-year mortality (HR 1.64, 95% CI 1.47-1.82). Furthermore, continuing steroid was associated with a significantly higher prevalence of CAV (OR 1.09, 95% CI 1.01-1.18), diabetes (OR 1.24, 95% CI 1.12-1.36), 2-year treated rejection (OR 2.50, 95% CI 2.25-2.73), and severe renal dysfunction (OR 1.66, 95% CI 1.50-1.84) but no difference in malignancy rates (OR 0.85, 95% CI 0.70-1.04). Conclusions: Steroid use beyond 1year post heart transplant was associated with significantly lower survival, and worsened morbidity among adult recipients. Whether this observation indicates steroid use is a marker of higher risk or worsens prognosis warrants prospective investigation.
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