ArticleJournal of the American Heart Association2026
Survival Benefit of Heart-Kidney Versus Heart Transplant With or Without Delayed Kidney Transplant.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundSimultaneous heart-kidney transplantation (SHKT) or isolated heart transplantation (IHT) benefits patients with end-stage heart disease and kidney dysfunction. Understanding the outcomes, risk factors for post-IHT kidney transplantation, and survival benefits of SHKT compared with those of IHT and kidney-after-heart transplantation can guide clinical decision-making. This study aimed to evaluate IHT outcomes, identify risk factors for post-IHT isolated kidney transplantation, and compare the survival benefits of IHT, SHKT, and kidney-after-heart transplantation.
methodsThis retrospective study analyzed data from the United Network for Organ Sharing database, spanning 2000 to 2022. Adult patients (aged ≥18 years) who underwent their first IHT (n=48 069) or SHKT (n=2345) were included. Among patients undergoing IHT, 667 (1.4%) subsequently received isolated kidney transplantation. The primary outcome was patient survival, which was visualized by Kaplan-Meier analysis and assessed using the shared-frailty Cox proportional hazards model. Survival rates were compared among IHT, SHKT, and kidney-after-heart transplantation recipients. Logistic regression analysis identified risk factors for post-IHT isolated kidney transplantation.
resultsThe recipient's age, body mass index, pre-IHT diabetes, prior dialysis, and estimated glomerular filtration rate were significant risk factors for post-IHT isolated kidney transplantation. Kaplan-Meier analysis showed significantly higher survival with SHKT than with IHT (1-year: 88.0% versus 85.7%; 5-year: 70.5% versus 64.1%; 10-year: 38.1% versus 30.3%; overall
conclusionsSelected patients with end-stage heart disease and kidney dysfunction derive more long-term survival benefit from SHKT than from IHT.
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