Evidence map›Paper›PMID 42731581›Full record

ArticleClinical transplantation2026

Delayed Graft Function After Simultaneous Heart-Kidney Transplantation Across Heart Allocation Eras: Predictors and Impact on Kidney Graft Survival in a National Cohort.

Somaya Zahran, Tyler Zemla, Byron Smith, Andrew Rosenbaum, Naim S Issa, Hatem Amer, Andrew J Bentall, Alexander R Cortez, Samy M Riad

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Article in Clinical transplantation, 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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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Somaya ZahranDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-0112-0894
Tyler ZemlaDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0009-0005-2390-3557
Byron SmithDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-9318-2437
Andrew RosenbaumDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-9202-0233
Naim S IssaDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0003-3165-5184
Hatem AmerDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-9570-0506
Andrew J BentallDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-8495-9782
Alexander R CortezDepartment of Surgery, Division of Transplantation Surgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-9686-8052
Samy M RiadDivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0001-5737-9742

Funding

ASTS-Takeda Socio Economic & Racial Disparity (SERD) GrantFulk Career Development Award
6 · The paper itself

Abstract

backgroundDelayed graft function (DGF) is common after simultaneous heart-kidney (SHK) transplantation, yet its predictors and long-term consequences in contemporary practice remain incompletely defined. We evaluated the incidence, determinants, and impact of DGF on kidney graft outcomes in a national SHK cohort.

methodsUsing the Scientific Registry of Transplant Recipients, between 2014-2025, we identified adult SHK recipients. After exclusions, 1637 recipients were analyzed. Baseline characteristics were compared by DGF status. Multivariable logistic regression identified DGF predictors. Cox proportional hazards models assessed DGF association with death-censored and overall kidney graft survival.

resultsDGF occurred in 29.1% of recipients (n = 477). Independent predictors of higher DGF odds included higher recipient BMI, pre-transplant dialysis, longer cold ischemia time, and higher refitted KDRI (all p < 0.01). In the adjusted models for long-term kidney graft outcomes, DGF was associated with higher death-censored graft loss (HR 2.02, 95% CI 1.11-3.65; p = 0.021) and overall graft loss (HR 2.04, 95% CI 1.47-2.82; p < 0.001). DGF rates and graft outcomes did not differ by heart allocation era (p = 0.179), and DGF was not associated with higher kidney (p = 0.133) or heart rejection (p = 0.848) at 1 year.

conclusionDGF is frequent after SHK transplantation and identifies a high-risk subgroup with substantially inferior long-term kidney graft survival, independent of rejection and allocation era. Given the frequency of DGF and its adverse outcomes, future studies are needed to evaluate kidney-after-heart safety-net utilization and post-heart-transplant renal recovery to optimize outcomes and promote judicious kidney allocation in SHK candidates at high risk for DGF.

Indexed as

Delayed Graft FunctionGraft RejectionGraft SurvivalHeart TransplantationKidney Failure, ChronicKidney TransplantationPostoperative ComplicationsResource AllocationTissue and Organ ProcurementAdultFemaleFollow-Up StudiesGlomerular Filtration RateHumansIncidenceKidney Function Testsdeath censored graft failuredelayed graft functionsimultaneous heart kidney transplantation

Identifiers

PMID42731581
PMCPMC13570805

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.