Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2011 Nov;15(7):699-705.
doi: 10.1111/j.1399-3046.2011.01564.x.

Risk factors for late renal dysfunction after pediatric heart transplantation: a multi-institutional study

Brian Feingold  1 , Jie Zheng, Yuk M Law, W Robert Morrow, Timothy M Hoffman, Kenneth B Schechtman, Anne I Dipchand, Charles E Canter; Pediatric Heart Transplant Study Investigators
Affiliations
Multicenter Study

Risk factors for late renal dysfunction after pediatric heart transplantation: a multi-institutional study

Brian Feingold et al. Pediatr Transplant. 2011 Nov.

Abstract

Renal dysfunction is a major determinant of outcome after HTx. Using a large, multi-institutional database, we sought to identify factors associated with late renal dysfunction after pediatric HTx. All patients in the PHTS database with eGFR ≥60 mL/min/1.73 m(2) at one yr post-HTx (n = 812) were analyzed by Cox regression for association with risk factors for eGFR <60 mL/min/1.73 m(2) at >1 yr after HTx. Freedom from late renal dysfunction was 71% and 57% at five and 10 yr. Multivariate risk factors for late renal dysfunction were earlier era of HTx (HR 1.84; p < 0.001), black race (HR 1.42; p = 0.048), rejection with hemodynamic compromise in the first year after HTx (HR 1.74; p = 0.038), and lowest quartile eGFR at one yr post-HTx (HR 1.83; p < 0.001). Renal function at HTx was not associated with onset of late renal dysfunction. Eleven patients (1.4%) required chronic dialysis and/or renal transplant during median follow-up of 4.1 yr (1.5-12.6). Late renal dysfunction is common after pediatric HTx, with blacks at increased risk. Decreased eGFR at one yr post-HTx, but not at HTx, predicts onset of late renal dysfunction. Future research on strategies to minimize late renal dysfunction after pediatric HTx may be of greatest benefit if focused on these subgroups.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURES

No author has a financial interest or other potential conflict of interest related to subject matter or materials mentioned in the manuscript.

Figures

Figure 1
Figure 1
Study population inclusion and exclusion details.
Figure 2
Figure 2
Freedom from late renal dysfunction after heart transplantation.
Figure 3
Figure 3
Normalized body mass (weight for length in children <2 years or body mass index in children ≥2 years) in the study population.
See this image and copyright information in PMC

Comment in

References

    1. Ojo AO, Held PJ, Port FK, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003 Sep 4;349(10):931–940. - PubMed
    1. Wilkinson AH, Cohen DJ. Renal failure in the recipients of nonrenal solid organ transplants. J Am Soc Nephrol. 1999 May;10(5):1136–1144. - PubMed
    1. Filler G, Sharma AP. High prevalence of chronic kidney disease in pediatric solid organ transplantation. Pediatr Transplant. 2009 Feb;13(1):7–10. - PubMed
    1. Lee CK, Christensen LL, Magee JC, Ojo AO, Harmon WE, Bridges ND. Pre-transplant risk factors for chronic renal dysfunction after pediatric heart transplantation: A 10-year national cohort study. J Heart Lung Transplant. 2007 May;26(5):458–465. - PubMed
    1. Ader JL, Rostaing L. Cyclosporin nephrotoxicity: Pathophysiology and comparison with FK-506. Curr Opin Nephrol Hypertens. 1998 Sep;7(5):539–545. - PubMed

Publication types

MeSH terms