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
. 2021 Nov;34(11):2297-2304.
doi: 10.1111/tri.14008. Epub 2021 Oct 19.

Cohort study: "Outcomes of kidney transplantation in patients with prosthetic heart valves"

Hajar Ouahmi  1   2 , Pamela Moceri  2   3 , Kevin Zorzi  1   2 , Laetitia Albano  1 , Matthieu Durand  4 , Fatimaezzahra Karimi  1 , Emmanuel Morelon  5 , Fanny Buron  5 , Moglie Le Quintrec  6 , Vincent Pernin  6 , Marc Ladriere  7 , Sophie Girerd  7 , Jacques Dantal  8   9 , Alexandre Loupy  10 , Lionel Couzi  11   12 , Emile Ferrari  3 , Vincent Esnault  1   2 , Pierre Merville  11   12 , Christophe Legendre  10 , Magali Giral  8   9 , Antoine Sicard  1   2   13 ; DIVAT Consortium
Collaborators, Affiliations
Free article

Cohort study: "Outcomes of kidney transplantation in patients with prosthetic heart valves"

Hajar Ouahmi et al. Transpl Int. 2021 Nov.
Free article

Abstract

The number of kidney transplant candidates with prosthetic heart valves (PHVs) is increasing. Yet, outcomes of kidney transplantation in these patients are still unclear. This is the first report of post-transplant outcomes in patients with PHVs at time of kidney transplantation. We conducted a matched cohort study among recipients from the multicentric and prospective DIVAT cohort to compare the outcomes in patients with left-sided PHVs at time of transplantation and a group of recipients without PHV matched according to age, dialysis time, initial disease, pretransplant DSA, diabetes, and cardiovascular events. Of 23 018 patients, 92 patients with PHVs were included and compared to 276 patients without PHV. Delayed graft function and postoperative bleeding occurred more frequently in patients with PHVs. Kidney graft survival was similar between groups. 5-year overall survival was 68.5% in patients with PHV vs. 87.9% in patients without PHV [HR, 2.72 (1.57-4.70), P = 0.0004]. Deaths from infection, endocarditis, and bleeding were more frequent in patients with PHV. Mechanical valves, but not bioprosthetic valves, were independent risk factors for mortality [HR, 2.89 (1.68-4.97), P = 0.0001]. Patients with PHV have high mortality rates after kidney transplantation. These data suggest that mechanical valves, but not biological valves, increase risks of post-transplant mortality.

Keywords: biological heart valve; cardiac valve replacement; end-stage kidney disease; kidney transplantation; mechanical heart valve; prosthetic heart valve.

PubMed Disclaimer

References

    1. Samad Z, Sivak JA, Phelan M, Schulte PJ, Patel U, Velazquez EJ. Prevalence and outcomes of left-sided valvular heart disease associated with chronic kidney disease. J Am Heart Assoc Cardiovasc Cerebrovasc Dis 2017; 6, e006044.
    1. Marwick TH, Amann K, Bangalore S, et al. Chronic kidney disease and valvular heart disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference. Kidney Int 2019; 96: 836.
    1. Rattazzi M, Bertacco E, Del Vecchio A, Puato M, Faggin E, Pauletto P. Aortic valve calcification in chronic kidney disease. Nephrol Dial Transplant 2013; 28: 2968.
    1. Williams ML, Bavaria JE, Acker MA, et al. Valve selection in end-stage renal disease: should it always be biological? Ann Thorac Surg 2016; 102: 1531.
    1. Phan K, Zhao DF, Zhou JJ, Karagaratnam A, Phan S, Yan TD. Bioprosthetic versus mechanical prostheses for valve replacement in end-stage renal disease patients: systematic review and meta-analysis. J Thorac Dis 2016; 8: 769.

LinkOut - more resources