Simultaneous heart-kidney transplantation outcomes in Asian populations in the United States: A united network for organ sharing database study

JHLT Open Pub Date : 2025-08-05 DOI:10.1016/j.jhlto.2025.100364

Shin Yajima MD, PhD , Hao He PhD , Stefan Elde MD , Yuanjia Zhu MD, PhD , Y. Joseph Woo MD , Yasuhiro Shudo MD, PhD, Clinical Associate Professor

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Abstract

Purpose

Simultaneous heart-kidney transplantation (HKTx) remains underutilized in regions outside the United States and Europe. Assessing the clinical outcomes of HKTx in Asian recipients is crucial for promoting its adoption in Asia. This retrospective study aimed to compare the survival outcomes of HKTx between Asian and non-Hispanic White (NHW) recipients with similar baseline characteristics.

Methods

This study included 1494 recipients aged ≥18 years who underwent HKTx for the first time between 2000 and 2022. Among them, 1392 were NHW and 102 were Asian. Propensity score matching was used to balance the baseline characteristics between the Asian and NHW recipients. Kaplan–Meier survival analysis and log-rank tests were utilized to evaluate and compare overall survival.

Results

In the prematched cohort, the in-hospital mortality rates were 10.0% and 6.7% for Asian and NHW recipients, respectively (p=0.216). Kaplan–Meier mortality estimates at 1, 5, and 10 years were 17.3%, 42.2%, and 67.7% for Asians, and 14.6%, 35.5%, and 65.9% for NHW recipients (p=0.692), respectively. After matching, the in-hospital mortality rates were 10.0% for Asians and 6.6% for NHW recipients (p=0.355). Long-term 1-, 5-, and 10-year mortality rates remained comparable: 13.9%, 36.1%, and 62.5% for Asians, versus 10.7%, 34.3%, and 59.2% for NHW recipients, respectively (p=0.665).

Conclusion

Asian recipients demonstrated comparable long-term survival to NHW recipients after HKTx.

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同时心肾移植在美国亚洲人群中的结果：一个器官共享数据库研究的联合网络

目的：在美国和欧洲以外的地区，同步心肾移植（HKTx）的应用仍然不足。评估HKTx在亚洲接受者中的临床结果对于促进其在亚洲的采用至关重要。本回顾性研究旨在比较基线特征相似的亚裔和非西班牙裔白人（NHW）受者的HKTx生存结局。方法本研究纳入1494例在2000年至2022年间首次接受HKTx的年龄≥18岁的接受者。其中外籍1392人，亚裔102人。倾向评分匹配用于平衡亚洲和NHW受助人之间的基线特征。Kaplan-Meier生存分析和log-rank检验用于评估和比较总生存率。结果在预匹配队列中，亚洲和NHW接受者的住院死亡率分别为10.0%和6.7% （p=0.216）。亚洲人在1、5和10年时的Kaplan-Meier死亡率估计分别为17.3%、42.2%和67.7%，NHW接受者的Kaplan-Meier死亡率估计分别为14.6%、35.5%和65.9% （p=0.692）。匹配后，亚洲人的住院死亡率为10.0%，NHW接受者为6.6% （p=0.355）。长期1年、5年和10年死亡率保持可比性：亚洲人的死亡率分别为13.9%、36.1%和62.5%，而NHW接受者的死亡率分别为10.7%、34.3%和59.2% （p=0.665）。结论：亚洲受者在HKTx后表现出与NHW受者相当的长期生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JHLT Open

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