Pre-Transplant Left Atrial Volume Index and One-Year Morbidity After Kidney Transplantation

IF 1.8 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2026-08-11 DOI:10.1111/ctr.70638

Sajid Kadir, Andres Pelaez, Sandeep Sasidharan, Ronald Zolty

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引用次数: 0

Abstract

Objectives

Pre-transplant echocardiography is routinely performed in kidney transplant candidates, although it remains unclear which parameters are associated with the broad spectrum of post-transplant complications beyond cardiovascular events. Left atrial volume index (LAVI) reflects chronic diastolic burden, and its relationship with overall post-transplant morbidity has not been well defined.

Material and Methods

In a single-center retrospective cohort of 242 adults undergoing first kidney-only transplantation (2020 to 2022) with pre-transplant echocardiography within 12 months, the main outcome was a composite of one-year post-transplant complications. Multivariable logistic regression was adjusted for age, sex, BMI, diabetes, and deceased donor status.

Results

LAVI was abnormal (>34 mL/m²) in 83 of 218 patients (38.1%), with largely preserved systolic function (mean LVEF 59.1 ± 6.2%). Abnormal LAVI was associated with the composite outcome (69.5% versus 53.2%, adjusted OR 2.01, 95% CI 1.08 to 3.73, p = 0.027), with a graded increase across tertiles (trend p = 0.030). No individual complication category reached significance. Excluding cardiac events, the non-cardiac composite was similar in magnitude but not conventionally significant (adjusted OR 1.80, 95% CI 0.98 to 3.32). No other echocardiographic parameter was associated with the outcomes. Atrial fibrillation analyses were exploratory and should be interpreted cautiously.

Conclusions

Pre-transplant LAVI >34 mL/m² was associated with a higher burden of one-year post-transplant morbidity, with a graded relationship across severity. No individual complication category reached significance. These findings are hypothesis-generating and require prospective validation before clinical use.

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移植前左心房容积指数与肾移植后1年发病率。

目的：移植前超声心动图是肾移植候选人的常规检查，尽管目前尚不清楚哪些参数与心血管事件以外的广泛移植后并发症相关。左心房容积指数（LAVI）反映慢性舒张负荷，其与移植后总体发病率的关系尚未明确。材料和方法：在一项单中心回顾性队列研究中，242名接受首次纯肾移植（2020年至2022年）的成年人在12个月内进行了移植前超声心动图检查，主要结局是移植后1年并发症的综合。多变量logistic回归校正了年龄、性别、BMI、糖尿病和已故供体状态。结果：218例患者中，83例（38.1%）LAVI异常（>34 mL/m2），收缩期功能基本保留（平均LVEF 59.1±6.2%）。异常的LAVI与综合结果相关（69.5%对53.2%，校正OR 2.01, 95% CI 1.08 ~ 3.73, p = 0.027），并且在各分位中呈分级增加（趋势p = 0.030）。个别并发症类别无显著性差异。排除心脏事件，非心脏复合事件的程度相似，但不具有传统意义（校正OR 1.80, 95% CI 0.98至3.32）。没有其他超声心动图参数与结果相关。房颤分析是探索性的，应谨慎解释。结论：移植前LAVI >34 mL/m2与移植后一年较高的发病率负担相关，且随严重程度分级。个别并发症类别无显著性差异。这些发现是假设产生的，需要在临床应用前进行前瞻性验证。

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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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.