Temporal Trends and Outcomes of Patients Undergoing Combined Organ Transplantation: Insights from the United Network for Organ Sharing (UNOS)

• Published in: The Journal of heart and lung transplantation Vol. 39; no. 4; pp. S167 - S168
• Main Authors: Briasoulis, A., Akintoye, E., Alvarez, P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2020.01.1126

Studies have shown that highly selected patients undergoing combined heart-kidney (HK) and heart-liver transplants (HL) have short- and long-term outcomes comparable to those observed in primary heart transplantation (HT). Adults patients with stage D heart failure that underwent combined HK, HLv and heart-lung (HL) were identified in the United Network for Organ Sharing (UNOS) registry between 1991 and 2016, with follow-up through March 2018. We conducted inverse-probability weighted estimator (IPWE) survival analysis of long-term survival stratified by type of combined organ transplant, accounting for donor, recipient and operative characteristics. We identified 2300 patients who underwent combined organ transplant (HK: 1,257, HLv: 212, HL: 831). HL recipients were more likely white (77%), females (58%), with congenital heart disease (44.5%), and longer waiting list time (median 195 days). HK transplant increased significantly during the study period where as HL decreased significantly (Figure). Median survival was 12.2 years for HK (95% Confidence intervals [CI], 10.8-12.8), 12 for HLv (95% CI 8.6-17.6) but significantly lower at 4.5 years for HL (95% CI 3.6-5.8) (Figure). Combined HK and HLv transplantation rates are increasing and long-term survival is comparable to primary HT, unlike HL which is associated with decreasing trends and significantly lower survival.