Influence of mildly and moderately elevated pulmonary artery systolic pressure on post-renal transplantation survival and graft function
© 2018 Wiley Periodicals, Inc..
BACKGROUND: Severe pulmonary hypertension (PH) has been associated with decreased post-kidney transplant survival and increased rate of long-term cardiovascular complications. Despite a high prevalence of PH in patients with end-stage renal disease, data on post-transplant renal allograft survival in recipients with pre-existing mild-to-moderate PH are limited.
METHODS: The single-center retrospective study cohort consisted of 192 consecutive (2008-2015) renal transplant recipients with documented pretransplantation transthoracic echocardiogram (TTE) pulmonary artery systolic pressure (PASP). Mean age was 50.9 ± 12.4 years, 36.5% were females, and 81.25% were Caucasians.
RESULTS: Elevated PASP ≥ 37 mm Hg was present in 51 patients. Elevated PASP was more common in patients with decreased <50% left ventricular ejection fraction (13.73% vs 3.55%, P = 0.010); otherwise, there were no significant differences in baseline demographic (age, ethnicity, gender, and donor status) and clinical parameters between patients with normal and elevated PASP. Four-year mortality (5.7%) was not significantly affected by elevated PASP. However, elevated PASP was associated with significantly decreased estimated glomerular filtration rate (eGFR) at 1 year (52.26 vs 60.13 mL/min, P = 0.019) and 2 years (51.04 vs 60.28 mL/min, P = 0.006) post-transplant.
CONCLUSION: Mild and moderately elevated pre-kidney transplant PASP does not affect 4-year post-transplant mortality or graft loss. However, elevated pretransplant PASP is significantly associated with decreased 1 year and 2 years post-transplant eGFR. Preoperative echocardiographic evaluation for PH may be useful in predicting the probability of short-term renal graft and long-term graft dysfunction in these patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
|---|---|
| Enthalten in: |
Echocardiography (Mount Kisco, N.Y.) - 36(2019), 1 vom: 15. Jan., Seite 22-27 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wang, Stephani C [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 03.05.2019 Date Revised 03.05.2019 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/echo.14192 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM290441404 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM290441404 | ||
| 003 | DE-627 | ||
| 005 | 20231225064736.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/echo.14192 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0968.xml |
| 035 | |a (DE-627)NLM290441404 | ||
| 035 | |a (NLM)30411400 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wang, Stephani C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Influence of mildly and moderately elevated pulmonary artery systolic pressure on post-renal transplantation survival and graft function |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.05.2019 | ||
| 500 | |a Date Revised 03.05.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2018 Wiley Periodicals, Inc. | ||
| 520 | |a BACKGROUND: Severe pulmonary hypertension (PH) has been associated with decreased post-kidney transplant survival and increased rate of long-term cardiovascular complications. Despite a high prevalence of PH in patients with end-stage renal disease, data on post-transplant renal allograft survival in recipients with pre-existing mild-to-moderate PH are limited | ||
| 520 | |a METHODS: The single-center retrospective study cohort consisted of 192 consecutive (2008-2015) renal transplant recipients with documented pretransplantation transthoracic echocardiogram (TTE) pulmonary artery systolic pressure (PASP). Mean age was 50.9 ± 12.4 years, 36.5% were females, and 81.25% were Caucasians | ||
| 520 | |a RESULTS: Elevated PASP ≥ 37 mm Hg was present in 51 patients. Elevated PASP was more common in patients with decreased <50% left ventricular ejection fraction (13.73% vs 3.55%, P = 0.010); otherwise, there were no significant differences in baseline demographic (age, ethnicity, gender, and donor status) and clinical parameters between patients with normal and elevated PASP. Four-year mortality (5.7%) was not significantly affected by elevated PASP. However, elevated PASP was associated with significantly decreased estimated glomerular filtration rate (eGFR) at 1 year (52.26 vs 60.13 mL/min, P = 0.019) and 2 years (51.04 vs 60.28 mL/min, P = 0.006) post-transplant | ||
| 520 | |a CONCLUSION: Mild and moderately elevated pre-kidney transplant PASP does not affect 4-year post-transplant mortality or graft loss. However, elevated pretransplant PASP is significantly associated with decreased 1 year and 2 years post-transplant eGFR. Preoperative echocardiographic evaluation for PH may be useful in predicting the probability of short-term renal graft and long-term graft dysfunction in these patients | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Garcia, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Torosoff, Mikhail |e verfasserin |4 aut | |
| 700 | 1 | |a Fein, Steven A |e verfasserin |4 aut | |
| 700 | 1 | |a Ashar, Ata |e verfasserin |4 aut | |
| 700 | 1 | |a Chandolias, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Conti, David |e verfasserin |4 aut | |
| 700 | 1 | |a Lyubarova, Radmila |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Echocardiography (Mount Kisco, N.Y.) |d 1990 |g 36(2019), 1 vom: 15. Jan., Seite 22-27 |w (DE-627)NLM084856041 |x 1540-8175 |7 nnns |
| 773 | 1 | 8 | |g volume:36 |g year:2019 |g number:1 |g day:15 |g month:01 |g pages:22-27 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/echo.14192 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 36 |j 2019 |e 1 |b 15 |c 01 |h 22-27 | ||