Kidney transplant in patients with Prosthetic heart valves tied to increased mortality: Study
End-stage renal disease requiring transplantation in India is estimated to be between 151 and 232 per million population. Renal transplant is the most popular treatment known to mankind.
A new study by Hajar Ouahmi and team has found out that the mortality rate in patients with prosthetic heart valves (PHV) was more in Kidney transplant patients. The study is published in transplant international.
The objective of the study was the concern for increasing kidney transplant candidates with prosthetic heart valves (PHVs) and outcomes of kidney transplantation in those patients are unclear. This being the first report of post-transplant outcomes in patients with PHVs at time of kidney transplantation accoeding to the researchers.
The researchers conducted a matched cohort study among recipients from the multicentric and prospective DIVAT cohort to compare 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, pre-transplant DSA, diabetes and cardiovascular events.
The researchers found out of 23018 patients, 92 patients with PHVs were included and compared to 276 patients without PHV. Delayed graft function and post-operative 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 versus 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).
The researchers concluded that "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." Being the first ever study reported further study is needed to validate these findings.
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