Abstract 3705: Long-Term Survival of Renal Transplant Patients in the US after Cardiac Valve Replacement and Impact of Valve Selection
There are no published data on the long-term outcome of renal transplant pts after valve surgery and impact of prosthesis type (tissue vs non-tissue). We searched the records of 1,698,706 pts in the United States Renal Data System database and identified 1363 renal transplant pts hospitalized from 1991–2004 for aortic (AVR) and/or mitral valve replacement (MVR). Long-term survival was estimated by Kaplan-Meier method and independent predictors of death were examined in a comorbidity-adjusted (by Charlson score) Cox model.
Results: The entire cohort was 17% age 0 – 44, 50% age 45– 64, 28% age 65–74, and 5% age 75+; 78% were white, 62% were male, and 20% had diabetes as the cause of renal failure. Tissue valves were received by 377 pts (28%). By site, 66% of pts had AVR, 25% MVR, and 9% both. Coronary artery bypass surgery (CAB) was performed in 37% of pts. In-hospital death was 14.2% The Table⇓ shows survival and predictors of death (non-tissue AVR is reference) with risk ratio (RR).
Conclusion: Valve replacement is associated with significant mortality in renal transplant pts. These data suggest survival of renal transplant pts after valve surgery is superior with tissue compared to non-tissue valves.