Risk of graft loss in kidney transplant recipients after aortic valve replacement

Authors

  • Stefan Büttner Medical Clinic III – Department of Nephrology, University Hospital Frankfurt, Frankfurt am Main, Germany; Medical Clinic I – Cardiology, Pneumology, Nephrology and Intensive Care Medicine, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany https://orcid.org/0000-0002-9085-2455
  • Carolin Zöller Medical Clinic III – Department of Nephrology, University Hospital Frankfurt, Frankfurt am Main, Germany; Medical Clinic II – Nephrology, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany; Medical Clinic III – Department of Cardiology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Sammy Patyna Medical Clinic III – Department of Nephrology, University Hospital Frankfurt, Frankfurt am Main, Germany https://orcid.org/0000-0001-7045-7696
  • Anisa Gradascevic Medical Clinic I – Cardiology, Pneumology, Nephrology and Intensive Care Medicine, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany https://orcid.org/0000-0002-9052-3985
  • Helge Weiler Medical Clinic I – Cardiology, Pneumology, Nephrology and Intensive Care Medicine, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
  • Mark Rosenberg Medical Clinic I – Cardiology, Pneumology, Nephrology and Intensive Care Medicine, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
  • Thomas Walther Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany https://orcid.org/0000-0002-2892-8949
  • Andreas M. Zeiher Medical Clinic III – Department of Cardiology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Helmut Geiger Medical Clinic III – Department of Nephrology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Mariuca Vasa-Nicotera Medical Clinic III – Department of Cardiology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Ingeborg Hauser Medical Clinic III – Department of Nephrology, University Hospital Frankfurt, Frankfurt am Main, Germany
  • Stephan Fichtlscherer Medical Clinic III – Department of Cardiology, University Hospital Frankfurt, Frankfurt am Main, Germany

DOI:

https://doi.org/10.17305/bjbms.2022.7720

Keywords:

Aortic valve stenosis, aortic valve replacement, TAVI, kidney transplant recipients, graft survival

Abstract

Surgical aortic valve replacement (SAVR) in kidney transplant recipients (KTR) is associated with high morbidity and mortality, and an increased risk of postoperative graft failure potentially leading to graft loss. Transcatheter aortic valve implantation (TAVI) emerged as an alternative in high-risk patients. However, data on TAVI in kidney transplant recipients are limited. We performed a retrospective analysis of 40 KTR in which aortic valve replacement was performed at our center between 2005 and 2015. The outcomes and follow-up of TAVI (n=20; 2010-2015) and SAVR (n=20; 2005-2015) were analyzed with respect to patient and graft survival. Baseline characteristics in both groups were comparable. Hospital stay after TAVI was significantly shorter compared to SAVR (19 [11.5-21.75] days vs. 33 [21-62] days, p=0.001). Acute graft failure occurred more frequently after SAVR (45% vs. 89.5%; p=0.006). Thirty-day mortality was 10% in both groups. However, in-hospital mortality reached 25% in the SAVR group (TAVI 10%), indicating a more complicated course after surgery. Moreover, during a median follow-up time of 1928 days in TAVI patients and 2717 days in patients after SAVR, graft loss occurred only in the surgically treated group (n=7). While one-year survival after TAVR was 90% compared to 69% after SAVR, long-term follow-up showed comparable results (at 5 years: TAVI 58% vs. 52% SAVR; log-rank-test: p=0.86). In KTR, TAVI can be performed with good mid- to long-term results. Compared to SAVR, renal outcomes seem to be improved after TAVI, suggesting better graft survival.

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Risk of graft loss in kidney transplant recipients after aortic valve replacement

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Published

2022-07-23

How to Cite

1.
Büttner S, Zöller C, Patyna S, Gradascevic A, Weiler H, Rosenberg M, Walther T, Zeiher AM, Geiger H, Vasa-Nicotera M, Hauser I, Fichtlscherer S. Risk of graft loss in kidney transplant recipients after aortic valve replacement . Bosn J of Basic Med Sci [Internet]. 2022Jul.23 [cited 2022Dec.6];. Available from: https://bjbms.org/ojs/index.php/bjbms/article/view/7720

Issue

Section

Translational and Clinical Research