E. W. Beal1, S. Bennett1, N. Jaik1, G. Phillips2, S. Black1,4, T. Pesavento3,4, R. Higgins1,4, B. Whitson1,4 1Ohio State University,The Department Of General Surgery,Columbus, OH, USA 2Ohio State University,Center For Biostatistics,Columbus, OH, USA 3Ohio State University,Department Of Internal Medicine,Columbus, OH, USA 4Ohio State University,Comprehensive Transplant Center,Columbus, OH, USA
Introduction: Solid organ transplant recipients have a propensity for both having pre-existing and developing cardiovascular disease. End-stage organ dysfunction and immunosuppression may hasten the development. Due to the nature of transplant recipients, interventions are high risk in this population and can affect graft function. We sought to evaluate the impact of cardiovascular interventions (CI) long-term outcomes in abdominal transplant recipients.
Methods: We retrospectively queried a prospectively maintained solid organ transplant database to identify adult recipients undergoing initial transplant over an 11 year period (kidney, kidney-pancreas, or liver) whose continuing-care was performed at our quaternary medical center. We stratified cohorts into CI (percutaneous, coronary artery bypass, valve surgery and complex procedures) and No-CI. We evaluated graft and overall survival. Standard Kaplan-Meier survival analysis, Cox proportional hazard modeling were performed.
Results: During the study period, 714 abdominal organ transplants met study criteria: 140 patients underwent CI and 574 did not. There were no demographic differences. Mean time from transplant to CI was 1360 days. Those patients undergoing renal transplant and CI had a longer graft survival than those undergoing renal transplant no-CI (p=0.013). Late long-term survival (7-14 years) showed a 167% increased risk of death in the CI cohort as compared to no-CI patients in the adjusted Cox proportional hazard model (p=0.003).
Conclusion: While those patients undergoing CI have a longer graft survival and better short-term survival, their long-term survival is significantly decreased compared to those not undergoing CI.