Yajima Shin, He Hao, Elde Stefan, Zhu Yuanjia, Woo Y Joseph, Shudo Yasuhiro
Department of Cardiothoracic Surgery, Stanford University, Stanford, CA.
Stanford Cardiovascular Institute, Stanford University, Stanford, CA.
JHLT Open. 2025 Aug 5;10:100364. doi: 10.1016/j.jhlto.2025.100364. eCollection 2025 Nov.
Simultaneous heart-kidney transplantation (HKTx) remains underutilized in regions outside the United States and Europe. Assessing the clinical outcomes of HKTx in Asian recipients is crucial for promoting its adoption in Asia. This retrospective study aimed to compare the survival outcomes of HKTx between Asian and non-Hispanic White (NHW) recipients with similar baseline characteristics.
This study included 1494 recipients aged ≥18 years who underwent HKTx for the first time between 2000 and 2022. Among them, 1392 were NHW and 102 were Asian. Propensity score matching was used to balance the baseline characteristics between the Asian and NHW recipients. Kaplan-Meier survival analysis and log-rank tests were utilized to evaluate and compare overall survival.
In the prematched cohort, the in-hospital mortality rates were 10.0% and 6.7% for Asian and NHW recipients, respectively (p=0.216). Kaplan-Meier mortality estimates at 1, 5, and 10 years were 17.3%, 42.2%, and 67.7% for Asians, and 14.6%, 35.5%, and 65.9% for NHW recipients (p=0.692), respectively. After matching, the in-hospital mortality rates were 10.0% for Asians and 6.6% for NHW recipients (p=0.355). Long-term 1-, 5-, and 10-year mortality rates remained comparable: 13.9%, 36.1%, and 62.5% for Asians, versus 10.7%, 34.3%, and 59.2% for NHW recipients, respectively (p=0.665).
Asian recipients demonstrated comparable long-term survival to NHW recipients after HKTx.
在美国和欧洲以外的地区，心脏-肾脏联合移植（HKTx）的应用仍然不足。评估亚洲受者接受HKTx的临床结局对于促进其在亚洲的应用至关重要。这项回顾性研究旨在比较具有相似基线特征的亚洲和非西班牙裔白人（NHW）受者接受HKTx后的生存结局。
本研究纳入了1494名年龄≥18岁、于2000年至2022年间首次接受HKTx的受者。其中，1392名是NHW受者，102名是亚洲受者。采用倾向评分匹配法来平衡亚洲和NHW受者之间的基线特征。利用Kaplan-Meier生存分析和对数秩检验来评估和比较总体生存率。
在匹配前的队列中，亚洲和NHW受者的住院死亡率分别为10.0%和6.7%（p=0.216）。亚洲受者1年、5年和10年的Kaplan-Meier死亡率估计分别为17.3%、42.2%和67.7%，NHW受者分别为14.6%、35.5%和65.9%（p=0.692）。匹配后，亚洲受者的住院死亡率为10.0%，NHW受者为6.6%（p=0.355）。长期1年、5年和10年死亡率仍然相当：亚洲受者分别为13.9%、36.1%和62.5%，NHW受者分别为10.7%、34.3%和59.2%（p=0.665）。
接受HKTx后，亚洲受者的长期生存率与NHW受者相当。
