#5854 RENAL TRANSPLANTATION: THE BEST THERAPEUTIC OPTION FOR HEART TRANSPLANT RECIPIENTS WITH ADVANCED CKD

Abstract

Abstract Background and Aims Chronic kidney disease is a frequent complication of heart transplant recipients (HT) and is associated with worse survival. Current literature shows that probably the best renal replacement therapy option for these patients is kidney transplantation (KT). The aim of our work is to assess the results of renal transplantation in HT recipients. Method Retrospective descriptive single-center study including all heart transplant recipients patients who received a kidney transplantation in our center between 1992 and 2022. Data on renal and overall vital survival as a well as the factors that could have influenced them and associated complications were analyzed. Results We included 14 patients, 64% men, with a mean age of 56 years at the time of the KT. A total of 30.8% received an anticipated KT. A total of 85.7% received a KT from a cadaveric donor. In 90% the induction immunosuppression consisted of thymoglobulin, prednisone, mycophenolate, and differed tacrolimus. The mean time between heart and kidney transplantation was 15 years. Six months after KT the mean GFR was 40 mil/min/1,73 m2, at 12 months 35 ml/min/1,73 m2 and at 5 years 30 ml/min/1,73 m2. Renal graft survival was 84% and patient survival was 93% at 10 years. Regarding complications, the most frequent were urological (38.5%) followed by infectious (30.8%). The incidence of acute rejection was 18%. Conclusion Our data confirms that kidney transplantation in heart transplant recipients has very positive results. It is necessary to promote collaboration between CT and RT units with the aim of identifying promptly those patients who are candidates for KT, being able to perform it in the best conditions (preemptive transplantation, possibility of living donor transplanation).