PMID- 28735990
OWN - NLM
STAT- MEDLINE
DCOM- 20180321
LR  - 20181202
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 49
IP  - 6
DP  - 2017 Jul - Aug
TI  - Echocardiographic Pulmonary Hypertension Predicts Post-transplantation Renal
      Allograft Failure.
PG  - 1256-1261
LID - S0041-1345(17)30341-X [pii]
LID - 10.1016/j.transproceed.2017.01.085 [doi]
AB  - BACKGROUND: Pulmonary hypertension in the setting of renal transplantation has
      been associated with early allograft dysfunction and increased mortality, but
      this relationship has not been extensively studied. METHODS: We performed a
      retrospective cohort study of adult patients who underwent their first renal
      transplantation in the years 2003-2009 and had pre-transplantation
      echocardiograms. Pulmonary hypertension was defined as right ventricular systolic
      pressure >/=40 mm Hg in the absence of left-sided valvular disease and/or left
      ventricular ejection fraction </=50%. Eighty-two of 205 patients (40%) met the
      inclusion criteria. The relationship between pulmonary hypertension and
      death-censored allograft failure (hemodialysis dependence or retransplantation)
      and serum creatinine was assessed with the use of Cox hazard regression and
      generalized mixed models. RESULTS: The presence of pulmonary hypertension was
      associated with a 3-fold increase in the risk of death-censored allograft failure
      (95% confidence interval, 1.20-7.32; P = .02). Failure rates were 19% at 24
      months and 51% at 96 months for those with pulmonary hypertension versus 7% at 24
      months and 20% at 86 months for those without pulmonary hypertension (P = .01).
      Among those without graft failure, there was an increase in creatinine levels
      after transplantation (P = .01). Effect estimates were unchanged by adjustment
      for multiple covariates and when pulmonary hypertension was defined as right
      ventricular systolic pressure >/=36 mm Hg. CONCLUSIONS: Pulmonary hypertension
      before renal transplantation carries a 3-fold increased risk of death-censored
      allograft failure. The relationship between the pulmonary circulation and renal
      allograft failure warrants further study.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Foderaro, A E
AU  - Foderaro AE
AD  - Department of Medicine, Alpert Medical School of Brown University, Providence,
      Rhode Island.
FAU - Baird, G L
AU  - Baird GL
AD  - Department of Surgery, Brown University School of Public Health, Providence,
      Rhode Island.
FAU - Bazargan-Lari, A
AU  - Bazargan-Lari A
AD  - Department of Health Services, Policy, and Practice, Alpert Medical School of
      Brown University, Providence, Rhode Island.
FAU - Morrissey, P E
AU  - Morrissey PE
AD  - Lifespan Biostatistics Core, Lifespan Hospital System, Providence, Rhode Island.
FAU - Gohh, R Y
AU  - Gohh RY
AD  - Department of Medicine, Alpert Medical School of Brown University, Providence,
      Rhode Island.
FAU - Poppas, A
AU  - Poppas A
AD  - Department of Medicine, Alpert Medical School of Brown University, Providence,
      Rhode Island.
FAU - Klinger, J R
AU  - Klinger JR
AD  - Department of Medicine, Alpert Medical School of Brown University, Providence,
      Rhode Island.
FAU - Ventetuolo, C E
AU  - Ventetuolo CE
AD  - Department of Medicine, Alpert Medical School of Brown University, Providence,
      Rhode Island; Department of Internal Medicine, Kaiser Permanente, West Los
      Angeles, California. Electronic address: corey_ventetuolo@brown.edu.
LA  - eng
GR  - 11FTF7400032/American Heart Association-American Stroke Association/United States
GR  - P20 GM103652/GM/NIGMS NIH HHS/United States
PT  - Evaluation Studies
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
SB  - IM
MH  - Adult
MH  - *Echocardiography
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*complications/diagnostic imaging/physiopathology
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Preoperative Period
MH  - Primary Graft Dysfunction/*etiology
MH  - Proportional Hazards Models
MH  - Retrospective Studies
PMC - PMC5567835
MID - NIHMS866087
EDAT- 2017/07/25 06:00
MHDA- 2018/03/22 06:00
CRDT- 2017/07/25 06:00
PHST- 2016/09/21 00:00 [received]
PHST- 2017/01/13 00:00 [revised]
PHST- 2017/01/24 00:00 [accepted]
PHST- 2017/07/25 06:00 [entrez]
PHST- 2017/07/25 06:00 [pubmed]
PHST- 2018/03/22 06:00 [medline]
AID - S0041-1345(17)30341-X [pii]
AID - 10.1016/j.transproceed.2017.01.085 [doi]
PST - ppublish
SO  - Transplant Proc. 2017 Jul - Aug;49(6):1256-1261. doi:
      10.1016/j.transproceed.2017.01.085.