Cardiovascular disease risk in patients receiving organ transplantation: a national cohort study

Abstract

Although organ transplantation is the definitive treatment for end-stage organ failure, the post-transplant outcomes can be substantially influenced by cardiovascular complications. A national cohort study was performed to estimate risks of cardiovascular diseases in those with heart, lung, kidney, and liver transplantation. This cohort study consisted of 5978 solid organ transplantations identified using the Taiwan National Health Insurance Database. Cardiovascular and mortality risks in transplant recipients were evaluated using standardized incidence ratios, excess absolute risks, and standardized mortality ratios as compared to those in the general population. In heart, kidney, and liver recipients, the standardized incidence ratios of overall cardiovascular diseases were 9.41 (7.75-11.44), 3.32 (2.29-3.77), and 1.4 (1.15-1.7) and the overall standardized mortality ratios were 5.23 (4.54-6.03), 1.48 (1.34-1.63), and 3.95 (3.64-4.28), respectively. Except for heart organ recipients who were at highest risk for coronary artery disease with a standardized incidence ratio of 13.12 (10.57-16.29), kidney and liver organ recipients had a ninefold increased risk in developing deep vein thrombosis post-transplant. In conclusion, solid organ transplant patients are at risk of cardiovascular disease, in particular, deep vein thrombosis, which may warrant early identification of high-risk patients in addition to prompt and adequate thromboprophylaxis perioperatively.

Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures

“…Importantly, micro- and macrovascular cardiovascular co-morbidities are common in SOT, notably in kidney and heart transplant recipients[ 30 , 31 ]. First, patients are dependent on polypharmacy with a substantial risk of progressive atherosclerosis, notably calcineurin inhibitors and steroids[ 2 , 32 , 33 ].…”

“…But a national cohort study from Taiwan showed that even renal transplant recipients still have a twofold higher annual cardiovascular mortality than the general population. The study also included heart, lung, and liver recipients and demonstrated that SOT recipients were at an approximately threefold risk of developing any type of vascular disease[ 30 ].…”

Safety and efficacy of direct oral anticoagulants under long‐term immunosuppressive therapy after liver, kidney and pancreas transplantation

“…It remains unclear whether this is caused by the transplantation itself or a sequel of the underlying disease or an effect of the immunosuppressive medication. Nevertheless, available data indicate that patients after SOT are at high risk for thromboembolic complications [1,2].…”

“…Patients who underwent solid organ transplantation (SOT) are at higher risk of developing cardiovascular complications such as atrial fibrillation (AF) and venous thromboembolism (VTE) compared to the general population [1,2]. The cumulative incidence of new onset AF within 36 months after kidney transplantation is 7.3% [3].…”

Myocardial remodeling after kidney transplantation: a case report

“…The pathophysiological interaction between the heart and the kidneys, also known as the cardio-renal syndrome (CRS), often occurs in heart failure and is associated with deterioration of renal function, as well as worse prognosis of therapy and quality of life. Considering the high risk of cardiological burdens and, thus, the possible impaired graft perfusion, there is a discussion about whether there are a validity and chance for graft durability and how high the risk of postoperative complications will be [5, 6]. Prospective and retrospective studies showed a significant improvement in cardiac function after kidney transplantation [7, 8] even in cases of pronounced cardiac failure [9–11].…”