Observational Study of the Association between Atrial Fibrillation and In-Hospital Mortality during Hospitalization for Solid Organ Transplants in Spain from 2004 to 2021

Abstract

(1) Background: We analyzed the association between atrial fibrillation or atrial flutter (AF) and in-hospital mortality (IHM) among patients who underwent solid organ transplants in Spain from 2004 to 2021. (2) Methods: We gathered information from all hospital admissions for lung, liver, kidney, and heart transplants. (3) Results: A total of 71,827 transplants were analyzed (4598 lung transplants; 18,127 liver transplants; 45,262 kidney transplants; and 4734 heart transplants). One third of these were for women. Overall, the prevalence of AF was 6.8% and increased from 5.3% in 2004–2009 to 8.6% in 2016–2021. The highest prevalence of AF was found for heart transplants (24.0%), followed by lung transplants (14.7%). The rates for kidney and liver transplants were 5.3% and 4.1%, respectively. The AF code increased over time for all of the transplants analyzed (p < 0.001). The patients’ IHM decreased significantly from 2004–2009 to 2016–2021 for all types of transplants. AF was associated with a higher IHM for all of the types of transplants analyzed, except for heart transplants. (4) Conclusions: The prevalence of AF among patients admitted for solid organ transplants was highest for those who underwent heart transplants. The mortality rate during the patients’ admission for lung, liver, kidney, or heart transplants decreased over time. AF was independently associated with a higher risk of dying in the hospital for those who underwent lung, liver, or kidney transplants.

National Incidence, Outcomes, and Management Strategies for Pre- and Post-Transplant Atrial Fibrillation in Heart Transplant Recipients

“…1 AF is even more common in patients with advanced heart failure, making it an important comorbidity to consider in heart transplant recipients. 2–4 Despite the fact that AF is a highly prevalent and clinically significant comorbidity in the pre- and post-transplant setting, there is a scarcity of literature on the impacts of AF on recipient outcomes.. 5…”

“…1 AF is even more common in patients with advanced heart failure, making it an important comorbidity to consider in heart transplant recipients. [2][3][4] Despite the fact that AF is a highly prevalent and clinically significant comorbidity in the pre-and post-transplant setting, there is a scarcity of literature on the impacts of AF on recipient outcomes.. 5 To our knowledge, published data on the association between pre-transplant AF and post-transplant outcomes is limited to a single-center study of 639 heart transplant recipients in Germany. 6 The authors reported that pre-transplant AF was associated with increased 1-year post-transplant mortality in heart transplant recipients, but they did not assess any longer-term outcomes.…”