TY - JOUR
T1 - Posttransplant lymphoproliferative disease and survival in adult heart transplant recipients
AU - Hayes, Don
AU - Tumin, Dmitry
AU - Foraker, Randi E.
AU - Tobias, Joseph D.
N1 - Publisher Copyright:
© 2016 Japanese College of Cardiology
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background The influence of posttransplant lymphoproliferative disease (PTLD) on long-term survival after heart transplantation (HTx) in adult recipients needs better characterization. Methods The United Network for Organ Sharing database was queried from 2006 to 2015 to compare survival between adult HTx recipients with and without PTLD. Cox proportional hazards models were used to analyze the primary outcome of survival, and competing-risks regression was used to analyze the outcome of PTLD development. Results A total of 14,487 HTx recipients who had data on PTLD were included in univariate Cox analysis and Kaplan–Meier survival function, while 10,422 were included in multivariable Cox analysis and 162 selected for a matched-pairs sample after matching on the propensity of developing PTLD. The cohort included 120 patients who were diagnosed with PTLD. Onset of PTLD, treated as a time-varying covariate, was adversely associated with survival in univariate (HR = 4.953; 95% CI: 3.768, 6.511; p < 0.001) and multivariable (HR = 3.849; 95% CI: 2.669, 5.552; p < 0.001) Cox proportional hazards models. Cox regression stratified on matched pairs of PTLD cases and non-PTLD controls confirmed the risk for death associated with PTLD onset (HR = 2.667; 95% CI: 1.043, 6.815; p = 0.040). Conclusions PTLD onset negatively influenced survival in adult HTx recipients, whereas no characteristics predisposing patients to PTLD development were identified in multivariate analysis.
AB - Background The influence of posttransplant lymphoproliferative disease (PTLD) on long-term survival after heart transplantation (HTx) in adult recipients needs better characterization. Methods The United Network for Organ Sharing database was queried from 2006 to 2015 to compare survival between adult HTx recipients with and without PTLD. Cox proportional hazards models were used to analyze the primary outcome of survival, and competing-risks regression was used to analyze the outcome of PTLD development. Results A total of 14,487 HTx recipients who had data on PTLD were included in univariate Cox analysis and Kaplan–Meier survival function, while 10,422 were included in multivariable Cox analysis and 162 selected for a matched-pairs sample after matching on the propensity of developing PTLD. The cohort included 120 patients who were diagnosed with PTLD. Onset of PTLD, treated as a time-varying covariate, was adversely associated with survival in univariate (HR = 4.953; 95% CI: 3.768, 6.511; p < 0.001) and multivariable (HR = 3.849; 95% CI: 2.669, 5.552; p < 0.001) Cox proportional hazards models. Cox regression stratified on matched pairs of PTLD cases and non-PTLD controls confirmed the risk for death associated with PTLD onset (HR = 2.667; 95% CI: 1.043, 6.815; p = 0.040). Conclusions PTLD onset negatively influenced survival in adult HTx recipients, whereas no characteristics predisposing patients to PTLD development were identified in multivariate analysis.
KW - Adult
KW - Heart transplantation
KW - Posttransplant lymphoproliferative disease
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84959889498&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2016.02.010
DO - 10.1016/j.jjcc.2016.02.010
M3 - Article
C2 - 26972343
AN - SCOPUS:84959889498
SN - 0914-5087
VL - 69
SP - 144
EP - 148
JO - Journal of Cardiology
JF - Journal of Cardiology
IS - 1
ER -