Simultaneous heart-kidney transplantation outcomes in Asian populations in the United States: A United Network for Organ Sharing database study

Simultaneous heart-kidney transplantation (HKTx) remains underutilized in regions outside the United States and Europe. Assessing the clinical outcomes of HKTx in Asian recipients is crucial for promoting its adoption in Asia. This retrospective study aimed to compare the survival outcomes of HKTx between Asian and non-Hispanic White (NHW) recipients with similar baseline characteristics. This study included 1494 recipients aged ≥18 years who underwent HKTx for the first time between 2000 and 2022. Among them, 1392 were NHW and 102 were Asian. Propensity score matching was used to balance the baseline characteristics between the Asian and NHW recipients. Kaplan-Meier survival analysis and log-rank tests were utilized to evaluate and compare overall survival. In the prematched cohort, the in-hospital mortality rates were 10.0% and 6.7% for Asian and NHW recipients, respectively (p=0.216). Kaplan-Meier mortality estimates at 1, 5, and 10 years were 17.3%, 42.2%, and 67.7% for Asians, and 14.6%, 35.5%, and 65.9% for NHW recipients (p=0.692), respectively. After matching, the in-hospital mortality rates were 10.0% for Asians and 6.6% for NHW recipients (p=0.355). Long-term 1-, 5-, and 10-year mortality rates remained comparable: 13.9%, 36.1%, and 62.5% for Asians, versus 10.7%, 34.3%, and 59.2% for NHW recipients, respectively (p=0.665). Asian recipients demonstrated comparable long-term survival to NHW recipients after HKTx.