{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:19:57Z","timestamp":1753877997798,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1K23HL157610"],"award-info":[{"award-number":["1K23HL157610"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>While stroke is a well\u2010recognized complication of isolated heart transplantation, stroke in patients undergoing simultaneous heart\u2010liver (HLT) and heart\u2010kidney transplantation (HKT) has not been explored. This study assessed postoperative stroke incidence, risk factors, and outcomes in HLT and HKT compared with isolated heart transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The United Network for Organ Sharing database was queried for adult patients undergoing HLT, HKT, and isolated heart transplants between 1994 and 2022. Patients were stratified by presence of in\u2010hospital stroke after transplant. Post\u2010transplant survival at 1\u2010year was assessed using Kaplan\u2010Meier analysis and log\u2010rank tests. Separate multivariable logistic regression models were constructed to identify risk factors for stroke after HKT and HLT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2326 HKT recipients, 85 experienced stroke, and of 442 HLT recipients, 19 experienced stroke. Stroke was more common after HKT and HLT than after an isolated heart transplant (3.7% vs. 4.3% vs. 2.9%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). One\u2010year post\u2010transplant survival was lower in those with stroke among both HKT recipients (64.5% vs. 88.7%, p(log\u2010rank)\u00a0&lt;\u00a00.001) and HLT recipients (43.8% vs. 87.4%, p(log\u2010rank)\u00a0&lt;\u00a00.001. Pre\u2010transplant pVAD, prior stroke, postoperative dialysis, diabetes, prior cardiac surgery, and heart cold ischemic time were independent risk factors for stroke after HKT, after adjusting for age, sex, and need for blood transfusion on the waitlist. For HLT, postoperative dialysis was a significant risk factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Stroke is more common after HKT and HLT than after isolated heart transplant, and results in poor survival. Independent risk factors for stroke include pre\u2010transplant percutaneous VAD (HKT) and postoperative dialysis (HKT and HLT).<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15369","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T11:59:43Z","timestamp":1718971183000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Risk Factors for Stroke After Combined Heart\u2010Kidney and Heart\u2010Liver Transplantation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4255-9019","authenticated-orcid":false,"given":"Armaan F.","family":"Akbar","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital  Baltimore Maryland USA"},{"name":"Department of Surgery Johns Hopkins Hospital  Baltimore Maryland 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Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5132-0958","authenticated-orcid":false,"given":"Sung\u2010Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Johns Hopkins Hospital  Baltimore Maryland 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