{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T19:41:34Z","timestamp":1787686894394,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Simultaneous heart\u2013kidney transplantation (SHKT) or isolated heart transplantation (IHT) benefits patients with end\u2010stage heart disease and kidney dysfunction. Understanding the outcomes, risk factors for post\u2010IHT kidney transplantation, and survival benefits of SHKT compared with those of IHT and kidney\u2010after\u2010heart transplantation can guide clinical decision\u2010making. This study aimed to evaluate IHT outcomes, identify risk factors for post\u2010IHT isolated kidney transplantation, and compare the survival benefits of IHT, SHKT, and kidney\u2010after\u2010heart transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This retrospective study analyzed data from the United Network for Organ Sharing database, spanning 2000 to 2022. Adult patients (aged \u226518\u2009years) who underwent their first IHT (n=48\u2009069) or SHKT (n=2345) were included. Among patients undergoing IHT, 667 (1.4%) subsequently received isolated kidney transplantation. The primary outcome was patient survival, which was visualized by Kaplan\u2013Meier analysis and assessed using the shared\u2010frailty Cox proportional hazards model. Survival rates were compared among IHT, SHKT, and kidney\u2010after\u2010heart transplantation recipients. Logistic regression analysis identified risk factors for post\u2010IHT isolated kidney transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The recipient's age, body mass index, pre\u2010IHT diabetes, prior dialysis, and estimated glomerular filtration rate were significant risk factors for post\u2010IHT isolated kidney transplantation. Kaplan\u2013Meier analysis showed significantly higher survival with SHKT than with IHT (1\u2010year: 88.0% versus 85.7%; 5\u2010year: 70.5% versus 64.1%; 10\u2010year: 38.1% versus 30.3%; overall\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005). Compared with kidney\u2010after\u2010heart transplantation, SHKT tended to show lower short\u2010term survival but higher long\u2010term survival (5\u2010year: 72.1% versus 61.9%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.047; 10\u2010year: 42.9% versus 15.8%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Selected patients with end\u2010stage heart disease and kidney dysfunction derive more long\u2010term survival benefit from SHKT than from IHT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043669","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:43:09Z","timestamp":1772628189000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Survival Benefit of Heart\u2013Kidney Versus Heart Transplant With or Without Delayed Kidney Transplant"],"prefix":"10.1161","volume":"15","author":[{"given":"Shin","family":"Yajima","sequence":"first","affiliation":[{"name":"Stanford University","place":["Stanford"]},{"name":"Stanford Cardiovascular Institute, Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7029-6992","authenticated-orcid":false,"given":"Hao","family":"He","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7103-6148","authenticated-orcid":false,"given":"Stefan","family":"Elde","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford"]},{"name":"Stanford Cardiovascular Institute, Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5642-9883","authenticated-orcid":false,"given":"Yuanjia","family":"Zhu","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford"]},{"name":"Stanford Cardiovascular Institute, Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2506-492X","authenticated-orcid":false,"given":"Y. Joseph","family":"Woo","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford"]},{"name":"Stanford Cardiovascular Institute, Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4545-1273","authenticated-orcid":false,"given":"Yasuhiro","family":"Shudo","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford"]},{"name":"Stanford Cardiovascular Institute, Stanford University","place":["Stanford"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab724.0831"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000324"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-310794"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.053"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezac563"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.05.028"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.07.020"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16390"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16888"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16512"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001155"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.08.004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341x.2000.00118.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1198\/106186001317114938"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020363010465"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1214\/09-sts313"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16466"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.09.017"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02588.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12522"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.09.026"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.06.012"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.02.012"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2008.559"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2023.10.007"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12864"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2020.03.002"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02540.x"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.02.004"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.01.063"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1998.00787.x"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003125"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2007.08.017"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ac620b"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.043669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:09:42Z","timestamp":1782990582000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.043669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,3,17]]}},"alternative-id":["10.1161\/JAHA.125.043669"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.043669","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2025-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e043669"}}