Pre-Transplant Left Atrial Volume Index and One-Year Morbidity After Kidney Transplantation

Area of Science:

• Nephrology
• Cardiology
• Transplant Medicine

Background:

• Pre-transplant echocardiography is standard for kidney transplant candidates.
• Current parameters primarily focus on cardiovascular events, leaving other complications under-evaluated.
• Left atrial volume index (LAVI), a marker of chronic diastolic burden, has not been well-studied in relation to overall post-transplant morbidity.

Purpose of the Study:

• To investigate the association between pre-transplant left atrial volume index (LAVI) and the spectrum of post-transplant complications.
• To determine if LAVI is a predictor of overall morbidity beyond cardiovascular events in kidney transplant recipients.

Main Methods:

• Retrospective cohort study of 242 adult kidney transplant recipients (2020-2022).
• Pre-transplant echocardiography performed within 12 months prior to transplantation.
• Primary outcome: composite of one-year post-transplant complications. Multivariable logistic regression adjusted for key clinical factors.

Main Results:

• Abnormal LAVI (>34 mL/m²) was present in 38.1% of patients, with preserved systolic function.
• Abnormal LAVI was significantly associated with the composite one-year post-transplant complication outcome (adjusted OR 2.01, p=0.027).
• A graded increase in complications was observed across LAVI tertiles (trend p=0.030); no specific complication category reached significance.

Conclusions:

• Pre-transplant elevated LAVI (>34 mL/m²) is associated with increased one-year post-transplant morbidity in kidney transplant recipients.
• The association demonstrates a graded relationship with LAVI severity.
• Findings are hypothesis-generating and warrant prospective validation for clinical application.