{"doi":"10.1111/ctr.15019","title":"Reduced incidence of cardiac rejection in multi‐organ transplants: A propensity matched study","abstract":"BACKGROUND: Rejection remains a primary cause of graft loss after heart transplant (HT). Recognizing the immunomodulation of multi-organ transplant can enhance our understanding of the mechanisms of cardiac rejection. METHODS: This retrospective cohort study identified patients from the UNOS database with isolated heart (H, N = 37 433), heart-kidney (HKi, N = 1516), heart-liver (HLi, N = 286), and heart-lung (HLu, N = 408) transplants from 2004 to 2019. Propensity score matching reduced baseline differences between groups. Outcomes included risk of rejection prior to transplant hospital discharge and within 1 year, and mortality within 1 year of transplant. RESULTS: In the propensity score matched data, the relative risk of being treated for rejection prior to transplant hospital discharge was 61% lower for HKi (RR .39, 95% CI .29, .53) and 87% lower for HLi (RR .13, 95% CI .05, .37) compared to H. Similarly, the probability of being treated for rejection in the first year after transplant remained lower in HKi (RR .45, 95% CI .35, .57) and HLi (RR .13, 95% CI .06, .28) compared to H. The 1-year survival analysis revealed an equivalent risk of death in HKi (HR .84, 95% CI .68, 1.03) and HLi (HR 1.41, 95% CI .83, 2.41) compared to H, while HLu had a higher risk of death in the first year after transplant (HR 1.65, 95% CI 1.17, 2.33). CONCLUSIONS: Recipients of HKi and HLi experience a reduced risk of rejection when compared to H, but an equivalent risk of 1 yr mortality. These findings have important implications for the future of HT medicine.","journal":"Clinical Transplantation","year":2023,"id":362204,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9403,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":738695,"name":"Xuemei Zhang","orcid":"0000-0003-0705-4231","position":1,"is_corresponding":false},{"id":271803,"name":"Andrew B. Goldstone","orcid":"0000-0002-2875-1290","position":2,"is_corresponding":false},{"id":361421,"name":"Joseph W. Rossano","orcid":"0000-0002-8284-0673","position":3,"is_corresponding":false},{"id":800071,"name":"Matthew J. O’Connor","orcid":"0000-0003-3012-5464","position":4,"is_corresponding":false},{"id":289368,"name":"J. William Gaynor","orcid":"0000-0001-7955-5604","position":5,"is_corresponding":false},{"id":225541,"name":"Jonathan J. Edwards","orcid":"0000-0002-8153-7066","position":6,"is_corresponding":false},{"id":800070,"name":"Carol Wittlieb‐Weber","orcid":"0000-0002-1299-3201","position":7,"is_corresponding":false},{"id":1115324,"name":"Katsuhide Maeda","orcid":"0000-0002-3087-6316","position":8,"is_corresponding":false},{"id":783501,"name":"Jonathan B. Edelson","orcid":"0000-0003-3220-7922","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T01:14:19.266946Z","pmid":"37212365","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}