*PURPOSE: To characterize prevalence of chronic kidney disease (CKD) and risk for CKD progression as evidenced by changes in estimated glomerular filtration rate (eGFR) in first time (FT) and repeat (RT) heart transplant recipients. *METHODS: All heart transplants (HT) at our center were reviewed from 1995-2021. Renal function was determined by eGFR derived from CKiD U25 calculator using creatinine. FT and RT were matched by age at HT, race, and gender. Changes were analyzed over 6 years using a linear mixed effect model. Associations between the development of CKD stage 3 or higher (CKD3) at recent follow-up for RT and the following variables were assessed using univariate analysis: gender, age at RT, race, number of rejections, and pre-HT eGFR. *RESULTS: A total of 36 patients from each group were matched, with table 1 showing the clinical characteristics of our population. Median follow-up time was 3 years (RT) and 4 years (FT). FT eGFR remained stable throughout follow-up period, whereas RT declined at 3 years from HT. FT eGFR was significantly higher than RT at all time points (Figure 1). There was no significance between the development of CKD3 and the variables tested (p>0.05). *CONCLUSIONS: While eGFR remains stable in FT, CKD progresses after RT as evidenced by gradual decline in eGFR at 3 years after RT. Renal function needs close monitoring in collaboration with nephrology after RT. Further studies into the risk factors, specifically age at HT and pre-HT eGFR, for the development of CKD3 in RT are warranted. [

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]CITATION INFORMATION: Chan M., Silveira L., Patterson D., Bock M., Pietra B., Everitt M., Simpson K., Miyamoto S., Auerbach S. Longitudinal Changes in Renal Function in After First Time and Repeat Heart Transplantation in Children and Young Adults AJT, Volume 23, Issue 6, Supplement 1.

Melvin Chan MD

University of Colorado and Children's Hospital of Colorado

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