Adverse in-hospital outcomes after radical or partial nephrectomy in cardiac transplant patients

Introduction: Cardiac transplant (CT) recipients represent a unique surgical population. However, it is unknown whether previous CT affects adverse in-hospital outcomes after partial nephrectomy (PN) or radical nephrectomy (RN). Methods: Using the National Inpatient Sample (2000–2019), we analyzed kidney cancer patients undergoing PN or RN. Descriptive analyses, 1:10 propensity score matching (PSM), and multivariable logistic and Poisson regression models were applied, stratifying patients according to previous CT status. Results: Overall, 39,373 patients underwent PN and 95,016 underwent RN; among them, 26 (0.1%) PN patients and 41 (0.1%) RN patients had a history of CT. CT status was not associated with significantly higher or lower rates of adverse in-hospital outcomes after either PN or RN. Specifically, among PN patients, CT was linked to higher rates of overall complications (+ 10.0%) and blood transfusions (+ 6.2%), but lower rates of cardiac (− 2.3%) and genitourinary complications (− 6.9%). Among RN patients, CT was associated with higher in-hospital mortality (+ 1.9%) but lower pulmonary complications (− 8.1%). After multivariable adjustment, CT status was not independently associated with any adverse in-hospital outcome for either PN or RN. Conclusion: Adverse in-hospital outcomes were similar between CT and non-CT patients undergoing PN or RN, with only small absolute differences. These findings suggest that carefully selected and optimized CT patients can safely undergo PN or RN, making both procedures feasible options in this population.