Pre-transplant Chemotherapy Does Not Affect Cardiac Transplant Survival in Light-Chain Amyloid Patients

s S51 (HR= 1.3, 95% CI 1.1-1.6, p= 0.003, p interaction= 0.016). Amongst patients with RD, PRA was significantly higher in those with an elevated BUN/Creat (10.4 ± 19.3 vs. 4.4 ± 8.1 ng/ml/hr, p= 0.013). In the subgroup with PRA available, RD was not associated with increased mortality if PRA was below the median (HR= 0.14, 95% CI 0.02-1.2, p= 0.14). However, in patients with a PRA above the median, RD was strongly associated with reduced survival (HR= 2.7, 95% CI 1.2-5.9, p= 0.017, p interaction= 0.029). The risk associated with RD tended to be the greatest in patients with both high PRA and high BUN/Creat (HR= 3.5, 95% CI 1.1-11.3, p= 0.035). Conclusion: The risk associated with RD in patients with HF appears to be largely restricted to patients with renal neurohormonal activation evidenced by an elevated PRA or BUN/Creat ratio. Additional research is necessary to determine if renal function and outcomes can be improved with targeted therapy in these patients.