DeFilippis, Ersilia M.

Kidney dysfunction after heart transplantation (HT) is associated with significant morbidity and mortality. Recipient and perioperative factors may all influence the risk of kidney injury. Furthermore, data suggest that the incidence of kidney dysfunction, both acute and chronic, is increasing after the implementation of the United States’ 2018 allocation system due to increasing use of temporary mechanical circulatory support and changing recipient characteristics. While data are robust regarding nephroprotective therapies such as renin-angiotensin-aldosterone system inhibition and SGLT2i (sodium-glucose cotransporter 2 inhibitors) to minimize the progression of chronic kidney disease in patients with heart failure, data in HT recipients are beginning to emerge. This state-of-the-art review will critically examine the existing literature regarding the epidemiology of kidney dysfunction after HT, mitigation strategies for acute kidney injury and chronic kidney disease, including pharmacotherapeutics, the need for kidney transplantation after HT, and practical next steps for the larger HT community.

Background The purpose of this study was to examine gender differences in authorship of manuscripts in select high‐impact cardiology journals during the early coronavirus disease 2019 (COVID‐19) pandemic. Methods and Results All manuscripts published between March 1, 2019 to June 1, 2019 and March 1, 2020 to June 1, 2020 in 4 high‐impact cardiology journals ( Journal of the American College of Cardiology , Circulation , JAMA Cardiology , and European Heart Journal ) were identified using bibliometric data. Authors' genders were determined by matching first name with predicted gender using a validated multinational database (Genderize.io) and manual adjudication. Proportions of women and men first, co‐first, senior, and co‐senior authors, manuscript types, and whether the manuscript was COVID‐19 related were recorded. In 2019, women were first authors of 176 (22.3%) manuscripts and senior authors of 99 (15.0%) manuscripts. In 2020, women first authored 230 (27.4%) manuscripts and senior authored 138 (19.3%) manuscripts. Proportions of woman first and senior authors were significantly higher in 2020 compared with 2019. Women were more likely to be first authors if the manuscript's senior author was a woman (33.8% for woman first/woman senior versus 23.4% for woman first/man senior; P <0.001). Women were less likely to be first authors of COVID‐19‐related original research manuscripts ( P =0.04). Conclusions Representation of women as key authors of manuscripts published in major cardiovascular journals increased during the early COVID‐19 pandemic compared with similar months in 2019. However, women were significantly less likely to be first authors of COVID‐19‐related original research manuscripts. Future investigation into the gender‐disparate impacts of COVID‐19 on academic careers is critical.