DAPARHT

Presented in FS.07 at AHA 2026 (Sunday 8 November) and published simultaneously in Circulation. DAPARHT (Dapagliflozin for Renal Protection in Heart Transplant Recipients) is an investigator-initiated, double-blind, placebo-controlled trial at six heart transplant centres in Northern Europe, led from Oslo University Hospital (Kaspar Broch, Lars Gullestad) with Erasmus MC Rotterdam, UMC Groningen and UMC Utrecht among the centres. Between June 2022 and September 2025, 430 adult recipients at least one year after transplantation with an eGFR of 25 mL/min/1.73 m2 or more were randomised 1:1 to dapagliflozin 10 mg or placebo for 12 months (217 versus 213; 424 in the full analysis set). Mean age 53, 29 percent women, baseline eGFR 67, median 7 years after transplantation. Primary endpoint: the chronic eGFR slope from 2 weeks to 12 months. The eGFR rose by 2.0 (95 percent CI 1.0 to 3.1) mL/min/1.73 m2 with dapagliflozin versus 0.3 (minus 0.8 to 1.4) with placebo, a difference of 1.7 (0.1 to 3.3), P = 0.03. No unexpected safety signals; adverse events including infections were similar. The first randomised trial of an SGLT2 inhibitor in heart transplant recipients; a 24-month open-label extension follows.