Washington: Heart transplant patients at great risk of death in the year following their surgeries, could be forewarned and saved with the help of a formula, US scientists say.
“Donor hearts are a limited resource,” says John V. Conte, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and the senior author of the study.
“Now, we have a simple-to-use tool that is highly predictive of survival after a heart transplant, and can help guide organ allocation decisions.”
Conte and his colleagues pulled together a series of risk factors already associated with poor outcomes, such as age, race, gender, the cause of a patient`s heart failure and whether he or she was on dialysis, and then assigned a number of points to each factor.
The sum of those points created a score. The higher the score, the higher was the risk of death one year after transplant.
Some factors were weighted more heavily than others, such as female gender (three points); African-American race (three points), and the need for dialysis in the time between being put on the transplant waiting list and getting a transplant (five points).
Patients with the lowest scores — between zero and two — had a 92.5 percent chance of being alive 12 months after surgery.
Patients with so-called IMPACT scores — the acronym the researchers came up with for the Index for Mortality Prediction After Cardiac Transplantation — above 20 points had a less than 50 percent chance of survival one year after surgery. Every point on the scale increased the chance of death within one year by 14 percent.
“As clinicians, we make an educated risk of what the risk is going to be,” he says. “This tool provides a quantitative way to assess the risk.”
The study has been published in the journal Annals of Thoracic Surgery.