Heart Transplant Scores Predict One-Year Survival Rates

Cheryl Clark, for HealthLeaders Media , September 8, 2011

For example, the patients who needed temporary circulatory support prior to transplant had the highest risk score of 7 points. Use of a ventricular assist device, other than the more common HeartMate II, counted 5 points, although reasons why are unclear.

A bilirubin count of 4 or higher was weighted at 4 and having dialysis between wait listing and transplant was scored at 3. Being female and being African American and being over age 60 each add three points.

When counted up, those patients who had conditions that tallied 20 points or more had a more than 50% chance of dying within one year, they found.

Those with the lowest scores, between zero and 2, had a 92.5% chance of one-year survival.

The research team was led by John V. Conte, MD, director of Johns Hopkins Heart Transplant program. Their findings are published in the September issue of the Annals of Thoracic Surgery.

According to the UNOS database, there were 3,196 people waiting for a heart on Monday across the country, but a shortage of donor hearts means that only about 2,000 transplants will be performed this year. For transplants performed between 2006 and 2007, 12% did not survive the full year, 19% did not survive three years and 25% did not survive five years.

Shah said that in general, heart transplant centers determine candidate eligibility based on how long a patient may have been on a transplant waiting list, and how sick he or she might be.

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