Predictors of Survival After Heart Transplant in the New Allocation System: A UNOS Database Analysis.

Autor:	Trivedi J; From the Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky., Pahwa S; From the Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky., Rabkin D; Department of Cardiovascular Surgery, Loma Linda University Hospital, Loma Linda, California., Gallo M; From the Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky., Guglin M; Division of Cardiovascular Disease, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana., Slaughter MS; From the Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky., Abramov D; Department of Cardiovascular Medicine, Loma Linda University Hospital, Loma Linda, California.
Jazyk:	angličtina
Zdroj:	ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2024 Feb 01; Vol. 70 (2), pp. 124-130. Date of Electronic Publication: 2023 Oct 20.
DOI:	10.1097/MAT.0000000000002070
Abstrakt:	Clinical predictors of posttransplant graft loss since the United Network for Organ Sharing (UNOS) heart allocation system change have not been well characterized. Single organ adult heart transplants from the UNOS database were identified (n = 10,252) and divided into a test cohort (n = 6,869, 67%) and validation cohort (n = 3,383, 33%). A Cox regression analysis was performed on the test cohort to identify recipient and donor risk factors for posttransplant graft loss. Based on the risk factors, a score (max 16) was developed to classify patients in the validation cohort into risk groups of low (≤1), mid (2-3), high (≥4) risk. Recipient factors of advanced age, Black race, recipient blood group O, diabetes, etiology of heart failure, renal dysfunction, elevated bilirubin, redo-transplantation, elevated pulmonary artery pressure, transplant with a durable ventricular assist device, or transplant on extracorporeal membrane oxygenation (ECMO) or ventilator were associated with more posttransplant graft loss. Donor factors of ischemic time and donor age were also associated with outcomes. One year graft survival for the low-, mid-, high-risk groups was 94%, 91%, and 85%, respectively. In conclusion, easily obtainable clinical characteristics at time of heart transplant can predict posttransplant outcomes in the current era. Competing Interests: Disclosure: The authors have no conflicts of interest to report. (Copyright © ASAIO 2023.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu