Researchers develop new way to predict heart transplant survival

September 1, 2011, Johns Hopkins University

(Medical Xpress) -- Johns Hopkins researchers say they have developed a formula to predict which heart transplant patients are at greatest risk of death in the year following their surgeries, information that could help medical teams figure out who would benefit most from the small number of available organs.

“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 , and can help guide organ allocation decisions.”

Conte and his colleagues, writing in the September issue of Annals of Thoracic Surgery, 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 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.

To develop and test the validity of IMPACT, Conte and his team analyzed data provided by the United Network of Organ Sharing comprising information from all heart transplants — 21,378 of them — conducted in the United States between 1987 and 2010.

More research is needed to learn what role is played by factors other than the recipient’s risks, Conte says. Resuslts of their study suggest, for example, that an organ coming from a donor over the age of 50 or one that has been outside the body for more than four hours also increases the risk of death in the recipient, he says.

More than 3,000 people are on the waiting list for a heart transplant in the United States, and many will die before they can get a new heart. Only about 2,000 heart transplants are performed in the U.S. annually. Currently, determining who gets an available heart takes into account how long a patient has been on the list and how sick they are. There is no standardized consideration of other factors that may predict patients’ outcomes, as is the case in determining which patients receive available lungs for transplant. Incorporating the IMPACT score would add another dimension to the conversation about who gets a heart transplant, says Conte, surgical director of heart transplantation at Johns Hopkins.

“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.”

Explore further: For older heart-transplant patients, hospitals doing the most operations yield better outcomes

Related Stories

For older heart-transplant patients, hospitals doing the most operations yield better outcomes

May 9, 2011
Older, sicker heart-transplant recipients are significantly more likely to be alive a year after their operations if they have their transplants at hospitals that do a large number of them annually new Johns Hopkins research ...

Medical center performs rare, double living donor organ transplant

May 3, 2011
Transplant surgeons at Penn State Milton S. Hershey Medical Center recently performed their first simultaneous, dual living donor organ transplant on a single recipient. The recipient, a 60-year-old man from the Hazleton ...

Racial disparity remains in heart-transplant mortality rates

April 25, 2011
(Medical Xpress) -- African-American heart transplant patients have had persistently higher mortality rates than white patients, but exactly why still remains a mystery.

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.