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Donor scoring system for heart transplantation and the impact on patient survival.
- Source :
-
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2012 Apr; Vol. 31 (4), pp. 387-97. Date of Electronic Publication: 2011 Dec 16. - Publication Year :
- 2012
-
Abstract
- Background: The aim of this study was to design and validate a heart donor score that reflects experts' perceived risk of allograft failure.<br />Methods: All heart donors reported to Eurotransplant between January 1, 2005 and December 31, 2008 (N = 4,110) were used to create a donor score. Based on observed discard rates and using multivariate regression, points were assigned for the following donor factors: age; cause of death; body mass index (BMI); diabetes mellitus (DM); duration of ICU stay; compromised history (drug, abuse, sepsis, meningitis, malignancy, HBsAg(+) or anti-HCV(+)); hypertension; cardiac arrest; echocardiography; coronary angiogram; serum sodium; and noradrenaline and dopamine/dobutamine doses. The donor score was obtained by adding all points. All heart donors reported to Eurotransplant in 2009 were included to validate the score (N = 885).<br />Results: All donor factors, except BMI, DM and duration of ICU stay, significantly predicted discard. Based on the median value of the score, donors were classified into low-risk donors (LRDs: ≤16 points) and high-risk donors (HRDs: ≥17 points). In the validation set, discard rates were significantly different when comparing HRDs (35%) and LRDs (7%) (p < 0.0001). In addition, the heart donor score was significantly associated with 3-year survival: LRD 81.5% vs HRD 70.0% (p = 0.004).<br />Conclusions: The heart donor score accurately reflects the likelihood of organ acceptance and predicts long-term patient mortality. Application of this score at time of donor reporting may facilitate donor risk assessment and allow for more appropriate matching of extended criteria donor hearts.<br /> (Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Factors
Aged
Cause of Death
Cohort Studies
Comorbidity
Europe
Female
Humans
Logistic Models
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Assessment methods
Treatment Outcome
Graft Rejection diagnosis
Graft Rejection mortality
Heart Transplantation methods
Heart Transplantation standards
Tissue Donors
Tissue and Organ Procurement methods
Tissue and Organ Procurement standards
Subjects
Details
- Language :
- English
- ISSN :
- 1557-3117
- Volume :
- 31
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 22177692
- Full Text :
- https://doi.org/10.1016/j.healun.2011.11.005