Weiss et al developed a risk index for a heart transplant recipient based on donor heart features. The authors are from New York Presbyterian Hospital, Columbia College of Physicians and Surgeons, and the Johns Hopkins University.
Patient: orthotopic heart transplant
Outcome: survival at 1 to 5 years
Parameters related to the donor:
(1) ischemic time in hours
(2) donor’s age in years
(3) races of donor and recipient
(4) BUN-to-creatinine ratio
BUN-to-creatinine ratio =
= (BUN in mg/dL) / (creatinine in mg/dL)
Parameter |
Finding |
Points |
ischemic time |
< 2 hours |
1 |
|
2 to 3.9 hours |
2 |
|
4 to 5.9 hours |
3 |
|
6 to 7.9 hours |
4 |
|
>= 8 hours |
5 |
donor’s age |
< 40 years |
0 |
|
40 to 49 years |
3 |
|
>= 50 years |
5 |
race of donor and recipient |
same |
0 |
|
differ (mismatch) |
2 |
BUN to creatinine ratio |
< 30 |
0 |
|
>= 30 |
3 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 1
• maximum score: 15
• The higher the score the worse the survival.
Total Score |
Survival at 1 Year |
1 or 2 |
90% |
3 to 5 |
88% |
6 to 8 |
82% |
9 to 15 |
77% |
Specialty: Cardiology, Surgery, general