Sunavasky et al reported findings predictive of a failure of high urgency listing for a patient waiting for heart transplant. These can help to identify a patient who may require more aggressive management. The authors are from Ruhr University Bochum in Germany.
Patient selection: high urgency for heart transplant
Failure for listing - one of the following:
(1) death
(2) delisting due to poor clinical condition
(3) delisting due to urgent mechanical circulatory support implant
Predictors of failure while awaiting transplant:
(1) blood group O (OR 2.5)
(2) INTERMACS class 1 or 2 (from 1 to 7, OR 5.1)
(3) vasopressor score (OR 1.18 per unit score; 7.8 to 12.8 for nonsurvivors vs 5.6 to 9.9)
(4) high serum BNP concentration in pg/mL (455 to 1860 for nonsurvivors vs 127 to 990)
Other factors that may contribute (Table 2):
(1) blood group B
(2) dilated cardiomyopathy
