Hong et al reported a risk stratification score (RSS) prior to heart transplantation. The score has two subscores - one for the recipient and one for the donor. The authors are from Columbia University, Mount Sinair Medical Center and University of Chicago.
Patient selection: heart transplant recipient
Recipient Parameters:
(1) recipient age in years
(2) previous cardiac surgery
(3) etiology
(4) diabetes complicated by cerebrovascular accident (CVA)
(5) eGFR in mL per min
(6) serum total bilirubin in mg/dL
(7) intubated
(8) hospitalized
(9) mechanical support
Parameter
Finding
Points
recipient age
< 55 years
0
55 to 70 years
1.2
> 70 years
2.1
previous cardiac surgery
no
0
yes
1.3
etiology
congenital
2.3
amyloidosis
1.8
other
0
diabetes with CVA
no
0
yes
1.4
eGFR
> 53 mL/min
0
33 and 53 mL/min
1.4
< 33 mL/min
2.8
total bilirubin
<= 2 mg/dL
0
> 2 mg/dL
1.7
intubated
no
0
yes
1.8
hospitalized
no
0
yes
1.2
mechanical support
RVAD only
4.7
ECMO
3.9
extracorporeal LVAD
2.7
total artificial heart
2.4
paracorporeal LVAD
1.2
none or other
0
recipient subscore =
= SUM(points for all of the parameters)
Interpretation:
• minimum subscore: 0
• maximum subscore based on data in Table 1: 19.3
• maximum subscore reported in paper: 23.2 (difference 3.9)
• One possibility is that RVAD only and ECMO could be both used.
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