Risk Index of Kilic et al for Predicting Acute Renal Failure (ARF) Following Heart/Cardiac Transplantation

Description

Kilic et al developed a risk index for predicting postoperative acute renal failure after a heart transplant. This can help to identify a patient who may require more aggressive management. The authors are from the Johns Hopkins University.

Patient selection: cardiac transplant surgery

Outcome: acute renal failure requiring dialysis

Parameters:

(1) age of recipient

(2) cause of heart failure in recipient

(3) creatinine clearance of recipient in mL per minute

(4) serum total bilirubin of recipient in mg/dL

(5) body mass index of recipient in kilograms per square meters

(6) diabetes mellitus in recipient

(7) need for mechanical ventilation in recipient

(8) need for intensive care prior to surgery by the recipient

(9) recent infection in the recipient

(10) blood transfusion to recipient while on waiting list

(11) donor age in years

(12) biatrial anastomosis to be performed

(13) ischemic time in hours

Parameter	Finding	Points
age of recipient	< 60 years of age	0
	>= 60 years of age	5
cause of heart failure	dilated cardiomyopathy	0
	ischemic heart disease	0
	congenital heart disease	16
	other	6
creatinine clearance	>= 60 mL per min	0
	30 to 59 mL per min	8
	< 30 mL per min	15
serum total bilirubin	< 1.0 mg/dL	0
	1.0 to 1.9 mg/dL	5
	2.0 to 2.9 mg/dL	6
	>= 3.0 mg/dL	7
body mass index	< 18.5	0
	18.5 to 24.9	0
	25.0 to 29.9	0
	30.0 to 34.9	5
	>= 35.0	6
diabetes mellitus	absent	0
	present	5
mechanical ventilation	absent	0
	present	9
intensive care unit	absent	0
	present	5
recent infection	absent	0
	present	6
blood transfusion	0 units	0
	>= 1 units	6
age of donor	< 30 years	0
	30 to 49 years	5
	>= 50 years	7
biatrial anastomosis	no	0
	yes	5
ischemic time	< 4.0 hours	0
	4.0 to 5.9 hours	6
	>= 6.0 hours	8

total score =

= SUM(points for all 13 parameters)

Interpretation:

• minimum score: 0

• maximum score: 100

• The higher the score the greater the risk for acute renal failure.

Total Score	Percent Risk of Acute Renal Failure (from Figure 1)
0 to 76	(0.0127 * ((score)^2)) + (0.01225 * (score)) + 1.853
76 to 100	> 74%

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Risk Index of Kilic et al for Predicting Acute Renal Failure (ARF) Following Heart/Cardiac Transplantation

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