Score of Russo et al for Determining a Patient's Risk Status Following a Combined Heart and Kidney Transplant

Description

Russo et al develop a score for determining a patient's risk following a combined heart and kidney transplant procedure. This can help identify a patient who may be better suited for the procedure so that scarce resources can be used more effectively. The authors are from Columbia University and Mount Sinai School of Medicine in New York City.

Patient selection: heart and renal failure being evaluated for heart and renal transplantation

Parameters based on pretransplantation status:

(1) recipient's age in years

(2) history of peripheral vascular disease

(3) cause for heart failure

(4) use of ventricular assist device (VAD) as a bridge to the transplant

(5) dialysis status at the time of the transplant

Parameter	Finding	Points
age in years	<= 65 years of age	0
	> 65 years of age	3.5
history of peripheral vascular disease	no	0
	yes	4
cause of heart failure	ischemic	0
	nonischemic	2
VAD use	not used	0
	used	2
dialysis status	not dependent	0
	dependent	2.5

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 14

• The higher the score the greater the patient's risk following the transplant.

• The authors found that the only patients who had a survival benefit from the combined transplant procedure were those with a low risk score, heart failure and an estimated GFR < 33 per mL.

Total Score	Risk	1-Year Survival
0 to 3.5	low	93%
4 to 6	moderate	74%
6.5 to 14	high	62%

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Description

Specialty

ICD-10