eMedicineLive

Considering the small number of hearts available for transplantation, doctors always want to give preference to those patients, who are most likely to benefit from a heart transplant. In a bid to predict the rate of survival of heart transplant patients following their surgeries, scientists from John Hopkins Institute have devised a simple formula with a high predictive value. According to John V. Conte, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and the senior author of the study, this formula will help in selecting patients for organ transplant in view of scarcity of donor hearts.

 

The formula, published in the September issue of the journal “Annals of Thoracic Surgery” is based on points allocated to various risk factors which are associated with a poor outcome of the transplant operation. These factors include age, race, gender, the cause of a patient's heart failure and whether he or she was on dialysis. The scientists devised this method of scoring after analyzing data of all heart transplants (21,378 in total) conducted in the United States between 1987 and 2010. Factors such as female gender (three points); African-American race (three points), and the need for dialysis in the time between being put on the transplant waiting list and getting a transplant (five points) are normally associated with a poor outcome of surgery. The score derived by adding up these points has been termed as IMPACT score, an acronym for the Index for Mortality Prediction after Cardiac Transplantation.

 

Patients with a score between zero and two have the best chance of survival following transplant surgery- a 92.5% chance of living beyond 12 months after surgery. Every point scored increases the chance of death within one year of surgery by 14%. A patient with a score above 20 points has less than 50% chances of surviving for more than a year after surgery. At present those patients who have been on the list for long or those who are sicker are given a preference for heart transplant operation. However, with the help of IMPACT score, doctors will be in a better position to decide which patients are the most suitable candidates for this operation.

 

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