Clinical Model Helps Predict Heart Failure Patients

June 16, 1997

DALLAS, June 17 -- Doctors have a new set of medical tools to help identify seriously ill patients for whom transplants might safely be deferred.

Researchers described in today's American Heart Association journal Circulation a clinical model that accurately predicted survival among groups of patients with moderate to severe heart failure. "The new approach should facilitate more efficient use of scarce donor hearts and selection of high-risk patients for enrollment in clinical trials of new heart failure therapies," says Keith Aaronson, M.D. He is a leader of a research team at the Hospital of the University of Pennsylvania, Philadelphia, and Columbia University's College of Physicians and Surgeons in New York City.

Because of donor organ shortages, several hundred individuals die each year while awaiting transplants. In 1995 there were 746 such deaths.

The model is made up of seven readily measurements, none involving "invasive" steps such as putting a diagnostic tube inside the heart. "Our goal was to separate out those patients who will do well for a time," explains Aaronson.

The research team initially evaluated 80 clinical characteristics in 268 heart-failure patients (80 percent of them men) before selecting the seven criteria that proved most accurate. A score was calculated for each patient based on seven tests, which are commonly obtained in patients with heart abnormalities including measures of oxygen use during exercise, blood pressure and resting heart rate, says Aaronson, now medical director of the heart transplant program at the University of Michigan Medical Center, Ann Arbor.

Using the test results, the researchers arrived at a predictive "score" for each patient and identified threshold values at which risk changes significantly and classified patients into low-, medium- and high-risk groups. During follow-up, the 268 Pennsylvania patients were compared with 199 other transplant candidates at New York who served as a "validation" group. One-year survival in the two low-risk groups was 93 percent and 88 percent, respectively; 72 percent and 60 percent in the medium-risk groups, and 43 percent and 35 percent in the two groups considered at high risk for emergency heart transplant or death without a transplant.

"Transplantation can be safely deferred in the low-risk group," he says.


Media advisory: Dr. Aaronson can be reached in Ann Arbor at (313) 936-5265. Reporters may call (214) 706-1173 for copies of the reports. (Please do not publish telephone numbers.)
-end-


American Heart Association

Related Transplant Articles from Brightsurf:

Survival on heart transplant waiting list
Survival of patients on the heart transplant waiting list was examined in this observational study.

New hope for kidney revival for transplant
Cell therapy delivered directly to the kidney can revive a 'marginal' organ, improving function and could offer new hope for providing more kidneys for transplant.

First Swedish transplant of uterus from deceased donor
The Swedish team responsible for uterine transplantation research has, for the first time, transplanted a uterus from a deceased donor.

New research may lead to increased use of available hearts for transplant
A new study provides hope that the number of children dying on the transplantation list while waiting for a new heart could potentially be reduced dramatically.

New research finds signal of decreased early post transplant survival in new heart transplant system
In an analysis of the new heart organ allocation system for transplant patients in the US, researchers have identified a signal of a decrease in heart transplant survival rates.

Researchers standardise test for predicting transplant rejection
Researchers from The Westmead Institute for Medical Research have developed a standardised method of measuring the immune response in islet transplant recipients, helping predict patient outcomes.

Measuring quality of life after pediatric kidney transplant
After receiving a kidney transplant, children may experience worrisome quality-of-life changes that underscore the importance of screening transplant recipients for psychosocial function, according to Children's research presented during the 10th Congress of the International Pediatric Transplant Association.

Kidney transplant patients need even better aftercare!
Kidney transplantation is the best renal replacement therapy available. Although survival and quality of life are significantly better compared to dialysis patients, transplant recipients nevertheless have a significantly higher cardiovascular morbidity and mortality than healthy people.

First birth after robot-assisted uterus transplant
A boy 48 centimeters long, weighing 2900 grams, is the first baby born after the technological shift in the Swedish world-leading research on uterine transplantation.

New clues discovered to lung transplant rejection
Researchers at Washington University School of Medicine in St. Louis have discovered clues to a particularly deadly form of rejection that can follow lung transplantation.

Read More: Transplant News and Transplant Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.