March 18, 2009

Heart-kidney transplant risk score created

U.S. scientists say they've identified criteria that, when combined with kidney function measures, could create a risk score for heart-kidney transplants.

Dr. Mark Russo of Columbia University Medical Center/New York-Presbyterian Hospital, who led the study, said such a risk score could help identify patients who are likely to receive a survival benefit from a combined heart and kidney transplant.

In the past, patients with end-stage heart failure having concurrent renal disease were not considered candidates for heart transplantation, the researchers said. With advances in operative techniques and perioperative management, combined heart and kidney transplantation is offered to select patients in this population.

The researchers analyzed data from the United Network for Organ Sharing involving 19,373 patients who underwent heart transplantation between 1995 and 2005. That included 274 patients who received combined heart and kidney transplants and 19,109 who received heart transplants alone.

They said they found patients appeared less likely to survive following a combined heart and kidney transplant if, before surgery, they had peripheral vascular disease, were older than 65, had heart failure that wasn't caused by blocked or narrowed arteries, were dependent on dialysis or were placed on a ventricular assist device as a bridge to transplantation.

The study appears in the journal Archives of Surgery.