"Donor hearts are a limited resource," says John V. Conte, M.D., a professor of surgery at the Johns Hopkins University School of Medicine and the senior author of the study. "Now, we have a simple-to-use tool that is highly predictive of survival after a heart transplant, and can help guide organ allocation decisions."
Conte and his colleagues, writing in the September issue of Annals of Thoracic Surgery, pulled together a series of risk factors already associated with poor outcomes, such as age, race, gender, the cause of a patient's heart failure and whether he or she was on dialysis, and then assigned a number of points to each factor. The sum of those points created a score. The higher the score, the higher the risk of death one year after transplant.
Some factors were weighted more heavily than others, 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).
Patients with the lowest scores — between zero and two — had a 92.5 percent chance of being alive 12 months after surgery.
Patients with so-called IMPACT scores — the acronym the researchers came up with for the Index for Mortality Prediction After Cardiac Transplantation — above 20 points had a less than 50 percent chance of survival one year after surgery. Every point on the scale increased the chance of death within one year by 14 percent.
To develop and test the validity of IMPACT, Conte and his team analyzed data provided by the United Network of Organ Sharing comprising information from all heart transplants — 21,378 of them — conducted in the United States between 1987 and 2010.
More research is needed to learn what role is played by factors other than the recipient's risks, Conte says. Resuslts of their study suggest, for example, that an organ coming from a donor over the age of 50 or one that has been outside the body for more than four hours also increases the risk of death in the recipient, he says.
More than 3,000 people are on the waiting list for a heart transplant in the United States, and many will die before they can get a new heart. Only about 2,000 heart transplants are performed in the U.S. annually. Currently, determining who gets an available heart takes into account how long a patient has been on the list and how sick they are. There is no standardized consideration of other factors that may predict patients' outcomes, as is the case in determining which patients receive available lungs for transplant. Incorporating the IMPACT score would add another dimension to the conversation about who gets a heart transplant, says Conte, surgical director of heart transplantation at Johns Hopkins.
"As clinicians, we make an educated risk of what the risk is going to be," he says. "This tool provides a quantitative way to assess the risk."
The other researchers involved in the study — all from Johns Hopkins — are Jeremiah G. Allen, M.D.; George Arnaoutakis, M.D.; Timothy J. George, M.D.; Stuart D. Russell, M.D.; and Ashish S. Shah, M.D. Eric S. Weiss, M.D., M.P.H., a former general surgery resident at Hopkins, was also involved.
For more information: http://www.hopkinsmedicine.org/transplant/Programs/heart/
Stephanie Desmon | EurekAlert!
GLUT5 fluorescent probe fingerprints cancer cells
20.04.2018 | Michigan Technological University
Scientists re-create brain neurons to study obesity and personalize treatment
20.04.2018 | Cedars-Sinai Medical Center
At the Hannover Messe 2018, the Bundesanstalt für Materialforschung und-prüfung (BAM) will show how, in the future, astronauts could produce their own tools or spare parts in zero gravity using 3D printing. This will reduce, weight and transport costs for space missions. Visitors can experience the innovative additive manufacturing process live at the fair.
Powder-based additive manufacturing in zero gravity is the name of the project in which a component is produced by applying metallic powder layers and then...
Physicists at the Laboratory for Attosecond Physics, which is jointly run by Ludwig-Maximilians-Universität and the Max Planck Institute of Quantum Optics, have developed a high-power laser system that generates ultrashort pulses of light covering a large share of the mid-infrared spectrum. The researchers envisage a wide range of applications for the technology – in the early diagnosis of cancer, for instance.
Molecules are the building blocks of life. Like all other organisms, we are made of them. They control our biorhythm, and they can also reflect our state of...
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.
The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
25.04.2018 | Physics and Astronomy
25.04.2018 | Physics and Astronomy
25.04.2018 | Information Technology