Simple score to assess the risk of rejection after orthotopic heart transplantation.
Kilic AE, Weiss S, et al.Circulation 125(24): 3013-3021, 2012.
Aims
To derive and validate a risk score for rejection after orthotopic heart transplantation.
Interventions
Orthotopic heart transplantation.
Participants
14,265 patients undergoing orthotopic heart transplantation between 1998 and 2008. 11,412 patients were randomly divided into a derivation cohort and 2,853 patients were divided into a validation cohort.
Outcomes
The primary outcome was drug-treated rejection within 1 year of orthotopic heart transplantation. Covariates used to generate rejection risk scores in the derivation cohort included age, race, sex, HLA mismatch, year of transplantation, center volume, previous malignancy, recent infection, serum bilirubin, transpulmonary gradient, donor body mass index, donor cigarette use, donor diabetes mellitus, donor hypertension and ischemic time. A 13-point risk score incorporating 4 variables (age, race, sex, HLA matching) were developed and validated in 2,853 patients (validation cohort).
Follow-up
Not applicable
CET Conclusions
In this interesting analysis of data from the United Network for Organ Sharing Registry, some 14,000 patients with a cardiac transplant were evaluated for risk factors for rejection within one year of transplantation. On the basis of this analysis a 13 point risk score was developed and then validated in a smaller cohort of just under 3,000 patients. The risk score proved to be highly predictive of clinically significant rejection episodes within one year of transplantation.
Quality notes
This is a pooled analysis of data from the United Network for Organ Sharing registry hence quality assessment is not appropriate.
Trial registration
Not reported