Featured Research

from universities, journals, and other organizations

Risk Score Helps Identify Candidates For Combined Heart And Kidney Transplants

Date:
March 16, 2009
Source:
JAMA and Archives Journals
Summary:
Researchers have identified a set of criteria that, when combined with a measure of kidney function, could help identify patients who are likely to receive a survival benefit from a combined heart and kidney transplant, according to a new report.

Researchers have identified a set of criteria that, when combined with a measure of kidney function, could help identify patients who are likely to receive a survival benefit from a combined heart and kidney transplant, according to a new report.

Related Articles


"In the past, patients with end-stage heart failure having concurrent renal [kidney] disease were not considered candidates for heart transplantation," the authors write as background information in the article. "With advances in operative techniques and perioperative [around the time of surgery] management, combined heart and kidney transplantation is offered to select patients in this population."

A 1997 article demonstrated that heart and kidney transplant recipients have similar survival rates as recipients of heart transplants alone. However, there are still no standardized guidelines for heart and kidney transplants, despite an increasing number of these procedures being performed. In a new study, Mark J. Russo, M.D., M.S., of Columbia University Medical Center/New York-Presbyterian Hospital, New York, and colleagues analyzed data from the United Network for Organ Sharing (UNOS) for 19,373 patients who underwent heart transplantation between 1995 and 2005. This included 274 patients who received combined heart and kidney transplants and 19,109 who received heart transplants alone. The researchers assessed illness status as assigned by UNOS, pretransplantation demographics and medical history to determine which factors affected survival.

Patients appeared less likely to survive following a combined heart and kidney transplant if, before surgery, they had peripheral vascular disease (disease of the blood vessels outside the heart and brain), were older than 65, had heart failure that was nonischemic (not caused by blocked or narrowed arteries), were dependent on dialysis or were placed on a ventricular assist device (pumping device that assists the heart) as a bridge to transplantation. When patients were stratified into three groups based on these risk factors, the one-year survival rate was 93.2 percent for those in the lowest-risk group and 61.9 percent for those in the highest-risk group.

Previous studies have shown that patients with an estimated glomerular filtration rate (eGFR, a measure of kidney function) of less than 33 milliliters per minute have decreased survival following heart transplantation, the authors note. When the authors further stratified patients in the study based on eGFR, patients with an eGFR of less than 33 milliliters per minute who were in the low-risk group appeared to survive longer following heart and kidney transplants than following heart transplants alone.

About one-fourth of patients in the highest-risk group died from infection. Patients who were bridged to transplantation with a ventricular assist device, had peripheral vascular disease or were older than 65 appeared more vulnerable to infection, explaining their increased risk of death. The underlying reasons for the increased risk of death due to nonischemic heart failure remains unclear, the authors note.

"Among patients with combined kidney failure (eGFR, less than 33 milliliters per minute) and heart failure, those classified by this risk stratification scheme as low-risk should undergo combined heart and kidney transplantation, while there is no demonstrable benefit for combined heart and kidney transplantation over heart transplantation alone in patients classified as high risk," they conclude.

This study was supported in part by a contract from the Health Resources and Services Administration, U.S. Department of Health and Human Services, and by a training grant from the National Institutes of Health.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Russo et al. Pretransplantation Patient Characteristics and Survival Following Combined Heart and Kidney Transplantation: An Analysis of the United Network for Organ Sharing Database. Archives of Surgery, 2009; 144 (3): 241 DOI: 10.1001/archsurg.2008.559

Cite This Page:

JAMA and Archives Journals. "Risk Score Helps Identify Candidates For Combined Heart And Kidney Transplants." ScienceDaily. ScienceDaily, 16 March 2009. <www.sciencedaily.com/releases/2009/03/090316173317.htm>.
JAMA and Archives Journals. (2009, March 16). Risk Score Helps Identify Candidates For Combined Heart And Kidney Transplants. ScienceDaily. Retrieved January 27, 2015 from www.sciencedaily.com/releases/2009/03/090316173317.htm
JAMA and Archives Journals. "Risk Score Helps Identify Candidates For Combined Heart And Kidney Transplants." ScienceDaily. www.sciencedaily.com/releases/2009/03/090316173317.htm (accessed January 27, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, January 27, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Mistakes Should Serve a Lesson Says WHO

Ebola Mistakes Should Serve a Lesson Says WHO

AFP (Jan. 25, 2015) The World Health Organization&apos;s chief on Sunday admitted the UN agency had been caught napping on Ebola, saying it should serve a lesson to avoid similar mistakes in future. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
Disneyland Measles Outbreak Spreads To 5 States

Disneyland Measles Outbreak Spreads To 5 States

Newsy (Jan. 24, 2015) Much of the Disneyland measles outbreak is being blamed on the anti-vaccination movement. The CDC encourages just about everyone get immunized. Video provided by Newsy
Powered by NewsLook.com
Growing Measles Outbreak Worries Calif. Parents

Growing Measles Outbreak Worries Calif. Parents

AP (Jan. 23, 2015) Public health officials are rushing to contain a measles outbreak that has sickened 70 people across 6 states and Mexico. The AP&apos;s Raquel Maria Dillon has more. (Jan. 23) Video provided by AP
Powered by NewsLook.com
Smart Wristband to Shock Away Bad Habits

Smart Wristband to Shock Away Bad Habits

Reuters - Innovations Video Online (Jan. 23, 2015) A Boston start-up is developing a wristband they say will help users break bad habits by jolting them with an electric shock. Ben Gruber reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins