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 December 22, 2014 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 December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Christmas Kissing Good for Health

Christmas Kissing Good for Health

Reuters - Innovations Video Online (Dec. 22, 2014) Scientists in Amsterdam say couples transfer tens of millions of microbes when they kiss, encouraging healthy exposure to bacteria. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Brain-Dwelling Tapeworm Reveals Genetic Secrets

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Reuters - Innovations Video Online (Dec. 22, 2014) Cambridge scientists have unravelled the genetic code of a rare tapeworm that lived inside a patient's brain for at least four year. Researchers hope it will present new opportunities to diagnose and treat this invasive parasite. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher 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