Scoring could postpone transplant for some patients

Some heart failure patients might be able to have their heart transplants deferred, thus facilitating more efficient use of scarce donor organs. Researchers at the Hospital of the University of Pennsylvania in Philadelphia have come up with a clinical scoring model that predicts survival among patients with moderate to severe disease.1 The team evaluated 80 clinical abnormalities in 268 patients, then selected seven that proved most accurate as predictors of event-free one-year survival.

Criteria include measures of oxygen use during exercise, blood pressure, and resting heart rate. Researchers arrived at a predictive score for each patient and identified thresholds at which risk changes significantly. Using the score, the team was able to categorize patients into low-, medium-, and high-risk groups, and it was determined that transplant can be safely postponed in the low-risk group.


1. Aaronson KD, Schwartz JS, Chen TM, et al. Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation 1997; 95:2,660-2,667.