Criteria for Selecting Patients for Inclusion in the Waiting List for Heart Transplantation
Abstract
Objective. The aim of the study was to optimize the methods of selecting patients for inclusion in the «waiting list» for heart transplantation on the basis of available international data and the introduction of selection criteria.
Materials and methods. The results of the study are based on survey data and dynamic monitoring of 49 patients (median age 38 (16; 65) years; 44 men, 5 women) who were treated from 2008-2018 in the centers: Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of cardiac surgery on the basis of Hospital «Feofania». Patients were examined during the initial examination, after 3 months, 6 months and after 1 year.
Results and discussion. The first group consisted of 24 patients with CHF who were on the waiting list for orthotopic heart transplantation, for circulatory support, median age 40.95 (18.0; 65.0) years, men - 23, women - 1; The second group consisted of 25 patients with CHF who were on the waiting list for
orthotopic heart transplantation without circulatory support, median age 38.56 (17.0; 64.0) years, men - 21, women - 4.
Conclusions. Scientific novelty of the obtained results. For the first time in Ukraine, a road map has been developed and implemented and the dynamics of the movement of recipients who are in the «waiting list» for heart transplantation has been analyzed. Identified risk factors that affect the long-term outcomes and quality of life of patients with heart failure III-IV functional class according to the NYHA classification. Criteria for selection of patients for primary heart transplantation have been developed and implemented. For the first time in Ukraine, a «waiting list» for a heart transplant has been formed.
References
- Prinzing A, Herold U, Berkefeld A, Krane M, Lange R,Voss B. Left ventricular assist devices – current state and perspectives. J. Thorac. Dis. 2016;8:E660-E666.
- Raymond RJ, Hinderliter AL, Willis PW, Ralph D, Caldwell EJ, Williams W, et al. Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. J Am Coll Cardiol. 2002 Apr 3;39(7):1214-9. https://doi.org/10.1016/s0735-1097(02)01744-8
- Hsu RB, Lin FY, Chen RJ, Chou NK, Ko WJ, Chi NH, et al. Incidence, risk factors, and prognosis of postoperative hyperbilirubinemia after heart transplantation. Eur J Cardiothorac Surg. 2007 Dec;32(6):917-22. https://doi.org/10.1016/j.ejcts.2007.09.013
- Russo MJ, Chen JM, Hong K, Stewart AS, Ascheim DD, Argenziano M, et al. Survival after heart transplantation is not diminished among recipients with uncomplicated diabetes mellitus: an analysis of the United Network of Organ Sharing Database. Circulation. 2006;114(21):2280-2287. https://doi.org/10.1161/CIRCULATIONAHA.106.615708
- Stevenson L. Clinical use of inotropic therapy for heart failure: looking backward or forward? Part II: chronic inotropic therapy. Circulation. 2003;108(4):492-497. https://doi.org/10.1161/01.CIR.0000078349.43742.8A
- Szlachcic J, Massie BM, Kramer BL, Topic N, Tubau J. Correlates and prognostic implication of exercise capacity in chronic congestive heart failure. Am J Cardiol. 1985 Apr 1;55(8):1037-42. https://doi.org/10.1016/0002-9149(85)90742-8
- Taylor DO, Edwards LB, Boucek MM, Trulock EP, Aurora P, Christie J, et al. Registry of the International Society for Heart and Lung Transplantation: twentyfourth official adult heart transplant report—2007. J Heart Lung Transplant. 2007 Aug;26(8):769-81. https://doi.org/10.1016/j.healun.2007.06.004
- Taylor DO, Edwards LB, Boucek MM, Trulock EP, Waltz DA, Keck BM, Hertz MI. Registry of the International Society for Heart and Lung Transplantation: Twenty-third Official Adult Heart Transplantation Report—2006. J Heart Lung Transplant. 2006 Aug;25(8):869-79. doi: 10.1016/j.healun.2006.05.002
- Tjang YS. Predicting Outcome Of Heart Transplantation. Enschede; 2008.
- Tjang YS, van der Heijden GJ, Tenderich G, Körfer R, Grobbee DE. Impact of recipient’s age on heart transplantation outcome. Ann Thorac Surg. 2008 Jun;85(6):2051-5. https://doi.org/10.1016/j.athoracsur.2008.02.015
- van den Broek SA, van Veldhuisen DJ, de Graeff PA, Landsman ML, Hillege H, Lie KI. Comparison between New York Heart Association classification and peak oxygen consumption in the assessment of functional status and prognosis in patients with mild to moderate chronic congestive heart failure secondary to either ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1992 Aug 1;70(3):359-63. https://doi.org/10.1016/0002-9149(92)90619-a
- Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med. 2004 Feb 12;350(7):655-63. https://doi.org/10.1056/NEJMoa031994
- Weber KT, Kinasewitz GT, Janicki JS, Fishman AP. Oxygen utilization and ventilation during exercise in patients with chronic cardiac failure. Circulation. 1982 Jun;65(6):1213-23. https://doi.org/10.1161/01.cir.65.6.1213
- Yacoub MH. A novel strategy to maximize the efficacy of left ventricular assist devices as a bridge to recovery. Eur Heart J. 2001 Apr;22(7):534-40. https://doi.org/10.1053/euhj.2001.2613
- Young JB. Healing the heart with ventricular assist device therapy: mechanisms of cardiac recovery. Ann Thorac Surg. 2001 Mar;71(3 Suppl 1):S210-9. https://doi.org/10.1016/s0003-4975(00)02633-3
- Young JB. Heart Failure’s Near Dead and Dying: Reconsidering Our Heart Transplant Wait List Scheme. J Am Coll Cardiol. 2007 Sep 25;50(13):1291-3. https://doi.org/10.1016/j.jacc.2007.07.008
- Zafeiridis A, Jeevanandam V, Houser SR, Margulies KB. Regression of cellular hypertrophy after left ventricular assist device support. Circulation. 1998 Aug 18;98(7):656-62. https://doi.org/10.1161/01.cir.98.7.656