New prioritization of heart transplant candidates on mechanical circulatory support in an era of severe donor shortage

Komoda, Takeshi; Drews, Thorsten; Hetzer, Roland; Lehmkuhl, H.

doi:10.1016/j.healun.2010.05.001

Cited by 11 publications

(15 citation statements)

References 25 publications

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“…9 Obesity is known to be a risk factor for mortality after heart transplantation (HTx), [1][2][3] and obese patients are recommended by physicians to reduce their body weight before listing for HTx. We investigate the risk of mortality after their progression to critically ill status (i.e., urgency listing or VAD implantation) in patients stratified by body mass index (BMI).…”

mentioning

confidence: 99%

Overweight is Advantageous for Heart-Transplant Candidates to Survive the Period of Critically Ill Status

Komoda¹,

Drews²,

Hetzer³

et al. 2012

ASAIO Journal

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Although extreme obesity and being underweight are both known as risk factors for mortality in patients with ventricular assist devices (VAD) and in those listed for urgent heart transplantation (HTx), the risk in patients between these extremes is controversial. We investigate the risk of mortality after their progression to critically ill status (i.e., urgency listing or VAD implantation) in patients stratified by body mass index (BMI). Risk of mortality on the waiting list was studied in group N (n = 134), normal weight, BMI: 18.5-24.9 kg/m(2); group OWt (n = 112), overweight, BMI: 25.0-29.9 kg/m(2); and group OB-I (n = 39), obesity class I, BMI: 30.0-34.9 kg/m(2). Patients' 1 year survival rate on the waiting list in group N (62.2%) and group OB-I (50.6%) was significantly lower than in group OWt (74.3%, p = 0.036 and p = 0.022, respectively). After adjustment for age, gender, serum creatinine, and primary use of VAD, group OB-I (hazard ratio [HR] 1.971, 95% confidence interval [CI] 1.062-3.659, p = 0.032) and group N (HR 1.792, 95% CI 1.058-3.036, p = 0.030) were at higher risk of mortality compared with group OWt. Overweight HTx candidates have the best prognosis on the waiting list. Obesity class I patients are encouraged to reduce their body weight to at least overweight.

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mentioning

confidence: 99%

Overweight is Advantageous for Heart-Transplant Candidates to Survive the Period of Critically Ill Status

Komoda¹,

Drews²,

Hetzer³

et al. 2012

ASAIO Journal

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“…Organ nakli konusunda karaciğer, böbrek, akciğer ve kalp nakli sırasında olan hastalar için öncelik kriterlerinin etkinliğine dair literatürde çeşitli çalışmalar bulunmaktadır [16][17][18][19][20] . Ancak kornea nakli konusunda yapılan çalışma sayısı oldukça kısıtlıdır.…”

Section: Tartıșmaunclassified

The factors effecting the waiting time before corneal transplantation operation

Kartal¹,

Kandemir²,

Set³

et al. 2014

Kafkas J Med Sci

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AIM: To evaluate the objectiveness of the criteria used for patient selection among the patients included in the corneal transplantation waiting list by comparing the characteristics of the operated patients with the patients still seen in the list. METHODS: The records of the patients included in the waiting 914'ü (%58,3) erkek, 653'ü (%41,7) kadındı. Hastaların yaș ortalaması 43,58±21,48 yıl (4 ay -94 yıl) idi. Hastaların 397'si (%25,3) kliniğimizde ameliyat olmuș, 117043,58±21,48 yıl (4 ay -94 yıl) idi. Hastaların 397'si (%25,3) kliniğimizde ameliyat olmuș, 'i (%74,7) ameliyat olmamıș (107443,58±21,48 yıl (4 ay -94 yıl) idi. Hastaların 397'si (%25,3) kliniğimizde ameliyat olmuș, /1170 %91,8) veya dıș merkezde (94/1170; %8,2)

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“…Similar to trends in the United States, a growing proportion of candidates are listed in the highurgency category, similar to UNOS Status 1A, following revision of the Eurotransplant allocation policy in 2000 and 2005, which provided for a high urgency category in addition to an urgent category (32)(33)(34). Furthermore, candidates who receive VADs (excluding nondurable mechanical support such as ECMO or IABP) are removed from the urgent category unless they develop VAD-related complications, a policy similar to that in the United Kingdom and countries in the Scandiatransplant program (35,36). Scandiatransplant policy will consider candidates aged less than 16 years and with an LVAD for more than 1 year as high-urgent status (Priority 0) (37).…”

Section: Comparison To International Heart Allocation Policiesmentioning

confidence: 99%

Lung and Heart Allocation in the United States

Colvin-Adams

Valapour

Hertz

et al. 2012

American Journal of Transplantation

116

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Lung and heart allocation in the United States has evolved over the past 20-30 years to better serve transplant candidates and improve organ utilization. The current lung allocation policy, based on the Lung Allocation Score, attempts to take into account risk of death on the waiting list and chance of survival posttransplant. This policy is flexible and can be adjusted to improve the predictive ability of the score. Similarly, in response to the changing clinical phenotype of heart transplant candidates, heart allocation policies have evolved to a multitiered algorithm that attempts to prioritize organs to the most infirm, a designation that fluctuates with trends in therapy. The Organ Procurement and Transplantation Network and its committees have been responsive, as demonstrated by recent modifications to pediatric heart allocation and mechanical circulatory support policies and by ongoing efforts to ensure that heart allocation policies are equitable and current. Here we examine the development of US lung and heart allocation policy, evaluate the application of the current policy on clinical practice and explore future directions for lung and heart allocation.

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New prioritization of heart transplant candidates on mechanical circulatory support in an era of severe donor shortage

Cited by 11 publications

References 25 publications

Overweight is Advantageous for Heart-Transplant Candidates to Survive the Period of Critically Ill Status

Overweight is Advantageous for Heart-Transplant Candidates to Survive the Period of Critically Ill Status

The factors effecting the waiting time before corneal transplantation operation

Lung and Heart Allocation in the United States

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