Derivation and validation of the bridge to transplantation with left ventricular assist device score for 1 year mortality after heart transplantation. The BTT-LVAD score


Okoh A. K., Fugar S., Dodoo S., Selevany M., Al-Obaidi N., ÖZTÜRK E., ...More

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, vol.45, pp.470-477, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 45
  • Publication Date: 2022
  • Doi Number: 10.1177/03913988221082690
  • Journal Name: INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, Agricultural & Environmental Science Database, BIOSIS, Biotechnology Research Abstracts, CINAHL, Communication Abstracts, EMBASE, MEDLINE, Metadex, Civil Engineering Abstracts
  • Page Numbers: pp.470-477
  • Keywords: Ventricular assist devices, artificial kidney, apheresis and detoxification techniques, cardiac assist and artificial heart, modeling cardiovascular, computational methods, computer simulation, UNITED NETWORK, RISK INDEX, SURVIVAL, OUTCOMES, IMPLANTATION, PREDICTORS, FAILURE, AGE
  • Hacettepe University Affiliated: Yes

Abstract

Background: To derive and validate a risk score that accurately predicts 1-year mortality after heart transplantation (HT) in patients bridged to transplant (BTT) with a left ventricular assist device (LVAD). Methods: The UNOS database was queried to identify patients BTT with an LVAD between 2008 and 2018. Patients with > 1-year follow up were randomly divided into derivation (70%) and validation (30%) cohorts. The primary endpoint was 1-year mortality. A simple additive risk score was developed based on the odds of 1-year mortality after HT. Risk groups were created, and survival was estimated and compared. Results: A total of 7759 patients were randomly assigned to derivation (n = 5431) and validation (n = 2328) cohorts. One-year post-transplant mortality was 9.8% (n = 760). A 33-point scoring was created from six recipient variables and two donor variables. Risk groups were classified as low (0-5), intermediate (6-10), and high (>10). In the validation cohort, the predicted 1-year mortality was significantly higher in the high-risk group than the intermediate and low-risk groups, 14.7% versus 9% versus 6.1% respectively (log-rank test: p < 0.0001). Conclusion: The BTT-LVAD Score can serve as a clinical decision tool to guide therapeutic decisions in advanced heart failure patients.