Cumulative Effect of Preoperative Risk Factors on Mortality After Pediatric Heart Transplantation

O’Connor and colleagues hypothesized that higher risk of posttransplant mortality in children receiving heart transplants could be predicted using patient-specific factors not currently accounted for in commonly used risk models. The authors retrospectively reviewed outcomes for 74 patients who underwent heart transplant over a six-year period in their center. They identified six risk factors: single-ventricle congenital heart disease, biventricular assist device, a history of four or more sternotomies, panel reactive antibody exceeding 10%, any previous operation at another institution, and pulmonary vein disease. After assigning a single point to each of these risk factors, a score of 4 points or more predicted posttransplant mortality with 57% sensitivity and 90% specificity.