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Published on: August 2, 2024
[THE MAIN CRITERIA FOR SELECTING PATIENTS WHEN FORMING A WAITING LIST FOR HEART TRANSPLANTATION]
O Tanska1, Yu Ostrovsky1, A Valentyukevich1
1KL «Feofania», Center of cardiac surgery, Kyiv, Ukraine; Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus.
Insights
This study optimized heart transplant waiting list selection criteria using international data and patient monitoring. New criteria were implemented in Ukraine, improving patient selection for heart transplantation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Health Services Research
Background:
- Optimizing patient selection for heart transplantation is crucial for improving outcomes.
- Existing international data and criteria require adaptation for local healthcare systems.
- Heart failure patients face challenges in accessing timely transplantation.
Purpose of the Study:
- To optimize patient selection methods for heart transplant waiting lists.
- To develop and implement novel selection criteria based on international data.
- To analyze the dynamics of patients on the heart transplant waiting list in Ukraine.
Main Methods:
- Analysis of international data and existing selection criteria.
- Survey data collection and dynamic monitoring of 49 heart failure patients (2008-2018).
- Comparison of two groups: patients with (n=24) and without (n=25) circulatory support on the waiting list.
Main Results:
- Developed and implemented a "road map" for heart transplant recipients in Ukraine.
- Identified risk factors impacting long-term outcomes and quality of life in heart failure patients (NYHA Class III-IV).
- Established specific criteria for primary heart transplantation selection.
Conclusions:
- The study successfully developed and implemented optimized criteria for heart transplant waiting lists in Ukraine.
- The new criteria aim to improve patient selection and long-term outcomes.
- This work represents a significant advancement in heart transplantation protocols in Ukraine.
Abstract:
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. The results of the study are based on survey data and dynamic monitoring of 49 patients (median age 38 (16; 65) years, men 44 patients, women 5 patients) 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 KL «Feofania» DUS, Kyiv, Ukraine. Patients were examined during the initial examination, after 3 months, 6 months and after 1 year. 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; Scientific novelty of the obtained results. 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.
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