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Updated: Jul 17, 2025
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Outcome of Heart Transplant Candidates Based on a High Volume Heart Transplant Center Experience in Iran
A Amin1, N S Razavi1, A Mohamadifar1
1Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences,Tehran, Iran.
Insights
Predicting mortality in heart transplant candidates is crucial. Right atrial pressure, pulmonary capillary wedge pressure, cardiac index, and systolic blood pressure are key indicators for patients awaiting heart transplantation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Health Services Research
Background:
- The heart transplant waiting list is a critical data registry for understanding patient characteristics and outcomes.
- Advanced heart failure necessitates careful management and prognosis assessment for patients awaiting transplantation.
Purpose of the Study:
- To investigate the prognosis of patients on the heart transplant waiting list.
- To identify factors associated with increased mortality risk in this population.
Main Methods:
- Retrieved demographic, clinical, hemodynamic, and echocardiographic data from a national heart transplantation registry (2011-2018).
- Compared patient outcomes in four groups: death before transplant, death after transplant, alive without transplant, and transplanted and alive.
- Analyzed data from 207 patients, with idiopathic dilated cardiomyopathy being the most common etiology.
Main Results:
- 86 patients (41%) received a heart transplant; median wait time was 84 days.
- 54 patients (26.1%) died while waiting or post-transplant, and 32% remained alive.
- Multivariate analysis identified elevated right atrial pressure, pulmonary capillary wedge pressure, lower cardiac index, and systolic blood pressure as independent predictors of mortality.
Conclusions:
- The heart transplant waiting list registry provides valuable data for improving allocation strategies and administrative planning.
- Developing accurate predictive models using identified mortality predictors can enhance care for advanced heart failure patients.
Background:
The waiting list for heart transplants is a valuable data registry that would offer very useful information on the characteristics of patients who have various outcomes while waiting in the list.
Objective:
The purpose of this study was to look at the prognosis of those waiting for heart transplants as well as the factors that increase mortality.
Methods:
Advanced heart failure patients' demographic, clinical, hemodynamic, and echocardiographic results, as well as their prognosis, were retrieved from the national registry for heart transplantation between 2011 and 2018. The study population was defined and compared in four groups: 1) Death while awaiting HTX, 2) Death after HTX, 3) Alive without a transplant, 4) Transplanted and alive.
Results:
The data of 207 patients [75% male, mean (SD) age of 34(10) years] were analyzed. The most common etiology of heart failure was idiopathic dilated cardiomyopathy. A total of 86 patients (41%) were successfully transplanted, with a median (IQR) time between listing and transplantation of 84 (30¬219) days, 54 patients (26.1%) were dead and 32% were still alive. The multivariate analysis showed right atrial pressure, pulmonary capillary wedge pressure, cardiac index, and systolic blood pressure at the time of listing as independent predictors of death.
Conclusion:
The study on HTX waiting list is very useful for both allocation strategies and administrative planning for patients with advanced heart failure by development of accurate models and scoring systems using predictors of death in the waiting list.
