Plasma Volume Score for Early Risk Stratification Following Heart Transplantation: An Exploratory Observational Study

Area of Science:

• Cardiology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Plasma Volume Score (PVS) is a validated marker for cardiovascular disease severity.
• Previous research highlights PVS prognostic value in heart failure.
• The role of pre-transplant PVS in heart transplant recipients is not well-established.

Purpose of the Study:

• To investigate the clinical relevance and prognostic value of pre-transplant Plasma Volume Score (PVS) in adult heart transplant recipients.
• To assess the association between baseline PVS and 1-year all-cause mortality, overall survival, and post-transplant dialysis.

Main Methods:

• Retrospective analysis of 375 adult heart transplant recipients.
• Calculation of baseline Plasma Volume Score (PVS) before transplantation.
• Analysis of PVS as a continuous and categorical variable (cut-off 3.1) with endpoints including 1-year mortality and post-transplant dialysis.

Main Results:

• A pre-transplant Plasma Volume Score (PVS) of 3.1 or higher was observed in 23.5% of patients.
• Elevated PVS correlated with lower estimated glomerular filtration rate, VAD support, infection, congestion, and higher bilirubin levels.
• Patients with PVS ≥ 3.1 had significantly lower 1-year survival (81.8% vs. 90.9%) and increased risk of post-transplant dialysis.

Conclusions:

• Elevated pre-transplant Plasma Volume Score (PVS) is an independent predictor of worse 1-year survival following heart transplantation.
• PVS serves as a valuable, accessible tool for pre-transplant risk stratification in heart transplant candidates.
• The findings suggest PVS can help identify patients at higher risk for adverse outcomes, including the need for post-transplant dialysis.