A decision tree based on individual risk factor points and one RO4929097 solubility dmso based on total points are represented in Figure 1 and 2. DT in Fig 2 shows that 85.6% of pts with < 2 points achieve 20 yrs survival.
For each inner node, the Bonferroni-adjusted p-values are given. Conclusions: This model allows LTS prediction post LT. Information provided by the model can be of importance for pts both during the evaluation and post LT. The model may represent a support tool in the decision to list pts for LT in view of maximizing efficiency of scarce donor availability. Disclosures: James F. Trotter – Speaking and Teaching: Salix, Novartis Goran Klintmalm – Advisory Committees or Review Panels: Novartis; Grant/ Research Support: Astellas, Novartis, Opsona, Quark
The following people have nothing to disclose: Giuliano Testa, Giovanna Sara-cino, Greg J. McKenna, Richard Ruiz, Nicholas Onaca, Tiffany Anthony, Peter T. Kim, Marlon F. Levy, Robert M. Goldstein Background: Combined heart and liver transplantation (CHLT) is the treatment option for patients with end-stage heart and liver disease. This is a review of nine patients who underwent combined heart and liver transplant at a single center. Methods: We conducted a detailed retrospective examination of nine patients who underwent simultaneous combined heart and liver transplantation at our institution from 2004 to 2013. Statistical analysis was performed using descriptive and Kaplan-Meier analyses. Results: Eight patients received combined heart and selleck chemicals liver transplantation and one patient received combined heart, liver and lung transplantation. Mean age was 53.2 + 11.3 years, 8 (78%) were male and 8 (78%) were white. Median Pyruvate dehydrogenase lipoamide kinase isozyme 1 biological MELD score was 13 (range, 6-20), and median BMI was 27 (range 15-31). Cardiac transplant indications were ischemic cardiomyopathy in 2 (22%), non-ischemic cardiomy-opathy in 2 (22%), hemochromatosis in 3 (34%), ATTR-amyloidosis in 1 (11%) and
pulmonary hypertension with end stage right heart failure in 1 (11%). All patients, but one with amyloidosis, had documented cirrhosis on liver biopsy. Eight (88%) patients had simultaneous heart and liver transplant within the same operation, while one patient had a heart and lung transplantation followed by a liver transplantation 24 hours apart. Observed patient year to date survival rates at 1, 3 and 5 years were 100%, 88% and 88% respectively, compared to our isolated heart transplant (n=222) at 91.6%, 77.5% and 71.1%. Among the nine patients who underwent CHLT, only two patients (22%) had one cardiac rejection episode based on biopsy (ISHLT grade 2R) in the presence of stable cardiac allograft function, and there were no liver rejection events in all nine patients. The mean left ventricular ejection fraction (LVEF) at 1-year follow-up was 63 ± 3%. At 5-year follow-up (n=6), there was no evidence of cardiac allograft vasculopathy by direct angiography.