A new nine-point risk score may be able to predict the risk of early rejection in pediatric heart transplant patients, according to a study published Sept. 8 in JACC: Heart Failure.

In a retrospective analysis, researchers used data from the United Network for Organ Sharing database to assess early rejection amongst 3,195 pediatric patients who underwent isolated orthotopic heart transplantation between January 2000 and December 2012. Transplants were divided into derivation (2,686) and validation (509). The risk score model was created using variables independently associated with rejection and tested in the validation cohort.

The results of the study showed that the model risk score predicted rejection correlated closely with actual rates of rejection. The final risk score used age, cardiac diagnosis and panel reactive antibody to accurately determine risk of early rejection in pediatric heart transplant recipients.

The authors of the study note that the risk score “has the potential to be used in clinical practice to aid in determining immunosuppressant regimen and frequency of rejection surveillance in the first post-transplant year.”

“[T]his is an excellent first step in the development of a risk score for rejection in a pediatric heart transplant population,” states Scott R. Auerbach, MD, in an accompanying editorial comment. “The authors now face the challenge of making progress on further validation and refinement of the score by incorporating additional variables and modeling the rejection endpoints that are most highly associated with adverse outcomes.” 

Keywords: Child, Heart Failure, Heart Transplantation, Immunosuppressive Agents

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