SNUBH finds indicator to boost survival of Korean heart transplant patients

Severance Hospital and Seoul National University Bundang Hospital (SNUBH) researchers have discovered an indicator that can improve the survival rate of Korean heart transplant patients.

When a patient with severe heart failure has to receive a heart transplant, it is important to find the “right heart.”

In such a case, the difference in heart size between the donor and the recipient should be minimized.

According to Severance Hospital, heart transplantation is currently carried out by matching the heart weights of donors and recipients to select an appropriate heart.

However, there was a limit to estimating the heart size based only on body weight, as the size of the heart varies depending on the physique.

To overcome this issue, Western medical institutions use the predicted heart mass (PHM), which estimates the heart size using height, gender, and body weight.

In Asia, however, there was a lack of evidence on whether the use of PHM can help estimate the survival rate of heart transplant patients in Asians, who have different physiques from Westerners.

To find a suitable method for Koreans, the team, led by Professors Kang Seok-min and Oh Jae-won at Severance Hospital, and Yoon Min-jae at SNUBH, compared and analyzed the survival rate of heart transplantation according to the difference in heart size between donors and recipients in 660 heart transplant patients registered in the Korean Organ Transplant Registry (KOTRY).

The research team divided the cases in which the difference in heart size between the donor and the recipient was appropriate and inappropriate into two groups based on weight and heart size index and compared the one-year mortality rate after heart transplantation in each group.

As a result, the team confirmed that when the difference was analyzed based on body weight, there was no difference in mortality after heart transplantation between the two groups.

However, when the difference was analyzed based on the heart size index, the team confirmed that the mortality rate was 50 percent higher in patients with an inappropriate heart size difference between the donor and recipient than in the appropriate group.

Notably, the difference in mortality was more pronounced when the recipient's body mass index (BMI) was less than 25.

"This study is the first study in Korea to show the usefulness of the heart size indicators," Professor Kang said. "The use of heart size indicators can help find a more suitable donor and increase the survival rate of patients."