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. 2023 Dec 11;12(24):7614.
doi: 10.3390/jcm12247614.

The Seattle Heart Failure Model in Kidney Transplant Recipients

Angelica Perez-Gutierrez  1 , Rita L McGill  2 , Braden Juengel  1 , Piotr J Bachul  1 , David N Danz  3 , Michelle Josephson  2 , Ben B Chung  4 , Ann Nguyen  4 , John J Fung  1 , Rolf N Barth  1 , Yolanda T Becker  1
Affiliations

The Seattle Heart Failure Model in Kidney Transplant Recipients

Angelica Perez-Gutierrez et al. J Clin Med. .

Abstract

Cardiovascular disease is the leading cause of mortality following kidney transplantation. Heart failure affects 17-21% of patients with chronic kidney disease and increases along with time receiving dialysis. The Seattle Heart Failure Model (SHFM) is a validated mortality risk model for heart failure patients that incorporates clinical, therapeutic, and laboratory parameters but does not include measures of kidney function. We applied the SHFM to patients with end-stage renal disease (ESRD) who were being evaluated for kidney transplantation to determine if the model was associated with post-transplant mortality. This retrospective single-center study analyzed survival among 360 adult deceased-donor kidney transplant recipients. Cox regression was used to model post-transplant patient survival. Our findings indicated that a 1.0-point increase in the adapted SHFM score was significantly associated with post-transplant mortality (HR 1.76, 95% CI = 1.10-2.83, p = 0.02), independently of the Kidney Donor Profile Index and Estimated Post-Transplant Survival. Individual covariates of the SHFM were evaluated in univariate analyses, and age, sodium, cholesterol, and lymphocyte count were significantly related to mortality. This study provides preliminary evidence that an adapted SHFM score could be a useful tool in evaluating mortality risk post-transplant in patients with ESRD.

Keywords: Seattle Heart Failure Model; cardiac risk; kidney transplant; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prediction nomogram for 2-year and 5-year patient survival, using the adapted Seattle Heart Failure Model (SHFM), Kidney Donor Profile Index (KDPI), and Expected Post-Transplant Survival (EPTS) scores.
Figure 2
Figure 2
Predicted two and five-year survival according to the Seattle Heart Failure Model (SHFM) for heart failure patients and kidney transplant candidates.
See this image and copyright information in PMC

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