[What are the criteria of priority for the patient to be accepted on the waiting list for cardiac transplantation?].
The limited resources (in grafts, human and financial resources) incited the authors to carry out a prospective assessment of the value of assessing adrenergic function (scintigraphy with meta- iodo- benzyl guanidine, MIBG) for the procedure of inscription on the waiting list of patients with cardiac failure awaiting cardiac transplantation. The study was undertaken from October 1988 to October 1992. Seventy-eight candidates for transplantation were included in the study. Forty-six patients with a MIBG cardiothoracic ratio less than 120% were placed on the waiting list. In July 1993, 35 had undergone transplantation after a 5 months delay. Four patients are still awaiting transplantation and 7 died whilst on the waiting list. Thirty two with a MIBG cardiothoracic ratio greater than 120% were treated medically: in 14 cases (43%) this decision was reviewed after 17 +/- 12 months. The clinical course was stable in the other 18 patients with a follow-up of 46 +/- 18 months (range: 12-72 months). In all, the results of this study show that a procedure of selection for inscription on the waiting list of patients with cardiac failure judged to be good candidates for transplantation based on the value of the MIBG cardiothoracic ratio allows deferrement of inscription of patients at least risk without changing the chances of survival in the whole population group within a 2 year period.
Loisance
D
D
Service de chirurgie thoracique et cardiovasculaire, CHU Henri-Mondor, Créteil.
Benvenuti
C
C
Merlet
P
P
Deleuze
P H
PH
Mazzucotelli
J P
JP
Hillion
M L
ML
Dubois-Randé
J L
JL
Castaigne
A
A
Syrota
A
A
D019797:3-Iodobenzylguanidine; D000328:Adult; D005260:Female; D005602:France; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013565:Sympatholytics; D013997:Time Factors; D014850:Waiting Lists
D007462:Iodobenzenes; D013565:Sympatholytics; D019797:3-Iodobenzylguanidine
Quels critères de priorité pour l'inscription sur la liste d'attente d'un candidat à la transplantation cardiaque?