*Risk profile of heart transplant patients*

*3.7 The risk profile of heart transplant patients at Harefield was higher in 2008 than in 2007 and 2006 (Figure 1). The risk model has been developed by the UKCTA from a dataset that extends back 13 years and is used to adjust for factors found to be associated with an increased risk of early death after heart transplant. The risk factors are diabetes, reduced creatinine clearance (renal function), previous open heart operation, older donor age and longer ischaemic times.* 

*3.8 Figure 2 shows that the proportion of transplant patients with individual risk factors (except for ischaemic time) was higher in 2008 than the previous two years.* 

*3.9 The proportion of patients, who at the time of transplant had been receiving inotrope drugs to improve heart contraction or mechanical circulatory support by ventricular assist devices (VADs), extracorporeal membrane oxygenation (ECMO) and/or intra-aortic balloon pump (IABP), was significantly higher at Harefield than at other centres: 93% compared to 45% (p=0.002). These factors are not included in the UKCTA risk model.* 

*3.10 The UKCTA report commented that "the data reported to the audit suggests that the majority of patients who underwent transplantation were high risk; only one of the patients transplanted this calendar year was not on inotropes, a VAD, ECMO or IABP at transplant".* 
