Abstract
BACKGROUND: Hypoalbuminemia has been recognized as a prognostic indicator in patients with heart failure. We recently reported a strong association between pre-operative albumin level and post-operative outcomes in patients undergoing ventricular assist device implant as well as those undergoing heart transplant (HTx). The purpose of this study was to create a post-transplant survival probability equation based on preoperative albumin concentration using parametric survival model. METHODS: Pre-operative albumin concentration and post-transplant survival data were obtained from 822 consecutive patients undergoing HTx at Columbia University Medical Center between 1999 and 2010. Available data from the United Network of Organ Sharing (UNOS) (n=13,671) was also analyzed. RESULTS: Parametric survival estimation model based on our institutional data showed that preoperative albumin concentration (Alb) alone can allow us to estimate survival probability (S) at post-transplant day (t), indicated S(t), by the following formula; λ=exp (−6.46455–0.580872×Alb), S(t)=exp(−λ × t). The survival probabilities of patients with an Alb of 3.0, 3.5 and 4.0 mg/dL at 2000 days post-HTx were 58.0, 66.5, and 73.7%, respectively. Based on the UNOS data, we can create the formula as; λ=exp(−8.22281–0.106462×Alb), S(t)=exp(−λ × t). CONCLUSIONS: Pre-transplant serum albumin level is a useful marker to estimate post-transplant survival.