This score was derived in a population of 1,024 orthotopic liver transplantrecipients age 18-75 years at a single large academic transplant center. Candidates were excluded from analysis if they had an absolute cardiac contraindication to transplant, defined as: (1) decreased left ventricular systolic function (ejection fraction < 45%), (2) decreased right ventricular function and/or significant right ventricular dilation, (3) uncontrolled pulmonary hypertension defined as pulmonary arterial systolic pressure (PASP) ≥ 35 mmHg at rest despite maximal medical management, (4) significant uncorrectable structural valvular abnormalities (aortic stenosis, mitral stenosis, aortic regurgitation, tricuspid regurgitation), (5) uncorrectable coronary artery disease with induced ischemia on stress testing, (6) significant carotid disease in particular if symptomatic, and (7) diffuse atherosclerotic disease involving multiple organs.Link to Publications
*A cardiovascular event is any death from a cardiovascular cause or hospitalization for a myocardial infarction, cardiac revascularization, heart failure, atrial fibrillation, cardiac arrest, pulmonary embolism, and/or stroke
**Optimal risk factors include: working for income, college education or higher, no history of atrial fibrillation, no current respiratory failure on a ventillator, no history of pulmonary hypertension, yes to a history hepatocellular carcinoma, no history of hypertension, no history of diabetes, and no history of heart failure.
***Worst case risk factors include: not working for income, high school education or lower, yes to a history of atrial fibrillation, yes to current respiratory failure on a ventillator, yes to a history of pulmonary hypertension, no history of hepatocellular carcinoma, yes to a history of hypertension, yes to a history of diabetes, and yes to a history of heart failure.