Preoperative Comorbidity Correlates Inversely with Survival after Intestinal and Multivisceral Transplantation in Adults
Table 1
Pretransplant risk assessment score for intestinal and multivisceral transplantation in adults. The score was assigned to the severity of each comorbidity resulting in a cumulative comorbidity score.
Score
Degree of comorbidity
0
Normal
1
Comorbidity with no significant functional impairment requiring treatment: (mild hypertension, slight glucose intolerance—diet controlled, mild exercise-induced asthma, renal impairment—slightly impaired GFR reduced by 10% only, smoker without respiratory dysfunction, and past history of depressive illness)
2
Comorbidity requiring treatment to prevent functional impairment—deemed to present a slightly increased surgical risk: (treated hypertension, mild coronary artery disease without symptoms, DM-oral hypoglycemics, mild asthma—stable on intermittent therapy, renal impairment—moderately reduced GFR 10–25%, smoker with mild respiratory dysfunction but no symptomatic limitation, treated and resolved depression).
3
Comorbidity that despite treatment causes functional impairment and presents a moderate risk to surgery: (poorly controlled hypertension, angina controlled by Tx—minor vessel disease, DM—insulin dependent, renal impairment—moderately reduced GFR 25–50%, treated but unresolved depression, COPD with mild symptoms requiring occasional treatment during exacerbations)
Venous access: after loss of two major venous access points each additional loss scores one point.