CRITERIA OF PRIORITY ON THE WAITING LIST FOR CARDIAC TRANSPLANTATION

The limited ressources (in grafts, human and financial resources) inci ted the authors to carry out a prospective assessment of the value of assessing adrenergic function (scintigraphy with meta-iodo-benzyl guan idine, MIBG) for the procedure of inscription on the waiting list of p atients with cardiac failure awaiting cardiac transplantation. The stu dy was undertaken from October 1988 to October 1992. Seventy-eight can didates for transplantation were included in the study. Forty-six pati ents with a MIBG cardiothoracic ratio less than 120 % were placed on t he 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 cardiothora cic ratio greater than 120 % were treated medically : in 14 cases (43 %) this decision was reviewed after 17 +/- 12 months. The clinical cou rse 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 p atients with cardiac failure judged to be good candidates for transpla ntation based on the value of the MIBG cardiothoracic ratio allows def errement of inscription of patients at least risk without changing the chances of survival in the whole population group within a 2 year per iod.