In much of the latest research on cardiac transplantation of patients with congenital heart disease, it has been pointed out that transplanting these patients at the optimal time is key to improving outcomes. Of course, cardiologists cannot choose when the transplant will take place, but they can decide about when to list. The issue of determining when to list patients with congenital heart disease is unclear and controversial and, as such, there have been calls in the literature for more tools to help guide clinicians in making this complex decision. 

Laura Delaney, an expert in Financial Mathematics at Kings College London, has devised a mathematical model, based on techniques used in corporate decision making, to determine the optimal time to list a patient with CHD for transplant. 

The model accounts for factors such as rate of clinical decline, long term life expectancy without getting the transplant, expected waiting time, as well as the risk factors cardiologists look for in a patient when deciding about listing. The theoretical prescriptions of the model are intuitive and in line with reality; for example, it prescribes that patients who are declining rapidly ought to be listed sooner than a more stable patient, ceteris paribus.

In collaboration with Louise Coats, Katrijn Jansen, Guy MacGowan and Zdenka Reinhardt, Laura is trialling this model using real world data in order to determine its effectiveness in prescribing the correct course of action. If validated, the model could provide an important assistive tool to cardiologists deciding the optimal timing for listing of a particular patient. 

For more information, contact laura.delaney@kcl.ac.uk