Cumulative Multidomain Vulnerability and Early Mortality After Heart Transplantation: Development and Temporal Evaluation of the RIGHT-HTx Framework

BACKGROUND Risk models from high-income transplant programmes may not generalise to resource-constrained settings with different recipient acuity, donor characteristics and access to mechanical circulatory support. We developed RIGHT-HTx, a parsimonious framework integrating clinical and physiological vulnerabilities, and evaluated its prognostic performance in a subsequent same-centre cohort. METHODS This retrospective single-centre study included 436 consecutive adult heart transplant recipients (2012-2026). Of 357 development recipients, 341 (95.5%) were score-evaluable. RIGHT-HTx incorpora

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