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correlation with serum albumin, bilirubin, and creatinine. We also explored the association between listing Karnofsky scale score and waitlist survival. Results: We identified 27091 patients, with an average Karnofsky scale of 50.8%. More than half of all patients (51%) had severe functional limitation (Karnofsky scale < 50%). Karnofsky scale negatively correlated with bilirubin (p< 0.001), creatinine (p< 0.001), and correlated positively with serum albumin (p< 0.001). After adjusting for UNOS listing status, baseline characteristics, there was a gradual decrease in wait-list survival with decreasing Karnofsky scale (p< 0.001). Similar results were seen in patients with mechanical circulatory support. Conclusion: Functional status, as measured by Karnofsky scale, correlates with measures of hepatorenal dysfunction, and predicts outcomes in patients listed for heart transplantation and in patients with mechanical circulatory support.

after a significantly longer median wait (P< 0.001) [Table 1]. The adjusted probability of survival at 2 years was 49% in group I versus 67% in group II (P< 0.001). Among patients who underwent HT, the adjusted probability of survival in groupI versus group II was 84% versus 73%, respectively (ns), though, in the subgroups treated with inotropes, was 84% in groupI versus 66 % in group II (P= 0.01). The mean 2-year cost was € 390,833±178,998 per patient in group I versus € 65,154±30,258 in groupII (P= 0.002). Conclusion: In ESHF with inotropes, VAD were clinically effective, did not lower survival after HT, though were an expensive strategy.