Role of ventricular assist devices in the German heart allocation system.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
Takeshi KomodaRoland Hetzer

Abstract

The Eurotransplant (ET) allocation algorithm, newly implemented in 2000, gives priority for heart transplantation (HTx) to patients with high urgency (HU) status, but now this status is rescinded upon ventricular assist device (VAD) implantation and only regained if severe complications occur during mechanical circulatory support (MCS). We studied the effects of this change on the patients in our institute who were waiting for HTx with MCS. The median duration of MCS until HTx in adult patients gradually increased from 3.1 months in 1994, reaching a peak of 16.7 months in 2000, and then gradually decreased to 6.0 months in 2003. Among the patients with VAD implantation as a bridge to HTx, two patients were on MCS for more than 1 year (the longest duration of MCS being 1.6 years) at the end of 1999, and this figure increased to nine patients and a maximum MCS duration of 3.7 years at the end of 2003. These data imply that the patients in whom a complication occurred in the early phase of MCS and who had overcome this complication underwent HTx early with HU status, and those who were stable during MCS waited a long time for HTx. Furthermore, the number of patients in the latter group is increasing. The new allocation algorithm i...Continue Reading

References

Oct 1, 1991·Journal of the American College of Cardiology·L W StevensonH Laks
Dec 22, 1999·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·D G RenlundR S Shaddy
Jul 21, 2000·The Thoracic and Cardiovascular Surgeon·M C DengH H Scheld
Jan 17, 2002·The New England Journal of Medicine·E A RoseUNKNOWN Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group
Nov 29, 2002·The Thoracic and Cardiovascular Surgeon·J GroetznerB Reichart
Dec 6, 2003·Transplantation·Wilbert B van den HoutUNKNOWN Eurotransplant heart transplant programs
Jun 24, 2004·Asian Cardiovascular & Thoracic Annals·Norihide FukushimaMotonobu Nishimura

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Citations

Sep 25, 2009·Artificial Organs·Lorenz GeidlHeinrich Schima
Dec 12, 2012·Progress in Cardiovascular Diseases·Richard B Freeman, James L Bernat
Jun 17, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Nader MoazamiDavid Feldman
Oct 18, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Takeshi KomodaHans B Lehmkuhl
Jun 19, 2007·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Y SawaH Watanabe
Jan 26, 2010·Transplantation·Vera Regitz-ZagrosekRoland Hetzer

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