Survival After Heart Transplantation in Patients Bridged With Mechanical Circulatory Support

Journal of the American College of Cardiology
Philicia MoonsamyMauricio A Villavicencio

Abstract

The United Network of Organ Sharing (UNOS) heart allocation policy designates patients on ECMO or with nondischargeable, surgically implanted, nonendovascular support devices (TCS-VAD) to higher listing statuses. This study aimed to explore whether temporary circulatory support-ventricular assist devices (TCS-VAD) have a survival advantage over extracorporeal membrane oxygenation (ECMO) as a bridge to transplant. The UNOS database was used to conduct a retrospective analysis of adult heart transplants performed in the United States between 2005 and 2017. Survival analysis was performed to compare patients bridged to transplant with different modalities. Of the 24,905 adult transplants performed, 7,904 (32%) were bridged with durable left ventricular assist devices (LVADs), 177 (0.7%) with ECMO, 203 (0.8%) with TCS-VAD, 44 (0.2%) with percutaneous endovascular devices, and 8 (0.03%) with TandemHeart (LivaNova, London, United Kingdom). Unadjusted survival at 1 and 5 years post-transplant was 90 ± 0.4% and 77 ± 0.7% for durable LVAD, 84 ± 3% and 71 ± 4% for all TCS-VAD types, 79 ± 9% and 73 ± 14% for biventricular TCS-VAD, and 68 ± 3% and 61 ± 8% for ECMO. After propensity-matched pairwise comparisons were made, survival after all...Continue Reading

References

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Citations

Dec 6, 2020·Current Opinion in Organ Transplantation·Jefferson L Vieira, Mandeep R Mehra
Dec 6, 2020·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Matthew H GonzalezRenzo Y Loyaga-Rendon
May 4, 2021·Current Opinion in Organ Transplantation·Peter J AltshulerPavan Atluri
May 20, 2021·Current Opinion in Organ Transplantation·Peter J AltshulerPavan Atluri
Jun 13, 2020·Journal of the American College of Cardiology·Ashish S Shah, Lynne Warner Stevenson
Jun 28, 2021·The Journal of Thoracic and Cardiovascular Surgery·Andrew M Vekstein, Oliver K Jawitz
Jul 3, 2021·Journal of Clinical Medicine·Jun Ho LeeYang Hyun Cho
Aug 8, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Fernando A AtikMarcelo B Ulhoa
Nov 13, 2021·Frontiers in Cardiovascular Medicine·Jean BonnemainLucas Liaudet
Nov 21, 2020·Journal of the American College of Cardiology·Renzo Y Loyaga-RendonJames K Kirklin

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