Heart Transplant Outcomes After Total Artificial Heart.

Autor: Arabía FA; Advanced Heart Program-University Medical Group and University of Arizona College of Medicine-Phoenix, Phoenix, Arizona. Electronic address: francisco.arabia@bannerhealth.com., Murray CF; Phoenix Medical Campus, University of Arizona, Phoenix, Arizona., Cantor R; Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama., Deng L; Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama., Gopalan R; University of Arizona College of Medicine and Center for Advanced Heart Failure/Mechanical Circulatory Support and Transplant, Banner-University Medical Center Phoenix, Phoenix, Arizona., Amabile O; University of Arizona College of Medicine-Phoenix, Phoenix, Arizona., Kalya A; University of Arizona College of Medicine and Center for Advanced Heart Failure/Mechanical Circulatory Support and Transplant, Banner-University Medical Center Phoenix, Phoenix, Arizona., Tasset MR; University of Arizona College of Medicine-Phoenix, Phoenix, Arizona., Colón MJ; University of Arizona College of Medicine-Phoenix, Phoenix, Arizona., Smith R; Banner-University Medical Center Tucson and South Tucson, Tucson, Arizona., Kirklin JK; Kirklin Institute for Research in Surgical Outcomes, University of Alabama, Birmingham, Alabama.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2023 Sep; Vol. 55 (7), pp. 1664-1673. Date of Electronic Publication: 2023 Jul 13.
DOI: 10.1016/j.transproceed.2023.05.020
Abstrakt: Background: We sought to compare heart transplant (HTX) outcomes from patients with a total artificial heart (TAH), biventricular assist device (BiVAD), or left ventricular assist device (LVAD) as a bridge to transplant (BTT). Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)-Scientific Registry of Transplant Recipients (SRTR) created a dataset with TAH or durable mechanical circulatory support (MCS) who reached HTX between 2006 and 2015.
Methods: The retrospective analysis compared TAH outcomes with those with a BiVAD or LVAD before HTX. The primary outcome was posttransplant survival at 1, 36, and 60 months. Secondary outcomes included simultaneous heart-kidney transplants, donor characteristics, and mortality risk factors. INTERMACS-SRTR cohort had, at the time of HTX, 2762 patients with LVAD; 205 BiVAD (139 durable and 66 temporary RVAD); 176 TAH (6 prior HeartMate II).
Results: Sixty months after HTX, mortality rates were 16.5% in the total group: LVAD 15.2%, BiVAD 22.4%, and TAH 29%. Survival differed between the LVAD, the TAH, and BiVAD but not between the BiVAD and TAH groups. One-year survival and complication rates were similar across groups-there was no difference in survival by donor age in the overall cohort. There was a difference in TTD based on recipient age in the LVAD group but not in BiVAD or TAH groups. Occurrence of HTX-kidney and post-transplant dialysis were higher in the TAH versus LVAD and BiVAD groups.
Conclusions: The TAH is an efficacious BTT. Refinements in technology and patient selection may improve outcomes.
Competing Interests: Declaration of Competing Interest Francisco A. Arabia is a consultant to SynCardia Systems. Richard Smith is a consultant to SynCardia Systems. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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