Post Heart Transplantation Outcomes of Patients Supported on Biventricular Mechanical Support
| Autor: | Sabeena Arora, Joseph Radojevic, Ayyaz Ali, Douglas L. Jennings, Jonathan Hammond, Jason Gluck, Abhishek Jaiswal, William L. Baker, Naga Vaishnavi Gadela, A. Scatola, Oisharya Dasgupta, David A. Baran |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors medicine.medical_treatment Biomedical Engineering Biophysics Bioengineering Biomaterials Internal medicine Cox proportional hazards regression medicine Extracorporeal membrane oxygenation Humans Retrospective Studies Heart Failure Heart transplantation business.industry Mortality rate General Medicine Treatment Outcome surgical procedures operative Propensity score weighting Cardiology Heart Transplantation Support system Heart-Assist Devices business |
| Zdroj: | ASAIO Journal. 68:914-919 |
| ISSN: | 1058-2916 |
| DOI: | 10.1097/mat.0000000000001588 |
| Popis: | With the implementation of the new heart transplant (HT) allocation system, patients requiring biventricular support systems have the highest priority, a shorter waitlist time, and a higher frequency of HT. However, the short-term and long-term outcomes of such patients are often disputed. Hence, we examined the outcomes of these patients who underwent HT before change in allocation scheme. Additionally, we compared post-HT outcomes of extracorporeal membrane oxygenation (ECMO) with other nondischargeable biventricular (BiVAD) supported patients. We identified adult ECMO or BiVAD supported HT recipients between 2000 and 2018 in the Scientific Registry of Transplant Recipients database. We compared survival with the Kaplan-Meier method. Using overlap propensity score weighting, we constructed Cox proportional hazards regression models to determine the risk-adjusted influence of BiVAD versus ECMO on survival. Of the 730 patients HT recipients; 528 (72.3%) and 202 (27.7%) were bridged with BiVAD and ECMO, respectively. For BiVAD versus ECMO patients, the 30-day, 1-year, 3-year, and 5-year mortality rates were 8.0% versus 14.4%, 16.3% versus 21.3%, 22.4% versus 25.3%, and 26.3% versus 25.7%, respectively. Risk-adjusted post-HT survival of BiVAD and ECMO patients at 30-day (HR 1.24 [95% CI, 0.68-2.27]; P = 0.4863), 1-year (HR 1.29 [95% CI, 0.80-2.09]; P = 0.3009), 3-year (HR 1.27 [95% CI, 0.83-1.94]; P = 0.2801), and 5-year (HR 1.35, 95% CI, 0.90-2.05; P = 0.1501) were similar. Around three-fourth of the ECMO or BiVAD supported patients were alive at 5-years post-HT. The short-term and long-term post-HT survivals of groups were comparable. |
| Databáze: | OpenAIRE |
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