The impact of bridge-to-transplant ventricular assist device support on survival after cardiac transplantation

David A. Bull, Bruce B. Reid, Craig H. Selzman, Rebecca Mesley, Stavros Drakos, Steven Clayson, Greg Stoddard, Edward Gilbert, Josef Stehlik, Feras Bader, Abdallah Kfoury, Deborah Budge, David D. Eckels, Anne Fuller, Dale Renlund, Amit N. Patel

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Objective: To determine the impact of bridge-to-transplant ventricular assist device support on survival after cardiac transplantation. Methods: From January 1, 1993, to April 30, 2009, a total of 525 cardiac transplants were performed. Ventricular assist devices were placed as a bridge to transplant in 110 patients. We focused our analysis on the 2 most common causes of end-stage heart failure requiring transplantation: idiopathic dilated cardiomyopathy (n = 201) and coronary artery disease (n = 213). Data including gender, age, date of transplant, cause of heart failure, prior heart transplant, placement of a ventricular assist device, type of ventricular assist device, and panel-reactive antibody sensitization were analyzed to derive Kaplan-Meier survival probabilities and multivariable Cox regression models. Results: In patients with idiopathic dilated cardiomyopathy who received a ventricular assist device as a bridge to transplant, survival was decreased at 1 year (P = .008) and 5 years (P = .019), but not at 10 years, posttransplant. In patients with coronary artery disease, the use of a ventricular assist device as a bridge to transplant did not influence survival at 1, 5, and 10 tears posttransplant. In patients with idiopathic dilated cardiomyopathy who received a Heartmate I (Thoratec Corp, Pleasanton, Calif) ventricular assist device as a bridge to a cardiac transplant, elevation in the pretransplant panel-reactive antibody correlated with a decrease in long-term survival. Conclusion: In patients with idiopathic dilated cardiomyopathy, placement of a Heartmate I ventricular assist device as a bridge to a cardiac transplant is associated with an elevation in the pretransplant panel-reactive antibody and a decrease in 1- and 5-year survivals after cardiac transplantation.

Original languageEnglish (US)
Pages (from-to)169-173
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume140
Issue number1
DOIs
StatePublished - Jul 2010
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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