Thorac Cardiovasc Surg 2015; 63 - OP164
DOI: 10.1055/s-0035-1544416

Influence of Duration of Continuous-Flow Ventricular Assist Device Support on Post-Transplant Outcome - Results Using the United Network for Organ Sharing Database

A.M. Bernhardt 1, A. P. Levin 2, H. Reichenspurner 1, V. Topkara 2
  • 1Universitäres Herzzentrum Hamburg, Herz- und Gefäßchirurgie, Hamburg, Germany
  • 2Columbia University Medical Center, New York City, United States

Background: An increasing number of patients is bridged to transplant by continuous-flow left ventricular assist devices (CF-LVAD). The purpose of this study is to analyze post-transplant outcomes of heart transplant recipients bridged to transplantation with CF-LVAD after different support durations.

Methods: The United Network for Organ Sharing Database (UNOS) was reviewed to identify first-time heart transplant recipients who were bridged to transplantation with CF-LVAD from January 2011 through September 2013. A total number of 8,006 patients were analyzed. Of those 2,660 patients (33.23%) were bridged to transplant by a CF-LVAD. 1,320 patients with a Thoratec HeartMate II and 146 patients with a HeartWare HVAD were transplanted. Patients were divided into quartiles.

Results: Mean age in heart transplant recipients was 53.8 ± 12.4 years and 77.2% were male. Mean time on device till transplant were 315.1 ± 267.8 days. Pre-transplant characteristics were not significantly different between the groups. Post-transplant survival rates were similar between the duration groups at at 24 months (90.6%, 82.8%, 81.4% and 83.1, respectively; p = n.s.). PRA peak levels were lowest in the second quartile, although the acute rejection episodes were highest in this group.

Conclusions: Post-transplant survival is not affected by the duration of pre-transplant VAD support. However, PRA levels were lowest in the second groups with a higher rate of acute rejection.