274: Cumulative Incidence and Pattern of Adverse Events in the First 60 Days Post Ventricular Assist Device Implantation

Abstract

this might guide VAD selection in bridge-to-transplant (BTT) patients. Methods and Materials: Thirty-four patients implanted between 2001 and 2007 had both preand post-VAD PRA data available. We compared sensitization rates between pulsatile and CF devices. Sensitization was defined as either an absolute PRA or an increase in PRA 10% by cytotoxicity or class I or II flow cytometry. One Heartmate II, four VentrAssist, and fifteen Jarvik 2000 patients comprised the CF group. The pulsatile group included two Heartmate XVE, seven Novacor, and five Thoratec pVAD patients. Groups were compared using the Mann-Whitney U test. Results: Patients in each group had similar rates of pre-VAD sensitization. Sensitization rates post-VAD did not differ significantly between pulsatile and CF VADs. Gender did not impact preor post-VAD sensitization. In BTT patients, the average time to cardiac transplant was significantly shorter for the CF VADs (mean 81 61d, n 16) as compared to the pulsatile VADs (mean 205 119d, n 8, p 0.007). Conclusions: Sensitization rates were similar in patients with pulsatile and CF VADs. Despite this, CF VADs were associated with a significantly shorter average time to cardiac transplant. Our data suggest that sensitization should not be a deciding factor in selecting a pulsatile or a CF device. Factors other than sensitization may contribute to decreased time to transplant in CF VAD patients, which may improve post-transplant outcomes.