Abstract

PurposeContinuous flow left ventricular assist devices (LVAD) are frequently used as a bridge to transplant (BTT) in patients with stage D heart failure. There is conflicting data regarding post transplant survival in patients bridged to transplant with a LVAD compared to those who proceed directly to transplant. We assessed post transplant outcomes at our institution among patients who received an axial or centrifugal flow LVAD as compared to those who went directly to transplant.MethodsNinety-seven patients underwent orthotopic heart transplant between January 2008 and October 2013. We performed a retrospective analysis of post transplant outcomes in patients with and without an isolated continuous flow LVAD as BTT. Patients with a permanent RVAD, pulsatile LVAD, re-transplant or dual-organ transplants were excluded. Eighty four patients were included in this analysis.ResultsThere was no statistically significant difference in baseline characteristics and post transplant outcomes between the groups.ConclusionThere was no difference in post transplant outcomes in patients bridged to transplant with an LVAD compared to those who went directly to transplant. There appeared to be a trend toward improved survival in the axial flow group and increased incidence of rejection in the centrifugal flow LVAD group. These findings should be further evaluated in future studies. PurposeContinuous flow left ventricular assist devices (LVAD) are frequently used as a bridge to transplant (BTT) in patients with stage D heart failure. There is conflicting data regarding post transplant survival in patients bridged to transplant with a LVAD compared to those who proceed directly to transplant. We assessed post transplant outcomes at our institution among patients who received an axial or centrifugal flow LVAD as compared to those who went directly to transplant. Continuous flow left ventricular assist devices (LVAD) are frequently used as a bridge to transplant (BTT) in patients with stage D heart failure. There is conflicting data regarding post transplant survival in patients bridged to transplant with a LVAD compared to those who proceed directly to transplant. We assessed post transplant outcomes at our institution among patients who received an axial or centrifugal flow LVAD as compared to those who went directly to transplant. MethodsNinety-seven patients underwent orthotopic heart transplant between January 2008 and October 2013. We performed a retrospective analysis of post transplant outcomes in patients with and without an isolated continuous flow LVAD as BTT. Patients with a permanent RVAD, pulsatile LVAD, re-transplant or dual-organ transplants were excluded. Eighty four patients were included in this analysis. Ninety-seven patients underwent orthotopic heart transplant between January 2008 and October 2013. We performed a retrospective analysis of post transplant outcomes in patients with and without an isolated continuous flow LVAD as BTT. Patients with a permanent RVAD, pulsatile LVAD, re-transplant or dual-organ transplants were excluded. Eighty four patients were included in this analysis. ResultsThere was no statistically significant difference in baseline characteristics and post transplant outcomes between the groups. There was no statistically significant difference in baseline characteristics and post transplant outcomes between the groups. ConclusionThere was no difference in post transplant outcomes in patients bridged to transplant with an LVAD compared to those who went directly to transplant. There appeared to be a trend toward improved survival in the axial flow group and increased incidence of rejection in the centrifugal flow LVAD group. These findings should be further evaluated in future studies. There was no difference in post transplant outcomes in patients bridged to transplant with an LVAD compared to those who went directly to transplant. There appeared to be a trend toward improved survival in the axial flow group and increased incidence of rejection in the centrifugal flow LVAD group. These findings should be further evaluated in future studies.

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