Abstract 19816: Recipient Body Mass Index and Role of Continuous Flow Mechanical Circulatory Assist Device in Patients Undergoing Heart Transplantation

Abstract

Introduction: Extremes of body mass indices (BMI) at the time of heart transplantation (HT) have been associated with adverse post-transplant survival. Data is limited in evaluating the survival impact of continuous flow left mechanical circulatory support (CF-LMCS) devices across categories of BMI. Method: We performed post-hoc analysis of 17,480 patients (age: 53±12 years, 74.5% males, 4.1 years of median follow-up) undergoing HT from the United Network of Organ Sharing (UNOS) registry database. Patients were divided into following BMI categories: underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to 24.9 kg/m2), overweight (BMI 25 to 29.9 kg/m2), mildly obese (BMI 30 to 34.9 kg/m2) and morbidly obese (BMI ≥35 kg/m2); Post-transplant survival was assessed for patients with and without CF-LMCS devices across these categories of BMI using Cox-proportional hazard analysis. Results: See Figure 1 and 2 Conclusion: At extremes of BMI, CF-LMCS devices had statistically non-significant association with post-HT survival. For those with BMI between 18.5 to 35 kg/m2, CF-LMCS devices offered survival advantage, suggesting that optimizing recipients' BMI within this range prior to undergoing HT may help improving their post-transplant survival.