Double Bridge May Result Similar 3-year Outcome after Heart Transplantation

Abstract

Bridge to transplantation may lead to different short-term or long-term result. We wonder the long-term outcome in the different bridge options, including the double bridge (ECMO then VAD), may lead different long-term result, especially for those with ECMO support. We retrospectively review the database of heart transplantation in the period of 2009 to 2018. Groups were divided into 1. group(No): without mechanical support, 2. group(IABP): with IABP support only, 3. group(ECMO): with ECMO support only but may with IABP, 4. group(VAD): supported by initial VAD without ECMO bridge, 5. group(double bridge): with initial ECMO support then bridge to VAD. Total 251 heart transplants were recruited, 115 without mechanical support, and 136 with mechanical support. There were 64 patients supported by IABP, 92 patients by ECMO, 88 patients by VAD. The detail number of different groups as followed: group (No): 115, group(IABP): 15, group(VAD): 88, group(double): 59. The survival curve demonstrated the 3-year survival were similar among the group(No), group(VAD) and group(double). The group(ECMO) and group(IABP) had a significant inferior survival in 3 years. Double bridge may possess a similar outcome to the initial VAD or without mechanical support. Early shift from ECMO to VAD may be considered as a strategy for a optimal outcome.