Post-Cardiac Transplant Survival of Patients Supported by the Heartmate 3 Devices: A UNOS Analysis

Abstract

Introduction Post cardiac transplant outcomes of patients supported with the Heartmate 3 left ventricular assist device (LVAD) have not been previously reported. The purpose of this analysis was to report status at the time of transplant and survival by continuous flow (CF) device type. Hypothesis Patients supported with a HeartMate 3 LVAD will have a similar post-transplant survival to other contemporary CF-LVADs. Methods The study cohort included adult patients supported on contemporary, continuous flow (CF) devices in the UNOS registry who underwent cardiac transplant between the years 2014-2018, prior to the 2018 UNOS allocation system change. The analysis was limited to patients who underwent initial LVAD implantation in 2014 and beyond to allow post-transplant comparisons among patients with similar LVAD support times. Multivariable cox regression was performed to assess the association between LVAD type and post-transplant survival. Results The study cohort consisted of 3,117 patients who underwent cardiac transplant while on LVAD support (Heartmate 2: 1,545, Heartmate 3: 179, HeartWare (HVAD): 1,393). No patients supported on Heartmate 3 devices were transplanted for pump thrombosis during this time period. Patients supported on the Heartmate 3 were less likely to be listed 1A for complications at the time of transplant (Heartmate3: 28 % (51/179), Heartmate 2: 44 % (680/1,545), HVAD 37 % (511/1,393, p Conclusions Patients supported with Heartmate 3 LVAD at the time of transplant have similar survival after transplant compared to other contemporary CF devices in this early experience. No patients with a Heartmate 3 were transplanted for device thrombosis.