Outcomes of mechanical support for cardiogenic shock associated with late cardiac allograft failure

Background Late graft failure (LGF) is an unresolved issue after orthotopic heart transplant (OHT). In this study, we report characteristics and outcomes of severe LGF requiring mechanical circulatory support (MCS). Methods All patients undergoing OHT from 2000 to 2018 at our center were reviewed. Patients re‐admitted to the hospital for late graft failure (>3 months after initial discharge) and developing cardiogenic shock requiring MCS were identified. Outcomes and mortality were evaluated. Results Twenty‐six patients were identified. Median age was 37.3 years (interquartile range: 28.2–47.6) and 69% were male. Median time from initial transplant to MCS was 2.9 years. Etiology of graft failure was rejection in 19 patients (73%), transplant coronary artery disease (tCAD) in 3 (12%), with mixed tCAD or rejection in 4 (15%).