Analysis of the Intrahospital and Long-Term Survival of Heart Transplant Patients With a Short-Term Mechanical Assistance Device

•There are different risk subgroups in terms of mortality among patients transplanted with a circulatory/ventricular assist device.•The 2 highest risk groups were those who had extracorporeal membrane oxygenation >10 days before transplantation and patients with Levitronix Centrimag implantation...

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Veröffentlicht in:Transplantation proceedings 2021-11, Vol.53 (9), p.2728-2730
Hauptverfasser: López-Vilella, Raquel, Sánchez-Lázaro, Ignacio, Moncho, Azucena Pajares, Peregrina, Mónica Talavera, Guillén, Manuel Pérez, Jáuregui, Iratxe Zarragoikoetxea, Costa, Ricardo Gimeno, Trenado, Víctor Donoso, Dolz, Luis Martínez, Puerta, Salvador Torregrosa, Bonet, Luis Almenar
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Sprache:eng
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Zusammenfassung:•There are different risk subgroups in terms of mortality among patients transplanted with a circulatory/ventricular assist device.•The 2 highest risk groups were those who had extracorporeal membrane oxygenation >10 days before transplantation and patients with Levitronix Centrimag implantation who were classified as INTERMACS 2.•Orotracheal intubation before transplantation has a negative effect on survival. The purpose of this study was to compare early and late survival among patients who have undergone heart transplantation (HTx) with a short-term mechanical assist device. This was an ambispective, single-center, consecutive study of patients undergoing urgent HTx for 5 years. Pediatric transplants, retransplants, and combined transplants were excluded. Forty-five patients were included. Four groups were analyzed: those with venoarterial extracorporeal membrane oxygenation (ECMO) implanted 10 days; patients classified as INTERMACS 2 to 3 with Levitronix Centrimag implanted; and those classified as INTERMACS 2 with Levitronix Centrimag implanted. Survival and the influence of orotracheal intubation (OI) at the time of transplantation were compared. There were differences in in-hospital mortality (P = .03) and total mortality (P = .06). The groups with the highest risk for mortality were those who carried ECMO for >10 days before transplantation or those classified as INTERMACS 2 with Levitronix Centrimag implanted. In these groups, the need for posttransplant circulatory support was also greater (P = .04) as was the length of stay in critical care (P = .02). The need for OI during the days of care and until transplantation had a negative effect on survival in all groups (P < .1). There are different risk subgroups among patients who are transplanted with a circulatory/ventricular assist device. The lowest mortality occurs when the days of ECMO implantation are
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2021.06.030