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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container_end_page 2730
container_issue 9
container_start_page 2728
container_title Transplantation proceedings
container_volume 53
creator 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
description •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
doi_str_mv 10.1016/j.transproceed.2021.06.030
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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 &lt;10 days before HTx; those with ECMO implanted for &gt;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 &gt;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 &lt; .1). There are different risk subgroups among patients who are transplanted with a circulatory/ventricular assist device. 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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 &lt;10 days before HTx; those with ECMO implanted for &gt;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 &gt;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 &lt; .1). There are different risk subgroups among patients who are transplanted with a circulatory/ventricular assist device. 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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 &lt;10 days before HTx; those with ECMO implanted for &gt;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 &gt;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 &lt; .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 &lt;10 and when the implanted device is a Levitronix Centrimag in INTERMACS 2 to 3 profile, particularly when the patient reaches the HTx without requiring OI.</abstract><pub>Elsevier Inc</pub><doi>10.1016/j.transproceed.2021.06.030</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0001-5145-8191</orcidid><orcidid>https://orcid.org/0000-0003-3740-6154</orcidid><orcidid>https://orcid.org/0000-0003-2851-4153</orcidid></addata></record>
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title Analysis of the Intrahospital and Long-Term Survival of Heart Transplant Patients With a Short-Term Mechanical Assistance Device
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