Use of a surgically implanted, nondischargeable, extracorporeal continuous flow circulatory support system as a bridge to heart transplant

We aimed to describe the clinical outcomes of the use of the CentriMag acute circulatory support system as a bridge to emergency heart transplantation (HTx). We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival. The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for> 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke. In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes. Nuestro objetivo es describir los resultados clínicos del uso del sistema de asistencia circulatoria mecánica CentriMag como puente a trasplante cardiaco (TxC) urgente. Se realizó un análisis descriptivo de los desenlaces clínicos de los pacientes incluidos en un registro multicéntrico de 16 hospitales españoles tratados con el dispositivo Centrimag, configurado para asistencia ventricular izquierda (AVI) o biventricular (ABV). Todos los pacientes estaban en lista de espera para TxC urgente durante el periodo 2010-2020. Se excluyó a los pacientes con solo asistencia ventricular derecha u oxigenador extracorpóreo de membrana sin AVI. El objetivo principal del estudio fue la supervivencia a 1 año del TxC. Se estudió a 213 pacientes tratados con ABV y 145 con AVI como puente a TxC urgente. En total, s