Details

Autor(en) / Beteiligte

• Bull, David A., MD
• Reid, Bruce B., MD
• Selzman, Craig H., MD
• Mesley, Rebecca, BS
• Drakos, Stavros, MD
• Clayson, Steven, MD
• Stoddard, Greg, PhD
• Gilbert, Edward, MD
• Stehlik, Josef, MD
• Bader, Feras, MD
• Kfoury, Abdallah, MD
• Budge, Deborah, MD
• Eckels, David D., PhD
• Fuller, Anne, BS
• Renlund, Dale, MD
• Patel, Amit N., MD

Titel

The impact of bridge-to-transplant ventricular assist device support on survival after cardiac transplantation

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2010-07, Vol.140 (1), p.169-173

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2010

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Objective To determine the impact of bridge-to-transplant ventricular assist device support on survival after cardiac transplantation. Methods From January 1, 1993, to April 30, 2009, a total of 525 cardiac transplants were performed. Ventricular assist devices were placed as a bridge to transplant in 110 patients. We focused our analysis on the 2 most common causes of end-stage heart failure requiring transplantation: idiopathic dilated cardiomyopathy (n = 201) and coronary artery disease (n = 213). Data including gender, age, date of transplant, cause of heart failure, prior heart transplant, placement of a ventricular assist device, type of ventricular assist device, and panel-reactive antibody sensitization were analyzed to derive Kaplan–Meier survival probabilities and multivariable Cox regression models. Results In patients with idiopathic dilated cardiomyopathy who received a ventricular assist device as a bridge to transplant, survival was decreased at 1 year ( P  = .008) and 5 years ( P  = .019), but not at 10 years, posttransplant. In patients with coronary artery disease, the use of a ventricular assist device as a bridge to transplant did not influence survival at 1, 5, and 10 tears posttransplant. In patients with idiopathic dilated cardiomyopathy who received a Heartmate I (Thoratec Corp, Pleasanton, Calif) ventricular assist device as a bridge to a cardiac transplant, elevation in the pretransplant panel-reactive antibody correlated with a decrease in long-term survival. Conclusion In patients with idiopathic dilated cardiomyopathy, placement of a Heartmate I ventricular assist device as a bridge to a cardiac transplant is associated with an elevation in the pretransplant panel-reactive antibody and a decrease in 1- and 5 - year survivals after cardiac transplantation.