The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 1 , Pages 174-181 , July 2010

Post–cardiac transplant survival after support with a continuous-flow left ventricular assist device: Impact of duration of left ventricular assist device support and other variables

Read at the Eighty-ninth Annual Meeting of The American Association for Thoracic Surgery, Boston, Massachusetts, May 9–13, 2009.

  • Ranjit John, MD

      Affiliations

    • Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minn
    • Corresponding Author InformationAddress for reprints: Ranjit John, MD, Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, MN 55455.
    • ,
  • Francis D. Pagani, MD

      Affiliations

    • University of Michigan, Ann Arbor, Mich
    • ,
  • Yoshifumi Naka, MD

      Affiliations

    • Columbia University, New York, NY
    • ,
  • Andrew Boyle, MD

      Affiliations

    • Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minn
    • ,
  • John V. Conte, MD

      Affiliations

    • Johns Hopkins University, Baltimore, Md
    • ,
  • Stuart D. Russell, MD

      Affiliations

    • Johns Hopkins University, Baltimore, Md
    • ,
  • Charles T. Klodell, MD

      Affiliations

    • University of Florida, Gainesville, Fla
    • ,
  • Carmelo A. Milano, MD

      Affiliations

    • Duke University, Durham, NC
    • ,
  • Joseph Rogers, MD

      Affiliations

    • Duke University, Durham, NC
    • ,
  • David J. Farrar, PhD

      Affiliations

    • Thoratec Corp, Pleasanton, Calif
    • ,
  • O. Howard Frazier, MD

      Affiliations

    • Texas Heart Institute, Houston, Tex

Received 2 June 2009 ,Revised 7 January 2010 ,Accepted 26 March 2010.

References 

  1. Taylor DO, Edwards LB, Aurora P, Christie JD, Dobbels F, Kirk R, et al. Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult heart transplant report—2008. J Heart Lung Transplant. 2008;27:943–956
  2. Frazier OH, Rose EA, Oz MC, Dembitsky W, McCarthy P, Radovancevic B, et al. Multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system in patients awaiting heart transplantation. J Thorac Cardiovasc Surg. 2001;122:1186–1195
  3. Frazier OH, Rose EA, McCarthy P, Burton NA, Tector A, Levin H, et al. Improved mortality and rehabilitation of transplant candidates treated with a long-term implantable left ventricular assist system. Ann Surg. 1995;222:327–336discussion 336-8
  4. Farrar DJ, Hill JD, Pennington DG, McBride LR, Holman WL, Kormos RL, et al. Preoperative and postoperative comparison of patients with univentricular and biventricular support with the Thoratec ventricular assist device as a bridge to heart transplantation. J Thorac Cardiovasc Surg. 1997;113:202–209
  5. Gammie JS, Edwards LB, Griffith BP, Pierson RN, Tsao L. Optimal timing of cardiac transplantation after ventricular assist device implantation. J Thorac Cardiovasc Surg. 2004;127:1789–1799
  6. Ashton RC, Goldstein DJ, Rose EA, Weinberg AD, Levin HR, Oz MC. Duration of left ventricular assist device support affects transplant survival. J Heart Lung Transplant. 1996;15:1151–1157
  7. Renlund DG, Taylor DO, Kfoury AG, Shaddy RS. New UNOS rules: historical background and implications for transplantation management. J Heart Lung Transplant. 1999;18:1065–1070
  8. Patolla V, Patten RD, DeNofrio D, Konstam MA, Krishnamani R. The effect of ventricular assist devices on post-transplant mortality. An analysis of the United Network for Organ Sharing Thoracic Registry. J Am Coll Cardiol. 2009;153:264–271
  9. Cleveland JC, Grover FL, Fullerton DA, Campbell DN, Mitchell MB, Lindenfeld J, et al. Left ventricular assist device as bridge to transplantation does not adversely affect one-year transplantation survival. J Thorac Cardiovasc Surg. 2008;136:774–777
  10. Jaski BE, Kim JC, Naftel DC, Jarcho J, Costanzo MR, Eisen HJ, et al. Cardiac transplant outcome of patients supported on left ventricular assist device vs intravenous inotrope therapy. J Heart Lung Transplant. 2001;20:449–456
  11. Morgan JA, Park Y, Kherani AR, Vigilance DW, Cheema FH, Oz MC, et al. Does bridging to transplantation with a left ventricular assist device adversely affect posttransplantation survival? A comparative analysis of mechanical versus inotropic support. J Thorac Cardiovasc Surg. 2003;126:1180–1190
  12. Aaronson KD, Eppinger MJ, Dyke DB, Wright S, Pagani FD. Left ventricular assist device therapy improves utilization of donor hearts. J Am Coll Cardiol. 2002;39:1247–1254
  13. Robertson JO, Lober C, Smedira NG, Navia JL, Sopko N, Gonzalez-Stawinski GV. One hundred days or more bridged on a ventricular assist device and effects on outcomes following heart transplantation. Eur J Cardiovasc Surg. 2008;34:295–300
  14. Stewart AS, Russo MJ, Martens TP, Naseem TM, Deng MC, Wang R, et al. Longer duration of continuous-flow ventricular assist device support predicts greater hemodynamic compromise after return to pulsatility. J Thorac Cardiovasc Surg. 2008;136:524–525
  15. Miller LW, Pagani FD, Russell SD, John R, Boyle AJ, Aaronson KD, et al. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885–896
  16. Koch CG, Li L, Duncan AI, Mihaljevic T, Cosgrove DM, Loop FD, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med. 2006;34:1608–1616
  17. John R, Lietz K, Schuster M, Naka Y, Rao V, Mancini D, et al. Immunologic sensitization in recipients of left ventricular assist devices. J Thorac Cardiovasc Surg. 2003;125:578–591
  18. Moazami N, Itescu S, Williams M, Argenziano M, Weinberg A, Oz M. Platelet transfusions are associated with the development of anti–major histocompatibility complex class I antibodies in patients with left ventricular assist device support. J Heart Lung Transplant. 1998;17:876–880
  19. Nwakanma LU, Williams JA, Weiss ES, Russell SD, Baumgartner WA, Conte JV. Influence of pretransplant panel-reactive antibody on outcomes in 8190 heart transplant recipients in recent era. Ann Thorac Surg. 2007;84:1556–1562
  20. Pagani FD, Miller LW, Russell SD, Aaronson KD, John R, Boyle AJ, et al. Extended mechanical circulatory support with a continuous-flow rotary ventricular assist device. J Am Coll Cardiol. 2009;51:312–321
  21. Schulman AR, Martens TP, Russo MJ, Christos PJ, Gordon RJ, Lowy FD, et al. Effect of left ventricular assist device infection on post-transplant outcomes. J Heart Lung Transplant. 2009;28:237–242
  22. Zierer A, Melby SJ, Voeller RK, Guthrie TJ, Ewald GA, Shelton K, et al. Late-onset driveline infections: The Achilles' heel of prolonged left ventricular assist device support. Ann Thorac Surg. 2007;84:515–521
  23. Kormos RL, Teuteberg JJ, Pagani FD, Russell SD, John R, Miller LW, et al. Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: incidence, risk factors, and effect on outcomes. J Thorac Cardiovasc Surg. 2010 Feb 2;[Epub ahead of print]
  24. Dembitsky WP, Tector AJ, Park S, Moskowitz AJ, Gelijns AC, Ronan NS, et al. Left ventricular assist device performance with long term circulatory support: lessons from the REMATCH trial. Ann Thorac Surg. 2004;78:2123–2130
  25. Morgan JA, Mazzeo PA, Flannery MR, Oz MC, Naka N. Effects of changes in UNOS policy regarding left ventricular assist devices. J Heart Lung Transplant. 2004;23:620–622
  26. Travis AR, Giridharan GA, Pantalos GM, Dowling RD, Prabhu SD, Slaughter MS, et al. Vascular pulsatility in patients with a pulsatile- or continuous-flow ventricular assist device. J Thorac Cardiovasc Surg. 2007;133:517–524

 Disclosures: Joseph Rogers, Francis Pagani, Stuart Russell, and Andrew Boyle report fees and grant support from Thoratec.

PII: S0022-5223(10)00335-1

doi: 10.1016/j.jtcvs.2010.03.037

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 1 , Pages 174-181 , July 2010

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