TITLE:
Influence of the Type of Circulatory/Ventricular Assistance in the Primary Graft Failure and Heart Transplantation Mortality
AUTHORS:
Raquel López-Vilella, Ignacio J. Sánchez-Lázaro, María Paz Fuset Cabanes, Azucena Pajares Moncho, Lucía Doñate Bertolín, Ricardo Gimeno Costa, Ignacio Moreno Puigdollers, Luis Martínez Dolz, Iratxe Zarragoikoetxea Jauregui, Salvador Torregrosa Puerta, Luis Almenar Bonet
KEYWORDS:
Urgent Heart Transplantation, Short-Medium Term Circulatory/Ventricular Assistance, Primary Graft Failure
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.8,
August
19,
2019
ABSTRACT: OBJECTIVES: In recent years, the percentage of heart transplantation (HT) with short/medium-term assistance devices has increased. This study aims at analyzing primary graft failure and in-hospital mortality according to the type of care. MATERIAL AND METHODS: From January 2013 to December2017 all patients undergoing urgent HT with circulatory/ventricular assistancewere retrospectively and consecutively recruited. Combined transplants, retransplantations and pediatric transplants were excluded. The sample was divided in 10 groups according to the type of shot/medium term assistance devices. RESULTS: A total of 53 patients were recruited, 79% men, average age 49 ± 13 years. 26 patients (51%) had mechanical ventilation at the time of the HT. Primary graft failure occurred in 20 patients (38.5%), whilst it was more frequent in patients assisted with ECMO (8 patients in group 1 (45%) and 7 in group 2 (54%), p 0.5). 14 deaths (27%) were registered, whereas a higher mortality was observed in the group assisted with ECMO (6 patients in group 1 (34%) and 4 in group 2 (31%), p 0.6). Mortality was 17% in the group of non-urgent Levitronix. CONCLUSIONS: Despite not showing statistical significance due to the low number of patients in some subgroups, hospitalmortality was high in HT patients with circulatory assistance. A trend towards a higher incidence of primary graft failure and mortality in patients assisted with ECMO was observed. The direct implantation of a centrifugal pump as a bridge to urgent transplantation could identify a subgroup with a better prognosis.