Survival on the heart transplant waiting list: impact of continuous flow left ventricular assist device as bridge to transplant.
作者： Jaimin R Trivedi , Allen Cheng , Ramesh Singh , Matthew L Williams , Mark S Slaughter
DOI: 10.1016/J.ATHORACSUR.2014.05.019
关键词: Transplant Waiting List 、 Heart transplantation 、 Pulmonary artery 、 Internal medicine 、 Propensity score matching 、 Retrospective cohort study 、 Ventricular assist device 、 Medicine 、 Survival rate 、 Transplantation 、 Surgery 、 Cardiology
摘要: Background Continued donor organ shortage and improved outcomes with current left ventricular assist device (LVAD) technology have increased the number of patients supported bridge-to-transplantation (BTT) therapy. Using United Network Organ Sharing (UNOS) database, we assessed impact on survival in BTT while heart transplant waiting list. Methods The UNOS database was queried from January 2005 to June 2012 identify listed for transplantation as status 1A or 1B. Patients implanted a pulsatile-flow an LVAD other than HeartMate II (HM II; Thoratec Inc, Pleasanton, CA) were excluded. divided into non-LVAD groups based at time listing. propensity matched (LVAD –non-LVAD = 1:2) age, sex, weight, presence diabetes, creatinine levels, mean pulmonary artery pressure, status. Kaplan-Meier curves analyzed survival. Results A total 8,688 analyzed, 1,504 (17%) group. Average age (52.6 ± 11.8 versus 51.3 12.9 years; p = 0.0002) weight (86.6 18.6 80.8 18.2 kg; 0.03) Of all patients, 6,943 (80%) underwent transplantation, 862 (10%) died, 883 remained the waiting After matching, significantly better group both 1 year (91% 77%) 2 years (85% 68%). Conclusions HM therapy older comorbidities; they demonstrated transplantation. use LVADs strategy can potentially improve patient allow allocation hearts.
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