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surgical operations without significantly increased risk of late mediastinitis or sternal wound infection. There are no data examining the late effects of this therapy after implantation of ventricular assist devices (VAD). Methods and Materials: Between October 1996 and October 2010, 364 patients underwent VAD implant. DSC was utilized in 184 (51%) pt for coagulopathy (155; 84%), hemodynamic instability (103; 56%), isolated RV dysfunction (15; 8%), or unspecified (17; 9%). Median duration of DSC was 1 day (range 1-7). Patients with DSC were older (54.5 vs. 50.3 yrs, p 0.002), had more prior sternotomies (42% vs. 28%, p 0.005), peop IABP (50% vs. 30%, p 0.001), preop mechanical circulatory support (23% vs. 10%, p 0.001), lower preop platelet count (171k vs. 209k, p 0.001) and lower hematocrit (32% vs. 36%, p 0.001). Results: DSC was not associated with a significant increase in operative (11% vs. 9%, p 0.65) or late (2 yr; 66 7% vs 66 7%; p 0.720) mortality, composite incidence of mediastinits, major driveline infection, pocket infection, device endocarditis (16% vs. 15%, p 0.79), re-exploration for bleeding (18% vs. 18%; p 0.99), urgent transplantation for infection (4% vs. 3%; p 0.99), or need for device exchange (9% vs. 10%; p 0.16). Patients with DSC had significantly longer ICU stay (10 vs. 5 days; p 0.001). Independent predictors of DSC included prior sternotomy (1.815 [1.097, 3.004]), preop IABP (2.009 [1.232, 3.275]), hematocrit (1.087 [1.031, 1.128]), platelet count (1.005 [1.002, 1.008]), concomitant tricuspid valve repair (6.153 [2.950, 12.831]), and RVAD (4.911 [2.242, 10.756]). Conclusions: DSC was performed after VAD implant most often for coagulopathy and hemodynamic instability. Patients with DSC are older with greater severity of illness manifest by greater degree of RV failure and greater history of prior sternotomy. DSC was associated with longer ICU stay, but not with a significantly increased risk of death or infection.

vascular macrophages were detected despite 35 grade 1R biopsies (in 10 patients; untreated) and 3 episodes of Grade 2R rejection (in three patients; treated). Conclusions: Capillary deposition of C4d occurs ‘normally’ in EMBs after cardiac Tx. C3d staining was more frequent and persistent. Intracapillary macrophages were not seen even in the presence of ACR and therefore could be a more specific marker of humoral rejection. The ‘normal’ pattern of complement deposition must be considered when assessing biopsies for AMR.

mean time gap between OHT to stem cell transplantation was 7.2 1.1 months. The patient with TTR amyloidosis had liver transplantation 5 years after OHT. The mean follow up period for AL amyloidosis is 15.5 7 months. The Follow up for TTR was 7 years. None of these patients had recurrence of cardiac amyloidosis in their transplanted heart during endomyocardial biopsies. There has not been signs or symptoms indicative of extra cardiac organ involvement with amyloidosis. Conclusion: Combined heart and stem cell transplantation in AL amyloidosis and combined heart and liver transplantation in transthyretin amyloidosis are successful strategies in treating cardiac amyloidosis with excellent intermediate-term survival.