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Posttransplant Long-Term Outcomes for Patients with Ventricular Assist Devices on the Heart Transplant Waitlist
- Source :
- ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs; August 2022, Vol. 68 Issue: 8 p1054-1062, 9p
- Publication Year :
- 2022
-
Abstract
- Ventricular assist devices (LVADs) are commonly used in end-stage heart failure for mechanical circulatory support as a bridge to heart transplantation. However, LVADs’ long-term effects on posttransplant survival are unknown. We sought to compare long-term mortality after transplantation for patients with and without LVADs. Using the Organ Procurement and Transplantation Network database, we investigated LVADs’ impact on long-term (3 month, 1 year, 2 years, 5 years, and 8 years) posttransplant mortality risk for all heart transplant recipients between 2010 and 2019. Time-to-event regression analysis quantified mortality risk by LVAD status in both unconditional and conditional survival analyses. Of 20,113 transplant recipients, 8,999 (45%) had a LVAD while on the waitlist. Among those who died after transplantation, patients with LVADs on average died sooner (1.8 years) than patients without LVADs (3.0 years; p< 0.01). On multivariable analysis, patients with LVADs had a 44% higher mortality risk within the first 3 months posttransplant (HR = 1.44, p= 0.03). There was no significant difference in mortality risk between patients who did and did not have pretransplant LVADs after 1, 2, and 5 years of posttransplant conditional survival. While LVAD patients have a survival disadvantage in the first year posttransplant, conditional survival analysis demonstrated no difference in mortality risk between patients with and without LVADs beyond 1 year of follow up. Of the patients who died posttransplant, patients with LVADs on average died sooner than patients without LVADs.
Details
- Language :
- English
- ISSN :
- 10582916 and 1538943X
- Volume :
- 68
- Issue :
- 8
- Database :
- Supplemental Index
- Journal :
- ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs
- Publication Type :
- Periodical
- Accession number :
- ejs60528140
- Full Text :
- https://doi.org/10.1097/MAT.0000000000001611