Does pretransplant left ventricular assist device therapy improve results after heart transplantation in patients with elevated pulmonary vascular resistance?

Lidén, Hans; Haraldsson, Åsa; Ricksten, Sven‐Erik; Kjellman, Ulf; Wiklund, Lars

doi:10.1016/j.ejcts.2008.12.024

Cited by 57 publications

(51 citation statements)

References 15 publications

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“…The aim of treatment of secondary PH is to normalize the wedge pressure, and, consequently, LVAD support can play a crucial role. Since the beginning of the 1990s, many authors have shown a decrease of PH during LVAD support [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Table 5 shows an overview of all literature data and results.…”

Section: Discussionmentioning

confidence: 98%

“…Some authors, such as Martin et al [13], Etz et al [11] and Zimpfer et al [18], considered only patients who did not respond to drugs, and others, such as Smedira et al [17] and Liden et al [12], gave a cutoff in terms of pulmonary hemodynamic parameters values to define a clinical scenario of severe PH. Consequently, we decided to divide our patient population into two different groups: responders and non-responders to inotrope therapy.…”

Section: Discussionmentioning

confidence: 99%

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Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Mikus

Stepanenko

Krabatsch

et al. 2011

European Journal of Cardio-Thoracic Surgery

109

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Mikus

Stepanenko

Krabatsch

et al. 2011

European Journal of Cardio-Thoracic Surgery

109

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“…A widely used salvage strategy for acute graft failure is temporary mechanical circulatory support using venoarterial extracorporeal membrane oxygenation or short-term left or right ventricular assist devices as a bridge to recovery or RTx (8). Recent publications have been encouraging by demonstrating that long-term outcomes for HTx recipients with preoperative left ventricular assist devices were comparable to those without (29)(30)(31). Careful patient selection and perioperative care is paramount considering the limited allograft resources.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and survival following heart retransplantation for cardiac allograft failure: a systematic review and meta-analysis

Rizvi

Luc

Choi

et al. 2018

Ann. Cardiothorac. Surg.

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Background: Long-term efficacy of heart retransplantation (RTx) for end-stage cardiac allograft failure remains unclear given the limited worldwide experience and is an important question to elucidate given the shortage of donor organs. The aim of this systematic review was to examine the outcomes of RTx in patients with cardiac allograft failure.Methods: Electronic search was performed to identify all studies in the English literature assessing RTx for cardiac allograft failure. All identified articles were systematically assessed for inclusion and exclusion criteria.Results: Eleven studies were included for analysis, with a total of 7,791 patients. A total of 7,446 patients underwent primary heart transplantation (HTx) whereas 345 patients underwent RTx with average time from primary HTx to RTx interval of 5.03 years (95% CI: 3.13-6.94 years). There were 35.2% of patients Conclusions:Patients who underwent heart RTx had a significant lower survival when compared to those who only underwent primary HTx. There were no significant differences in post-transplantation freedom from rejection. Careful patient selection and perioperative care can make heart RTx a viable option for selected recipients.

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“…Left ventricular assist devices (LVADs) have been widely adopted by most transplantation programs to stabilize decompensated heart failure patients awaiting primary transplantation; recent publications have suggested that long-term outcomes for patients with preoperative LVADs were comparable to results for those without. [15][16][17] Patients in our series had intra-aortic balloon pumps and extracorporeal membrane oxygenation available, but no other LVADs or mechanical assist devices were used until recently.…”

Section: Discussionmentioning

confidence: 99%

Early and late outcomes after cardiac retransplantation

Saito¹,

Novick²,

Kiaii³

et al. 2013

Can J Surg

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Background: Cardiac retransplantation remains the most viable option for patients with allograft heart failure; however, careful patient selection is paramount considering limited allograft resources. We analyzed clinical outcomes following retransplantation in an academic, tertiary care institution. Methods:Between 1981 and 2011, 593 heart transplantations, including 22 retransplantations were performed at our institution. We analyzed the preoperative demographic characteristics, cause of allograft loss, short-and long-term surgical outcomes and cause of death among patients who had cardiac retransplantations.Results: Twenty-two patients underwent retransplantation: 10 for graft vascular disease, 7 for acute rejection and 5 for primary graft failure. Mean age at retransplantation was 43 (standard deviation [SD] 15) years; 6 patients were women. Thirteen patients were critically ill preoperatively, requiring inotropes and/or mechanical support. The median interval between primary and retransplantation was 2.2 (range 0-16) years. Thirty-day mortality was 31.8%, and conditional (> 30 d) 1-, 5-and 10-year survival after retransplantation were 93%, 79% and 59%, respectively. A diagnosis of allograft vasculopathy (p = 0.008) and an interval between primary and retransplantation greater than 1 year (p = 0.016) had a significantly favourable impact on 30-day mortality. The median and mean survival after retransplantation were 3.3 and 5 (SD 6, range 0-18) years, respectively; graft vascular disease and multiorgan failure were the most common causes of death. Conclusion:Long-term outcomes for primary and retransplantation are similar if patients survive the 30-day postoperative period. Retransplantation within 1 year of the primary transplantation resulted in a high perioperative mortality and thus may be a contraindication to retransplantation. Contexte :Une nouvelle transplantation cardiaque demeure l'option la plus viable pour les patients qui présentent une insuffisance de leur coeur transplanté. Il est toutefois crucial de bien sélectionner les patients, compte tenu du nombre limité d'organes disponibles. Nous avons analysé les résultats cliniques des secondes transplantations cardiaques dans un établissement universitaire de soins tertiaires. Méthodes :Entre 1981 et 2011, on a procédé dans notre établissement à 593 transplantations cardiaques, dont 22 secondes transplantations. Nous avons analysé les carac téristiques démographiques préopératoires, la cause de la perte du coeur transplanté, les résultats chirurgicaux à court et à long terme et la cause de mortalité chez les patients soumis à une seconde transplantation.

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Does pretransplant left ventricular assist device therapy improve results after heart transplantation in patients with elevated pulmonary vascular resistance?

Cited by 57 publications

References 15 publications

Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Outcomes and survival following heart retransplantation for cardiac allograft failure: a systematic review and meta-analysis

Early and late outcomes after cardiac retransplantation

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