Predictors of Renal Failure in Patients Treated With the Total Artificial Heart

Desai, K.; Tang, Daniel; Quader, Mohammed; Kasirajan, Vigneshwar; Thacker, Leroy R.; Sawey, E.J.; Tchoukina, Inna; Shah, Keyur B.

doi:10.1016/j.cardfail.2020.05.011

Cited by 2 publications

(2 citation statements)

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“…Again, early infection and respiratory failure were found to be primary early pathways to death in this cohort. Renal failure specifically should be avoided in this patient population when possible secondary to these findings, with specific risk factors among TAH patients having been identified 13 . With that being said, there can be renal recovery associated with TAH implantation in some settings, and utilization of the TAH system as a bridge to combined heart and kidney transplantation in selected patients has been successfully reported 14 …”

Section: Discussionmentioning

confidence: 99%

“…Renal failure specifically should be avoided in this patient population when possible secondary to these findings, with specific risk factors among TAH patients having been identified. 13 With that being said, there can be renal recovery associated with TAH implantation in some settings, and utilization of the TAH system as a bridge to combined heart and kidney transplantation in selected patients has been successfully reported. 14 Perhaps the largest series to date is the recent multicenter (six sites) series of 217 patients in North America undergoing BTT with TAH.…”

Section: Transplant Outcomes Following Bridge With Tahmentioning

confidence: 99%

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Trends and outcomes following total artificial heart as bridge to transplant from the UNOS database

Coyan

Huckaby

Díaz-Castrillón

et al. 2022

Journal of Cardiac Surgery

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Introduction Bridge to transplantation (BTT) with a SynCardia Total Artificial Heart (TAH) has been gaining momentum as a therapy for patients with biventricular heart failure. Recent transplant waitlist and posttransplant outcomes with this strategy have not been comprehensively characterized. We reviewed the United Network for Organ Sharing (UNOS) database to examine BTT outcomes for the TAH system since approval. Methods Adult patients listed for heart transplantation in the UNOS system between 2004 and 2020 who underwent BTT therapy with a TAH were included in the study. Trends in utilization of TAH compared with other durable mechanical support strategies were examined. The primary outcome was 1‐year survival following heart transplantation following BTT with TAH. Secondary outcomes included waitlist deterioration and risk factors for waitlist or posttransplant mortality. Results During the study 433 total patients underwent TAH implant as BTT therapy; 236 (54.4%) were listed with the TAH, while the remaining patients were upgraded to TAH support while on the waitlist. Waitlist mortality was 7.4%, with 375 patients (86.6%) ultimately being transplanted. Age, cerebrovascular disease, functional status, and ventilator dependence were risk factors for waitlist mortality. One‐year survival following successful BTT was 80%. Risk factors for mortality following BTT included age, body mass index, and underlying diagnosis. Conclusions Patients undergoing BTT with TAH demonstrate acceptable waitlist survival and good 1‐year survival. While utilization initially increased as a BTT therapy, there has been a plateau in relative utilization. Individual patient and transplantation center factors deserve further investigation to determine the ideal population for this therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Transplant Outcomes Following Bridge With Tahmentioning

confidence: 99%