The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 Heart Transplant Allocation System

Yuzefpolskaya, M.; Schroeder, Sarah E.; Houston, Brian A.; Robinson, Monique; Gošev, Igor; Reyentovich, Alex; Koehl, Devin; Cantor, Ryan S.; Jorde, Ulrich P.; Kirklin, James K.; Pagani, Francis D.; D’Alessandro, David A.

doi:10.1016/j.athoracsur.2022.11.023

Cited by 158 publications

(107 citation statements)

References 9 publications

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“…8 While most adverse events in the VAD population typically occur early, device-specific infection is a notable exception. 6,8,23 No diminishment over time is seen, with event rates of 0.16 events per patient-year in both the early and late periods postimplantation. 6 These incidences have also not changed significantly over time.…”

Section: Epidemiologymentioning

confidence: 99%

“…6,8,23 No diminishment over time is seen, with event rates of 0.16 events per patient-year in both the early and late periods postimplantation. 6 These incidences have also not changed significantly over time. 6,8,23 Rehospitalization rates for major infection were found to be lower in the MOMENTUM 3 trial continued access protocol when comparted with the pivotal trial, at 34.1 vs. 42.3 events per hundred patient years, respectively (p < 0.05).…”

Section: Epidemiologymentioning

confidence: 99%

“…1–5 The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) 13th annual report documents 27,314 isolated CF-LVADs implanted from 2012 to 2021. 6 Of these, patients are increasingly undergoing VAD implantation as destination therapy (DT) compared with bridge-to-transplant (BTT), with an increase in DT designation from 56.5% of patients in 2018 to 81.1% of patients in 2021. 6 Marketed CF devices in the United States have included the axial flow HeartMate II (HMII, Abbott Laboratories, Inc, Chicago, IL) and the newer, intrapericardially implanted, and centrifugal pumps: HeartMate 3 (HM3, Abbott Laboratories, Inc, Chicago, IL) and HeartWare HVAD (Medtronic Inc, Dublin, Ireland).…”

mentioning

confidence: 99%

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Infections in Patients With Left Ventricular Assist Devices: Current State and Future Perspectives

et al. 2023

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Mechanical circulatory support is increasingly being used as bridge-to-transplant and destination therapy in patients with advanced heart failure. Technologic improvements have led to increased patient survival and quality of life, but infection remains one of the leading adverse events following ventricular assist device (VAD) implantation. Infections can be classified as VAD-specific, VAD-related, and non-VAD infections. Risk of VAD-specific infections, such as driveline, pump pocket, and pump infections, remains for the duration of implantation. While adverse events are typically most common early (within 90 days of implantation), device-specific infection (primarily driveline) is a notable exception. No diminishment over time is seen, with event rates of 0.16 events per patient-year in both the early and late periods postimplantation. Management of VAD-specific infections requires aggressive treatment and chronic suppressive antimicrobial therapy is indicated when there is concern for seeding of the device. While surgical intervention/hardware removal is often necessary in prosthesis-related infections, this is not so easily accomplished with VADs. This review outlines the current state of infections in patients supported with VAD therapy and discusses future directions, including possibilities with fully implantable devices and novel approaches to treatment.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

mentioning

confidence: 99%

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Infections in Patients With Left Ventricular Assist Devices: Current State and Future Perspectives

et al. 2023

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“…The introduction of the newer generation continuous‐flow left ventricular assist devices (CF‐LVADs) have contributed significantly to patient survival and salvaged numerous patients with advanced HF who were not eligible for heart transplant or could not wait for one 1 . While historically LVADs were implanted mainly as a bridge to transplant indication, 81.1% of LVADs were implanted as destination therapy in 2021 2 . HeartMate 3™ (HM3), a fully magnetically levitated centrifugal pump, is the newest device available and has been shown to further improve outcomes of this patient population 2,3 …”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal bleeding on continuous‐flow left ventricular assist device therapy

2023

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While technological advances in the field of continuous-flow left ventricular assist device (CF-LVAD) are constantly being made, CF-LVAD recipients are still subjected to a relatively high rate of LVAD-related adverse events, with post-LVAD gastrointestinal bleeding (GIB) being the most common one. GIB is associated with a significant impairment in quality of life, multiple hospital admissions, blood transfusion requirements and possibly death. Furthermore, of those patients who bled once, many will experience recurrent GIB events, which further aggravates their discomfort. While some medical and endoscopic treatment options are available, evidence regarding their benefit remains largely equivocal, with all related studies based on data from registries rather than clinical trials. Although having a major impact on LVAD recipients, an effective and validated pre-implant screening options to predict GIB events post-implant are scarce. This review focuses on the aetiology, incidence, risk factors, treatment options and the effect of new generation devices on post-LVAD GIB.

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“…In the discussion, the authors indicate the high annual number of VAD implants in the Netherlands in contrast to the United States, where it has dropped by 23.5% in 2021 [7] and where a change in the heart donation allocation system has resulted in a dramatic reduction in number of patients transplanted on devices [8,9]. This came paired with a modest increase (4.3%) in total number of heart transplantations (https://unos.org>news >2022).…”

mentioning

confidence: 99%

Implantable mechanical circulatory support in The Netherlands

Lahpor

2023

Neth Heart J

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The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 Heart Transplant Allocation System

Cited by 158 publications

References 9 publications

Infections in Patients With Left Ventricular Assist Devices: Current State and Future Perspectives

Infections in Patients With Left Ventricular Assist Devices: Current State and Future Perspectives

Gastrointestinal bleeding on continuous‐flow left ventricular assist device therapy

Implantable mechanical circulatory support in The Netherlands

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