Influence of the Type of Circulatory/Ventricular Assistance in the Primary Graft Failure and Heart Transplantation Mortality

• 作者: Azucena Pajares Moncho Ignacio J. Sánchez-Lázaro Ignacio Moreno Puigdollers Iratxe Zarragoikoetxea Jauregui Lucía Do?ate Bertolín Luis Almenar Bonet Luis Martínez Dolz María Paz Fuset Cabanes Raquel López-Vilella Ricardo Gimeno Costa Salvador Torregrosa Puerta
• 来源期刊: 心血管病(英文)
• 学科: 医学
• 关键词: URGENT Heart Transplantation Short-Medium TERM Circulatory/Ventricular ASSISTANCE PRIMARY GRAFT Failure
• 年，卷（期）: 2019,（8）
• 页码范围: 545-552
• 页数: 8页
• 分类号: R73

摘要

OBJECTIVES: In recent years, the percentage of heart transplantation (HT) with short/medium-term assistance devices has increased. This study aims at analyzing primary graft failure and in-hospital mortality according to the type of care. MATERIAL AND METHODS: From January 2013 to December?2017 all patients undergoing urgent HT with circulatory/ventricular assistance?were retrospectively and consecutively recruited. Combined transplants, retransplantations and pediatric transplants were excluded. The sample was divided in 10 groups according to the type of shot/medium term assistance devices. RESULTS: A total of 53 patients were recruited, 79% men, average age 49 ± 13 years. 26 patients (51%) had mechanical ventilation at the time of the HT. Primary graft failure occurred in 20 patients (38.5%), whilst it was more frequent in patients assisted with ECMO (8 patients in group 1 (45%) and 7 in group 2 (54%), p 0.5). 14 deaths (27%) were registered, whereas a higher mortality was observed in the group assisted with ECMO (6 patients in group 1 (34%) and 4 in group 2 (31%), p 0.6). Mortality was 17% in the group of non-urgent Levitronix. CONCLUSIONS: Despite not showing statistical significance due to the low number of patients in some subgroups, hospital?mortality was high in HT patients with circulatory assistance. A trend towards a higher incidence of primary graft failure and mortality in patients assisted with ECMO was observed. The direct implantation of a centrifugal pump as a bridge to urgent transplantation could identify a subgroup with a better prognosis.