Short‐term mechanical circulatory support devices as bridge to heart transplantation: A prospective single‐center experience in Argentina. Issue 7 (2nd June 2020)

• Record Type: Journal Article
• Authors: Giordanino, Elian F.; Absi, Daniel O.; Favaloro, Liliana E.; Renedo, Maria F.; Ratto, Roxana D.; Rubira, Daniela M.; Ameri, Aldana; Giunta, Gustavo; Favaloro, Roberto R.; Bertolotti, Alejandro M.
• Is Part Of: Clinical transplantation. Volume 34:Issue 7(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-06-02
• Subjects: extracorporeal membrane oxygenation -- heart transplantation -- heart‐assist devices; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.13888
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Patients with cardiogenic shock may require hemodynamic stabilization with short‐term mechanical circulatory support devices (ST‐MCS) such as extracorporeal membrane oxygenation (ECMO) and centrifugal pump (CP) as bridge to transplantion (BTT). This study aimed to describe ECMO and CP during BTT and after heart transplant. Methods: A cohort of patients on ECMO or CP as BTT between April 2006 and April 2018 in a single hospital. Results: Thirty‐seven consecutive patients with ECMO (n = 14) or CP (n = 23) were included. Acute kidney injury was more prevalent during CP (28.6% vs 69.6%, P = .02). There were no differences in stroke, thrombosis, sepsis, or vasoplegia. Bleeding (0% vs 56.5%, P = .0003) and reoperation (0% vs 47.8%, P = .002) were more frequent in CP group as well as mortality (0 vs 7 [30.4%], P = .03). The remaining 30 patients (81.1%) underwent heart transplantation, without differences in primary graft dysfunction, vasoplegia, reoperation for bleeding, or hospital stay. Mortality was 23.3% at 30 days, similar in both groups, with no further deaths at median follow‐up of 44.2 months. Conclusions: In patients with cardiogenic shock, ST‐MCS with ECMO or CP as BTT are a lifesaving approach allowing successful transplantation in the majority of cases, with good short‐ and long‐term survival.