Outcomes of MCS as a Bridge to Heart Transplantation: Are We Compromising Shortand Long-term Outcomes?
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1 Outcomes of MCS as a Bridge to Heart Transplantation: Are We Compromising Shortand Long-term Outcomes?
2 US Heart Transplant: United Network Organ Sharing (UNOS) Report STS/EACTS Latin America Cardiovascular Surgery Conference Colvin et al. OPTN/SRTR 2015 Annual Data Report: Heart. Am J Transplant. 2017
3 US Heart Transplant: United Network Organ Sharing (UNOS) Report STS/EACTS Latin America Cardiovascular Surgery Conference Colvin et al. OPTN/SRTR 2015 Annual Data Report: Heart. Am J Transplant. 2017
4 Bridging to Heart Transplantation Increased competition for hearts has increased the use of durable LVADs as a bridge to heart transplant Has the use of durable LVAD adversely affected transplant outcomes? STS/EACTS Latin America Cardiovascular Surgery Conference
5 STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Trivedi et al. Ann Thorac Surg 2014;98:
6 ORIGINAL RESEARCH ARTICLE Morbidity and Mortality in Heart Transplant Candidates Supported with Mechanical Circulatory Support. Is Reappraisal of the Current UNOS Thoracic Organ Allocation Policy Justified? Omar Wever-Pinzon, Stavros G. Drakos, Abdallah G. Kfoury, Jose N. Nativi, Edward M. Gilbert, Melanie Everitt, Rami Alharethi, Kim Brunisholz, Feras M. Bader, Dean Y. Li, Craig H. Selzman, Josef Stehlik CF-LVAD STS/EACTS Latin America Cardiovascular Surgery Conference
7 ORIGINAL RESEARCH ARTICLE Morbidity and Mortality in Heart Transplant Candidates Supported with Mechanical Circulatory Support. Is Reappraisal of the Current UNOS Thoracic Organ Allocation Policy Justified? Omar Wever-Pinzon, Stavros G. Drakos, Abdallah G. Kfoury, Jose N. Nativi, Edward M. Gilbert, Melanie Everitt, Rami Alharethi, Kim Brunisholz, Feras M. Bader, Dean Y. Li, Craig H. Selzman, Josef Stehlik LVAD without Complication LVAD Complication STS/EACTS Latin America Cardiovascular Surgery Conference
8 STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Cleveland et al. J Thorac Cardiovasc Surg 2008;136:
9 STS/EACTS Latin America Cardiovascular Surgery Conference
10 * Unadjusted Survival STS/EACTS Latin America Cardiovascular Surgery Conference
11 STS/EACTS Latin America Cardiovascular Surgery Conference
12 LVAD Bridge to Transplantation Survival to transplant improved compared to UNOS Status 1A bridged with inotropes or IABP LVAD complications adversely affect waitlist survival Durable LVADs have superior outcomes compared to temporary LVADs The duration of bridging does not affect post-transplant survival STS/EACTS Latin America Cardiovascular Surgery Conference
13 Survival by Indication STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Kirklin et al. Eighth Annual Intermacs Report: Special focus on framing the impact of adverse events. J Heart Lung Transplant. 2017;xx:xx-xx. 13
14 Competing Outcomes for BTT Indication STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Kirklin et al. Seventh Annual Intermacs Report: 15,000 patients and counting. J Heart Lung Transplant. 2017;34(12):
15 Survival by Intermacs Patient Profile STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Kirklin et al. Eighth Annual Intermacs Report: Special focus on framing the impact of adverse events. J Heart Lung Transplant. 2017;xx:xx-xx. 15
16 Survival by Degree of Renal Dysfunction STS/EACTS Latin America Cardiovascular Surgery Conference
17 STS/EACTS Latin America Cardiovascular Surgery Conference 2017 Kirklin et al. J Heart Lung Transplant. 2015;34:
18 Device Landscape 2017 HeartMate 3 HeartMate II HVAD
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22 HeartMate 3: US MOMENTUM TRIAL Short Term Cohort: 6 Months This article was published on November 16, 2016, at NEJM.org. DOI: /NEJMoa
23 Conclusions Durable LVADs improve survival to transplant over other bridging strategies Transplant outcomes are not affected unless bridging with LVAD complication Patient selection key to optimal outcomes New devices offer reduced risk of device thrombosis STS/EACTS Latin America Cardiovascular Surgery Conference
24 Thank You
Heart transplantation provides remarkable improvement. Transplantation
Transplantation Morbidity and Mortality in Heart Transplant Candidates Supported With Mechanical Circulatory Support Is Reappraisal of the Current United Network for Organ Sharing Thoracic Organ Allocation
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