Veli K Topkara1, James K O'Neill2, Adam Carlisle2, Eric Novak2, Scott C Silvestry3, Gregory A Ewald2. 1. Department of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri. Electronic address: vktopkara@gmail.com. 2. Department of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri. 3. Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Abstract
BACKGROUND: The purpose of this study is to comparatively analyze outcomes of heart transplant patients bridged to transplantation with HeartWare (HW-VAD) versus HeartMate II (HMII-VAD) left ventricular assist devices. METHODS: The United Network for Organ Sharing Database was reviewed to identify first-time heart transplant recipients who were bridged to transplantation with either HW-VAD (n=141) or HMII-VAD (n=1824) from January 2009 through July 2012. RESULTS: Recipients of HW-VAD had a higher proportion of female patients (27.0% versus 18.9%; p=0.019), a lower body surface area (2.01±0.25 m2 versus 2.06±0.25 m2; p=0.035), and a trend toward a higher peak percentage of panel reactive antibody against human leukocyte class I antigens (40.4%±32.8% versus 33.0%±30.4%; p=0.070). Pretransplantation recipient cardiac index (2.33±0.66 L⋅min(-1)⋅m(-2) versus 2.33±0.68 L⋅min(-1)⋅m(-2)), serum creatinine (1.21±0.43 mg/dL versus 1.26±0.57 mg/dL), and total bilirubin (1.34±3.45 mg/dL versus 1.06±1.84 mg/dL) were comparable between the two groups (p>0.05 for all comparisons). After transplantation, there were no significant differences in freedom from rejection or freedom from cardiac allograft vasculopathy. Posttransplant graft survival rates were similar between the HW-VAD group and the HMII-VAD group at 1, 2, and 3 years (88.4% versus 87.8%, 79.9% versus 83.8%, and 77.4% versus 79.9%, respectively; p=0.843). CONCLUSIONS: These findings suggest similar hemodynamic unloading, pretransplant end-organ function, and posttransplant outcomes in patients bridged to transplantation with both the HW-VAD and HMII-VAD.
BACKGROUND: The purpose of this study is to comparatively analyze outcomes of heart transplant patients bridged to transplantation with HeartWare (HW-VAD) versus HeartMate II (HMII-VAD) left ventricular assist devices. METHODS: The United Network for Organ Sharing Database was reviewed to identify first-time heart transplant recipients who were bridged to transplantation with either HW-VAD (n=141) or HMII-VAD (n=1824) from January 2009 through July 2012. RESULTS: Recipients of HW-VAD had a higher proportion of female patients (27.0% versus 18.9%; p=0.019), a lower body surface area (2.01±0.25 m2 versus 2.06±0.25 m2; p=0.035), and a trend toward a higher peak percentage of panel reactive antibody against human leukocyte class I antigens (40.4%±32.8% versus 33.0%±30.4%; p=0.070). Pretransplantation recipient cardiac index (2.33±0.66 L⋅min(-1)⋅m(-2) versus 2.33±0.68 L⋅min(-1)⋅m(-2)), serum creatinine (1.21±0.43 mg/dL versus 1.26±0.57 mg/dL), and total bilirubin (1.34±3.45 mg/dL versus 1.06±1.84 mg/dL) were comparable between the two groups (p>0.05 for all comparisons). After transplantation, there were no significant differences in freedom from rejection or freedom from cardiac allograft vasculopathy. Posttransplant graft survival rates were similar between the HW-VAD group and the HMII-VAD group at 1, 2, and 3 years (88.4% versus 87.8%, 79.9% versus 83.8%, and 77.4% versus 79.9%, respectively; p=0.843). CONCLUSIONS: These findings suggest similar hemodynamic unloading, pretransplant end-organ function, and posttransplant outcomes in patients bridged to transplantation with both the HW-VAD and HMII-VAD.
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