Takeshi Nakatani1, Kazuhiro Sase2, Hiroaki Oshiyama3, Masatoshi Akiyama4, Masao Horie5, Kan Nawata6, Tomohiro Nishinaka7, Yoshihisa Tanoue8, Koichi Toda9, Masao Tozawa10, Shunichi Yamazaki11, Masanobu Yanase12, Hiroshi Ohtsu13, Michiko Ishida14, Ayaka Hiramatsu14, Kensuke Ishii14, Soichiro Kitamura15. 1. Principal Investigator, Chair, J-MACS Operating Committee, Maki Hospital, Osaka, Japan. Electronic address: tnakatan@maki-group.jp. 2. Co-principal Investigator, J-MACS Operating Committee, Juntendo University, Tokyo, Japan. 3. Co-principal Investigator, J-MACS Operating Committee, Medical Technology Association of Japan, Tokyo, Japan. 4. Investigator, J-MACS Operating Committee, Tohoku University, Miyagi, Japan. 5. Investigator, J-MACS Operating Committee, Nipro Corporation, Osaka, Japan. 6. Investigator, J-MACS Operating Committee, The University of Tokyo, Tokyo, Japan. 7. Investigator, J-MACS Operating Committee, Tokyo Women's Medical University, Tokyo, Japan. 8. Investigator, J-MACS Operating Committee, Kyushu University, Fukuoka, Japan. 9. Investigator, J-MACS Operating Committee, Osaka University, Osaka, Japan. 10. Investigator, J-MACS Operating Committee, Century Medical, Inc., Tokyo, Japan. 11. Investigator, J-MACS Operating Committee, Sun Medical Technology Research Corp. Nagano, Japan. 12. Investigator, J-MACS Operating Committee, National Cerebral and Cardiovascular Center, Osaka, Japan. 13. National Center for Global Health and Medicine, Tokyo, Japan. 14. Pharmaceuticals and Medical Devices Agency, Tokyo, Japan. 15. Chair, J-MACS Steering Committee, National Cerebral and Cardiovascular Center, Osaka, Japan.
Abstract
BACKGROUND: In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers. METHODS: The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) is a prospective registry designed to be harmonized with the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS). Participation in J-MACS is mandatory for device manufacturers to meet the conditions of approval as well as for hospitals to obtain authorization for reimbursement from the national health insurance system. RESULTS: From June 2010 to April 2015, 476 patients were registered at 31 hospitals. Of these, analysis of primary VAD patients (n = 332) revealed that their overall 360-day survival was 91% (implantable 93%, extracorporeal 84%). CONCLUSIONS: This initial report from J-MACS focuses on patients' demographics, device types, survival, competing outcomes, adverse events and successful examples of system failure detection.
BACKGROUND: In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers. METHODS: The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) is a prospective registry designed to be harmonized with the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS). Participation in J-MACS is mandatory for device manufacturers to meet the conditions of approval as well as for hospitals to obtain authorization for reimbursement from the national health insurance system. RESULTS: From June 2010 to April 2015, 476 patients were registered at 31 hospitals. Of these, analysis of primary VAD patients (n = 332) revealed that their overall 360-day survival was 91% (implantable 93%, extracorporeal 84%). CONCLUSIONS: This initial report from J-MACS focuses on patients' demographics, device types, survival, competing outcomes, adverse events and successful examples of system failure detection.
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