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Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry

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dc.contributor.author Barge Caballero, Eduardo
dc.contributor.author Almenar Bonet, Luis
dc.contributor.author González-Vilchez, Francisco
dc.contributor.author Lambert Rodríguez, José Luis
dc.contributor.author González Costello, José
dc.contributor.author Segovia Cubero, Javier
dc.contributor.author Castel Lavilla, María A.
dc.contributor.author Delgado Jiménez, Juan
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.contributor.author Crespo Leiro, María G.
dc.contributor.author Et al.
dc.date.accessioned 2018-05-14T07:57:54Z
dc.date.available 2018-05-14T07:57:54Z
dc.date.issued 2018
dc.identifier.citation Barge‐Caballero, E., Almenar‐Bonet, L., Gonzalez‐Vilchez, F., Lambert‐Rodríguez, J. L., González‐Costello, J., Segovia‐Cubero, J., ... & Crespo-Leiro, M.G. (2018). Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry. European Journal of Heart Failure, 20(1), 178-186. DOI: 10.1002/ejhf.956 spa
dc.identifier.issn 1388-9842
dc.identifier.issn 1879-0844
dc.identifier.uri http://hdl.handle.net/11268/7266
dc.description.abstract Background: In Spain, listing for high-urgent heart transplantation is allowed for critically ill candidates not weanable from temporary mechanical circulatory support (T-MCS). We sought to analyse the clinical outcomes of this strategy. Methods and results: We conducted a case-by-case, retrospective review of clinical records of 291 adult patients listed for high-urgent heart transplantation under temporary devices from 2010 to 2015 in 16 Spanish institutions. Survival after listing and adverse clinical events were studied. At the time of listing, 169 (58%) patients were supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO), 70 (24%) on temporary left ventricular assist devices (T-LVAD) and 52 (18%) on temporary biventricular assist devices (T-BiVAD). Seven patients transitioned from VA-ECMO to temporary ventricular assist devices while on the waiting list. Mean time on T-MCS was 13.1 ± 12.6 days. Mean time from listing to transplantation was 7.6 ± 8.5 days. Overall, 230 (79%) patients were transplanted and 54 (18.6%) died during MCS. In-hospital postoperative mortality after transplantation was 33.3%, 11.9% and 26.2% for patients bridged on VA-ECMO, T-LVAD and T-BiVAD, respectively (P = 0.008). Overall survival from listing to hospital discharge was 54.4%, 78.6% and 55.8%, respectively (P = 0.002). T-LVAD support was independently associated with a lower risk of death over the first year after listing (hazard ratio 0.52, 95% confidence interval 0.30–0.92). Patients treated with VA-ECMO showed the highest incidence rate of adverse clinical events associated with T-MCS. Conclusion: Temporary devices may be used to bridge critically ill candidates directly to heart transplantation in a setting of short waiting list times, as is the case of Spain. In our series, bridging with T-LVAD was associated with more favourable outcomes than bridging with T-BiVAD or VA-ECMO. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry spa
dc.type article spa
dc.description.impact 10.683 JCR (2017) Q1, 6/128 Cardiac and Cardiovascular Systems spa
dc.identifier.doi 10.1002/ejhf.956
dc.rights.accessRights closedAccess spa
dc.subject.uem Trasplante de órganos spa
dc.subject.uem Cardiología spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Trasplante de órganos spa
dc.description.filiation UEM spa
dc.relation.publisherversion http://ezproxy.universidadeuropea.es/login?url=http:/ /dx.doi.org/10.1002/ejhf.956 spa
dc.peerreviewed Si spa


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