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- W2921574049 abstract "Purpose For heart transplantation (htx) a new scoring system which considers a potential postoperative benefit is scheduled for the near future. In our patients we aimed to analyze HU-LVAD-patients after cardiac transplant, particularly with regard to the clinical conditions causing HU-status. Methods Between 2010 and 09/2018, 115 patients underwent htx in our department. 74 of these patients were supported by an LVAD before transplant and 39 of those were transplanted with HU-status, 35 with elective status “T”. With regard to the HU-causing complications the LVAD-HU-group could be divided into 6 groups: Group HU1 suffered from severe LVAD-infections, group HU2 from thromboembolic events and group-HU3 from neurological complications. Right heart failure, severe cardiac arrhythmias and intractable gastrointestinal bleeding were the reasons for HU-listing in groups HU4, HU5 and HU6, respectively. LVAD-patients which were transplanted electively (group T) served as controls. Results The subgroups HU1 to HU6 consisted of 14, 7, 6, 7, 3 and 2 patients, respectively. Thirty-day mortality was 14.3% in group T and 15.4% in group-HU, with 33.3% and 28.6% in groups HU5 and HU2. Extracorporeal life support (ECLS) was applied in 25.7% in group T, whereas 43.6 % of HU-patients needed perioperative ECLS, p=0.065, with the highest incidence in HU5 and HU1 with 66.7% and 50%. Duration of intubation, postoperative stay on ICU and in hospital was significantly prolonged in group-HU1 compared to all other HU-patients and by trend to group T. Severe postoperative infections occurred in 14.3% of group T, compared to 20.5% in all HU-patients (p>0.05), as expected most frequent in group HU1 with 57.1% (p Conclusion With our single-center experience we could show that the outcome of HU-listed LVAD-patients after htx is significantly different with regard to the underlying complication while on LVAD. Patients with severe LVAD-infections displayed the worst short- and midterm outcome after htx. This fact should be considered in preparation of the new “benefit”-allocation score." @default.
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- W2921574049 date "2019-04-01" @default.
- W2921574049 modified "2023-09-26" @default.
- W2921574049 title "Outcome after Heart Transplantation in High-Urgent Listed Patients on LVAD: Impact of Type of Complication" @default.
- W2921574049 doi "https://doi.org/10.1016/j.healun.2019.01.719" @default.
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