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Attrition from heart transplant waiting list for patients on ventricular assist devices is not affected by desensitization strategies.

Abstract：

BACKGROUND:Ventricular assist device (VAD) patients, who are commonly sensitized, can be successfully transplanted using strategies aimed at diminishing antibody burden. However, the impact of these therapies on outcomes for VAD patients on the waiting list is ill-defined. The following study was conducted to ascertain the relationship between desensitization therapies and attrition rate from the waiting list for VAD patients. METHODS:The VAD patients listed between July 1996 and June 2002 were used for this report. Transplant and inpatient pharmacy databases were queried for demographics, date of transplantation, degree of allosensitization, use of desensitization therapy, immunosuppressive strategies, and specific causes of death. RESULTS:Among 232 patients listed for heart transplantation who required bridging to transplantation with a VAD, 79 (34%) died while on the waiting list. Common causes of death included multisystem organ failure in 32 (40.5%), sepsis in 19 (24.0%), and stroke in 10 (12.6%) patients. While nearly 50% of these patients were sensitized at listing, only 5 (6.3%) patients received desensitization therapy following VAD implantation. Therapies included mycophenolate mofetil in 3 (3.7%) and IVIG in 2 (2.5%) patients. Not a single patient underwent plasmapheresis or OKT3 therapy. CONCLUSION:For patients bridged to heart transplantation with a VAD, attrition from the waiting list was associated with factors other than desensitization or induction regimens.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Gonzalez-Stawinski GV,Cook DJ,Smedira NG,Navia JL,Taylor DO,Yamani MH,Hoercher K,Starling RC,Banbury MK

doi

10.1016/j.transproceed.2007.03.016

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

1571-2

issue

5

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)00292-8

journal_volume

39

pub_type

杂志文章

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