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Cardiac transplantation and mechanical circulatory support at Cleveland Clinic

Katherine J Hoercher1, Nader Moazami, Randall C Starling

  • 1The George M. and Linda H. Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio, USA. HOERCHK@ccf.org

Clinical Transplants
|June 1, 2013
PubMed

Insights

Cleveland Clinic

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Mechanical Circulatory Support

Background:

  • Cleveland Clinic has performed over 1,600 adult heart transplants.
  • The 2006 heart allocation system changes impacted transplant volume and recipient acuity.
  • Left ventricular assist devices (LVADs) are increasingly used as a bridge to transplant.

Purpose of the Study:

  • To evaluate outcomes in adult heart transplantation at Cleveland Clinic.
  • To assess the impact of the 2006 allocation system changes.
  • To review the role and advancements of mechanical circulatory support (MCS) in heart failure management.

Main Methods:

  • Retrospective analysis of adult orthotopic heart transplant data.
  • Review of patient outcomes including survival rates.
  • Assessment of trends in MCS utilization and patient selection.

Main Results:

  • 1-year survival is 96%, 3-year survival is 82%.
  • Increased LVAD use as bridge to transplant has not compromised outcomes.
  • LVADs are expanding to patients ineligible for transplant, with improving results.

Conclusions:

  • Excellent outcomes are maintained despite changes in allocation and increased MCS utilization.
  • LVAD technology is advancing, offering life-saving therapy to more patients.
  • Further refinements in patient selection and management are needed for permanent MCS therapy.

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