Perioperative Prophylaxis for Total Artificial Heart Transplantation

Area of Science:

• Cardiology
• Infectious Diseases
• Surgical Innovation

Background:

• Significant practice variation exists in perioperative antimicrobial prophylaxis for total artificial heart transplantation (TAH-t).
• Understanding current infection prevention strategies is crucial for improving outcomes in TAH-t recipients.

Purpose of the Study:

• To assess current practices for infection prevention in total artificial heart (TAH) recipients across different transplant programs.
• To identify variations in antimicrobial prophylaxis protocols used in TAH transplantation.

Main Methods:

• An electronic survey was distributed to programs performing Syncardia TAH implants.
• Data on antimicrobial prophylaxis regimens and infection rates were collected and analyzed.
• Proportions and means with standard deviations were used for categorical and continuous variables, respectively.

Main Results:

• 80.8% of centers utilize a formal surgical infection prophylaxis protocol for TAH recipients.
• Significant variation exists in antimicrobial regimens, with diverse multi-drug and single-drug approaches reported.
• Postoperative infections occurred in 52.2% of centers, with bacteremia and driveline infections being most common in the first month.

Conclusions:

• Perioperative antimicrobial prophylaxis is administered universally for TAH-t, yet substantial inter-institutional variation persists.
• Standardizing infection prevention protocols is essential to reduce morbidity and mortality associated with TAH transplantation.
• The majority of centers have established formal prophylactic protocols, but regimen diversity remains a key area for improvement.