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Determinants of Short-Term Survival After Heart Transplantation in Patients Bridged to Transplant With Left

Suat Şenkaya1, Ümit Kahraman2, Ayşen Yaprak Kapkın2

  • 1İzmir City Hospital, Department of Cardiovascular Surgery, İzmir, Turkey.

Transplantation Proceedings
|September 17, 2025
PubMed

Insights

Early survival after bridge to heart transplantation is impacted by patient age, longer ventricular assist device support, and device-specific infections. These factors, along with longer cardiac ischemia and cardiopulmonary bypass times, increase early mortality risk in heart transplant candidates.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Mechanical Circulatory Support

Background:

  • Bridge to heart transplantation remains a debated strategy.
  • Identifying factors influencing early survival post-transplant is crucial.

Purpose of the Study:

  • To determine factors affecting early survival after bridge to heart transplantation.
  • To analyze demographic and procedural variables associated with 30-day mortality.

Main Methods:

  • Retrospective analysis of 60 patients undergoing bridge to heart transplantation (2011-2019).
  • Data collected included demographics, device support duration, operative times, blood product use, and post-transplant outcomes.
  • Patients were categorized by 30-day mortality versus survival longer than 30 days.

Main Results:

  • Older patients (P = .009), longer ventricular assist device (VAD) support (P = .027), higher International Normalized Ratio (INR) (P = .025), and device-specific infections (P = .003) were associated with 30-day mortality.
  • Longer cardiac ischemia (P = .013) and cardiopulmonary bypass (CPB) (P = .006) durations, increased blood product use, and nitric oxide (NO) administration were more frequent in the mortality group.
  • Post-transplant complications like stroke, sepsis, kidney failure, and arrhythmia were significantly higher in patients with 30-day mortality (P < .05).

Conclusions:

  • Bridge to transplantation presents challenges, including reoperation under high INR levels and potential inflammatory states.
  • Device-specific infection is a significant factor in early mortality and a critical indicator for timely heart transplantation.
Abstract

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