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Improved multiorgan function after prolonged univentricular support

C M Burnett1, J M Duncan, O H Frazier

  • 1Transplant Service, Texas Heart Institute/St. Luke's Episcopal Hospital, Houston 77225-0345.

The Annals of Thoracic Surgery
|January 1, 1993
PubMed
Summary
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Prolonged use of the HeartMate left ventricular assist device (LVAD) in cardiac transplant candidates with multiorgan dysfunction safely improved end-organ function and led to successful transplantation and long-term survival for most patients.

Area of Science:

  • Cardiology
  • Mechanical Circulatory Support
  • Transplantation Medicine

Background:

  • Cardiac transplant candidates often present with multiorgan dysfunction, complicating their eligibility and outcomes.
  • Left ventricular assist devices (LVADs) are used for end-stage heart failure, but their role in supporting patients with multiorgan dysfunction requires further investigation.

Purpose of the Study:

  • To evaluate the effect of prolonged HeartMate LVAD support on end-organ recovery in cardiac transplant candidates with hepatic, pulmonary, and/or renal dysfunction.
  • To assess the impact of extended LVAD support on the ultimate outcome of cardiac transplantation.

Main Methods:

  • Retrospective analysis of 11 male cardiac transplant candidates with multiorgan dysfunction supported by HeartMate LVAD for over 30 days.
  • Evaluation of end-organ function (hepatic, pulmonary, renal) before, during, and after LVAD support.

Related Experiment Videos

  • Assessment of cardiac transplantation success and patient survival post-transplant.

    • Main Results:

    • All 11 patients underwent successful cardiac transplantation.
    • 10 patients survived a mean of 24 months post-transplantation.
    • Significant recovery of hepatic (8/9), pulmonary (7/8), and renal (4/6) function was observed during LVAD support.
    • One patient requiring hemodialysis and ventilatory support died 7 weeks post-transplantation due to progressive multiorgan failure.

    Conclusions:

    • Prolonged HeartMate LVAD support is a safe and effective strategy for critically ill cardiac transplant candidates with multiorgan dysfunction.
    • This approach allows for reversal of end-organ dysfunction, leading to healthier transplant recipients and improved survival.
    • LVAD support in the context of donor shortages can significantly benefit severely ill patients awaiting cardiac transplantation.