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What If the Destination Is Transplant? Outcomes of Destination Therapy Patients Who Were Transplanted. ASAIO journal (American Society for Artificial Internal Organs : 1992) Atluri, P., Silvestry, S. C., Teuteberg, J. J., Milano, C. A., Selzman, C. H., Cowger, J. A. 1800; 68 (2): 178-183

Abstract

We sought to characterize patients who underwent heart transplant (HTx) following destination therapy (DT) implant in the combined ENDURANCE/ENDURANCE Supplemental Trials (DT/DT2). A post hoc analysis of the DT/DT2 trials was performed. Baseline characteristics and adverse events between the HTx and no-HTx cohorts were analyzed. Reasons for transplant were examined. Time to HTx was compared with contemporaneous HVAD BTT trial patients. Of the 604 DT/DT2 HVAD patients, 80 (13%) underwent HTx. The HTx cohort was younger (53.6±11.1 vs. 65.2±10.8, P<0.0001) with fewer Caucasians (60.0% vs. 76.5%, P=0.002), less ischemic cardiomyopathy (42.5% vs. 58.8%, P=0.01), and atrial fibrillation (38.8% vs. 54.4%, P=0.01). The HTx cohort had longer 6-minute walk distances (183.6 vs. 38.0 m, P=0.02). Most HTx in DT/DT2 were categorized as elective (n=63, 79%) and, of these, 70% were due to modification of behavioral issues and weight loss. Adverse events were the main indication for urgent HTx (n=17, 21%). Median times to HTx were longer in DT/DT2 (550.0 days) versus BTT/lateral (285.2 days). In this post hoc analysis of the DT/DT2 trials, over 1 in 10 underwent heart transplantation within 3 years of HVAD support. In DT therapy patients, consideration for transplant following DT VAD implant may be feasible.

View details for DOI 10.1097/MAT.0000000000001425

View details for PubMedID 35089262