Does A Pre-Left Ventricular Assist Device Screening Score Predict Long-Term Transplantation Success? A 2-Center Analysis
DOI:
https://doi.org/10.1532/HSF98.20061063Abstract
Background. A risk factor summation score was previously validated to successfully predict survival after insertion of a left ventricular assist device (LVAD). We investigated whether this scoring system also predicts clinical outcomes after eventual heart transplantation in LVAD recipients.
Methods. A retrospective review was performed on 153 consecutive patients who received an LVAD as a bridge to transplantation at 2 large-volume centers from 1996 to 2003. The scoring system was used to designate low- and high-scoring groups.
Results. Thirty-day mortality and 5-year survival after transplantation were equivalent between groups (4.46% versus 7.32% and 76% versus 70%, respectively). No difference was seen in length of posttransplantation ventilator dependence (2.83 ± 0.49 versus 3.3 ± 0.72 days) or intensive care unit monitoring (6.38 ± 0.77 versus 6.97 ± 1.1 days). However, low-scoring patients had a significantly decreased duration of inotrope support (5.57 ± 0.45 versus 7.74 ± 1.0 days, P = .035).
Conclusion. A risk factor summation score may predict which LVAD patients will require prolonged inotropic support following heart transplantation. However, survival in high-risk (elevated score) LVAD patients following heart transplantation is comparable to low-risk groups, favoring the continued practice of LVAD implantation as a bridge to transplantation even in high-risk patients.
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