Use of a surgically implanted, nondischargeable, extracorporeal continuous flow circulatory support system as a bridge to heart transplant
Gonzalo Cabezón Villalba 1 , Eduardo Barge Caballero 2 , Francisco González Vílchez 3 , María Ángeles Castel-Lavilla 4 , Manuel Gómez Bueno 5 , Luis Almenar Bonet 6 , José González Costello 7 , José Luis Lambert-Rodríguez 8 , Manuel Martínez Sellés 9 , Luis De La Fuente-Galán 10 , Sonia Mirabet Pérez 11 , María Dolores García-Cosío Carmena 12 , Daniela Hervás Sotomayor 13 , Diego Rangel Sousa 14 , Teresa Blasco Peiró 15 , Iris P Garrido-Bravo 16 , Gregorio Rábago Juan-Aracil 17 , Javier Muñiz 18 , María G Crespo-Leiro 19
Introduction and objectives: We aimed to describe the clinical outcomes of the use of the CentriMag acute circulatory support system as a bridge to emergency heart transplantation (HTx).
Methods: We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival.
Results: The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for > 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke.
Conclusions: In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes.
CITATION Rev Esp Cardiol (Engl Ed). 2023 May 20;S1885-5857(23)00139-1. doi: 10.1016/j.rec.2023.05.002