title: Effects of left ventricular assist devices on outcomes in patients undergoing heart transplantation.
abstract: BACKGROUND
  Left ventricular assist devices (LVADs) are increasingly being used to "bridge" patients to heart transplantation.
  
  
  METHODS
  Data from 40 consecutive status 1 heart transplantation patients treated with intravenous inotrope therapy (n = 20) or the HeartMate LVAD (n = 20) were retrospectively analyzed.
  
  
  RESULTS
  Baseline clinical characteristics were similar in the two groups. At the time of transplantation, LVAD patients had significantly higher blood pressure and sodium with significantly lower blood urea nitrogen and creatinine. After transplantation, renal failure (52.6% versus 16.7%) and right heart failure (31.6% versus 5.6%) occurred more frequently (p < 0.05) in the inotrope group. Six-month survival after transplantation did not significantly differ in the inotrope or LVAD groups (73.7% versus 88.9%) but event-free survival was significantly (p < 0.05) lower in the inotrope group (15.8% versus 55.6%). Total hospital charges were significantly lower in the inotrope group ($213,860 +/- $107,560 versus $342,620 +/- $104,420), but average daily hospital charges were not different ($3,990 +/- $1,300 versus $4,130 +/- $2,050).
  
  
  CONCLUSIONS
  Status 1 heart transplant patients treated with an LVAD as opposed to inotrope therapy have improved clinical and metabolic function at the time of transplant and improved survival to 6 months after transplant without major complications. Total costs are higher in the LVAD patients but average daily costs are similar.
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, USA. bankx001@tc.umn.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Bank
authors.forename: S H
authors.initials: SH
authors.lastname: Mir
authors.forename: D Q
authors.initials: DQ
authors.lastname: Nguyen
authors.forename: R M
authors.initials: RM
authors.lastname: Bolman
authors.forename: S J
authors.initials: SJ
authors.lastname: Shumway
authors.forename: L W
authors.initials: LW
authors.lastname: Miller
authors.forename: D R
authors.initials: DR
authors.lastname: Kaiser
authors.forename: S M
authors.initials: SM
authors.lastname: Ormaza
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000328:Adult; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000209:etiology; D016027:Heart Transplantation / Q000191:economics / Q000401:mortality; D006353:Heart-Assist Devices / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D012964:Sodium; D003404:Creatinine