title: Effect of left ventricular assist device bridging to transplantation on donor waiting time and outcomes in Canada.
abstract: BACKGROUND
  The Thoratec left ventricular assist device (LVAD; Thoratec Laboratories Corporation, USA) was used as a bridge to transplantation at the Montreal Heart Institute. LVAD patients were activated on the waiting list as soon as they were in suitable clinical status.
  
  
  OBJECTIVE
  To analyze the effect of introducing the Thoratec LVAD in the heart transplantation program at the Montreal Heart Institute.
  
  
  METHODS
  The results of 16 LVAD patients and 20 patients who underwent heart transplantation without LVAD support between January 2000 and February 2002 were reviewed.
  
  
  RESULTS
  Sixteen patients in cardiogenic shock underwent emergency implantation of a Thoratec LVAD following acute myocardial infarction (five patients), acute viral cardiomyopathy (five patients), idiopathic cardiomyopathy (three patients), postpartum cardiomyopathy (two patients) and failure to wean from cardiopulmonary bypass (one patient). Thirteen of 16 (81%) LVAD patients underwent heart transplantation, and three LVAD patients were not listed and died from multiorgan failure. The wait for transplantation averaged 17+/-19 days in LVAD patients compared with 87+/-66 days for the 20 patients undergoing transplantation without LVAD support (P=0.01). Survival 12 months following transplantation averaged 84+/-10% in LVAD supported patients and 90+/-7% in those without LVAD support (P=0.6).
  
  
  CONCLUSIONS
  The use of Thoratec LVAD as a bridge to transplantation did not prolong the wait for a donor of patients without LVAD support (United Network Organ Sharing status II). Moreover, listing patients as soon as they appear suitable for transplantation resulted in a short period of LVAD support and a good rate of survival one year after transplantation.
authors.affiliation: Department of Surgery, Montreal Heart Institute, Montreal, Canada. michel.carrier@icm-mhi.org
authors.forename: Michel
authors.initials: M
authors.lastname: Carrier
authors.forename: Louis P
authors.initials: LP
authors.lastname: Perrault
authors.forename: Denis
authors.initials: D
authors.lastname: Bouchard
authors.forename: Michel
authors.initials: M
authors.lastname: Pellerin
authors.forename: Normand
authors.initials: N
authors.lastname: Racine
authors.forename: Michel
authors.initials: M
authors.lastname: White
authors.forename: Guy
authors.initials: G
authors.lastname: Pelletier
mesh_terms: D000328:Adult; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D014850:Waiting Lists