Does a pre-left ventricular assist device screening score predict long-term transplantation success? A 2-center analysis.
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).


CONCLUSIONS
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.
Lima
Brian
B
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27713, USA.
Kherani
Aftab R
AR
Hata
Jonathan A
JA
Cheema
Faisal H
FH
Casher
Jennifer
J
Oz
Mehmet C
MC
Rao
Vivek
V
Fal
Jennifer M
JM
Chen
Jonathan M
JM
Morgan
Jeffrey A
JA
Vigilance
Deon W
DW
Garrido
Mauricio J
MJ
Milano
Carmelo A
CA
Naka
Yoshifumi
Y
D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome