title: Does a pre-left ventricular assist device screening score predict long-term transplantation success? A 2-center analysis.
abstract: 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.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, North Carolina 27713, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Lima
authors.forename: Aftab R
authors.initials: AR
authors.lastname: Kherani
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Hata
authors.forename: Faisal H
authors.initials: FH
authors.lastname: Cheema
authors.forename: Jennifer
authors.initials: J
authors.lastname: Casher
authors.forename: Mehmet C
authors.initials: MC
authors.lastname: Oz
authors.forename: Vivek
authors.initials: V
authors.lastname: Rao
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Fal
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Chen
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Morgan
authors.forename: Deon W
authors.initials: DW
authors.lastname: Vigilance
authors.forename: Mauricio J
authors.initials: MJ
authors.lastname: Garrido
authors.forename: Carmelo A
authors.initials: CA
authors.lastname: Milano
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
mesh_terms: 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