Successful treatment of heart failure due to acute transplant rejection with the Impella LP 5.0.
Cardiogenic shock resulting from transplant rejection is a serious complication with high mortality and morbidity. Often resistant to maximal medical therapy, this condition frequently requires mechanical circulatory support until recovery or retransplantation. We present a 52-year-old patient with multiorgan failure secondary to acute graft rejection after orthotopic heart transplantation. Maximal medical therapy was not successful, and the patient was bridged to recovery with an Impella LP 5.0 (Abiomed Inc, Danvers, MA) left ventricular assist device (LVAD). The relative merits of this therapeutic approach are outlined and discussed. The patient was discharged 3 weeks after LVAD removal and remains clinically stable.
Samoukovic
Gordan
G
Division of Cardiothoracic Surgery, McGill University Health, Montreal, Quebec, Canada.
Al-Atassi
Talal
T
Rosu
Cristian
C
Giannetti
Nadia
N
Cecere
Renzo
R
D000208:Acute Disease; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D006334:Heart Function Tests; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000601:surgery*; D013318:Stroke Volume; D016896:Treatment Outcome