title: Differential impact on post-transplant outcomes between pulsatile- and continuous-flow left ventricular assist devices.
abstract: BACKGROUND
  The HeartMate II (HMII) left ventricular assist device (LVAD) has proven reliable and durable and has become the preferred choice for bridge to transplant therapy (BTT) when compared with the pulsatile HeartMate XVE (XVE). In this study, we compared the post-transplant (PTx) outcomes between XVE and HMII using a large national data registry.
  
  
  METHODS
  The Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) Thoracic Registry database was queried for all patients implanted with either an XVE or an HMII as BTT during 2004-2009. Statistical analysis between XVE and HMII were performed using Kaplan-Meier survival analysis and Cox regression analyses.
  
  
  RESULTS
  A total of 673 patients were implanted with the XVE and 484 with HMII. When adjusted for age, gender, ethnicity, intra-aortic balloon pump, ventilator, inotropes, dialysis, body mass index, creatinine, bilirubin, transfusion, pulmonary capillary wedge, and pulmonary arterial pressures, the HMII had similar one- and three-yr survival (hazard ratio = 0.95, CI = 0.64, 1.42) and rejection-free survival PTx compared to XVE. The XVE group had more early incidences of allograft rejection (AR) and hospitalization for infection (HI).
  
  
  CONCLUSIONS
  Compared to XVE, patients with HMII have similar one- and three-yr survival after heart transplantation with less risk of early graft rejection and significant infection. With a strong shift toward use of continuous-flow LVADs, PTx outcomes are expected to continue to improve.
authors.affiliation: Utah Artificial Heart Program, Intermountain Medical Center, Salt Lake City, UT, USA.
authors.forename: Pere A
authors.initials: PA
authors.lastname: Ventura
authors.forename: Rami
authors.initials: R
authors.lastname: Alharethi
authors.forename: Deborah
authors.initials: D
authors.lastname: Budge
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Reid
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.forename: Nathan O
authors.initials: NO
authors.lastname: Mason
authors.forename: Sandi
authors.initials: S
authors.lastname: Stoker
authors.forename: William T
authors.initials: WT
authors.lastname: Caine
authors.forename: Brad
authors.initials: B
authors.lastname: Rasmusson
authors.forename: John
authors.initials: J
authors.lastname: Doty
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Clayson
authors.forename: Abdallah G
authors.initials: AG
authors.lastname: Kfoury
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality*; D006352:Heart Ventricles / Q000503:physiopathology* / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome