title: Heart transplant program at IRCCS-ISMETT: Impact of mechanical circulatory support on pre- and post -transplant survival.
abstract: BACKGROUND
  Heart transplantation (HTx) improves the quality of life and survival in patients affected by end-stage heart failure. The purpose of the current study is to present the patients' clinical data and results of HTx in a single Center of Sicily. Focus on survival after pre and post HTx mechanical circulatory support use will be performed.
  
  
  METHODS
  133 HTx were done from 2004 to the end of 2015.The average donor age was 34±13.5years and the proportion of male donors was 67%. Percentage of use of mechanical circulatory support to bridge patients to HTx was 18%.
  
  
  RESULTS
  Overall pre-transplant mechanical circulatory support was not correlated to worse post-transplant prognosis, p=0.757. Severe primary early graft failure requiring extra corporeal membrane oxygenator support strongly impact the early mortality after heart transplantation (p<0.001).
  
  
  CONCLUSIONS
  The results of HTx at ISMETT are comparable to those reported in high volume Italian transplant centers as well as in the ISHLT registry. The favorable outcome can be related to focus on multidisciplinary approach, strict recipients' selection and young donor population. Post HTx mechanical circulatory support use in general remains associated with worse post-transplant outcomes. This does not apply to pre-op mechanical circulatory support population.
authors.affiliation: Cardiac Surgery and Heart Transplantation Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy. Electronic address: giuseppe.raffa78@gmail.com.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Raffa
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Di Gesaro
authors.affiliation: Cardiac Surgery and Heart Transplantation Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sciacca
authors.affiliation: Research Office, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tuzzolino
authors.affiliation: Cardiac Surgery and Heart Transplantation Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Turrisi
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Falletta
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Minà
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romano
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vitale
authors.affiliation: Department of Anesthesia and Critical Care, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Panarello
authors.affiliation: Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Clemenza
authors.affiliation: Cardiac Surgery and Heart Transplantation Unit, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Via Tricomi 5, 90127 Palermo, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Pilato
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000401:mortality* / Q000639:trends*; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality* / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012802:Sicily / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
keywords: Coronary allograft disease; Early graft failure; Heart failure; Heart transplantation; Mechanical circulatory support