title: Effects of Left Ventricular Assist Device Support on End-Organ Function in Patients With Heart Failure: Comparison of Pulsatile- and Continuous-Flow Support in a Single-Center Experience.
abstract: BACKGROUND
  Limited data exist about the effects of continuous-flow versus pulsatile-flow left ventricular assist devices (LVADs) on end-organ function. We hypothesized that a pulsatile Polvad MEV (PM) would result in outcomes similar to those of similarly ill patients implanted with a continuous-flow LVAD (Heartware [HW] or Heartmate II [HMII]). We aimed to compare renal, hepatic, and hematologic functions in the 1st 30 days of support.
  
  
  METHODS
  We retrospectively reviewed patients with 24 PM (21 M, 3 F; group P) and 15 HW and 5 HMII (20 M, 0 F); group C LVAD implantations from April 2007 to February 2014. Creatinine, bilirubin, aspartate (AST) and alanine (ALT) transaminases, hematocrit, platelet count, international normalized ratio (INR), and activated partial thromboplastin time (APTT) parameters were analyzed before implantation and during 30 days of support. Demographic parameters were similar.
  
  
  RESULTS
  No significant differences were found between the groups regarding baseline renal, hepatic, or hematologic function. Baseline INR and APTT were significantly higher in group P. Levels of creatinine were similar between groups. They increased from baseline to postoperative day (POD) 1 and then decreased. Bilirubin levels were insignificantly higher in group P. Transaminases were significantly higher in group P (AST in PODs 3-6, ALT in PODs 3-7). INR values were significantly higher at baseline and in POD 0. APTT values were insignificantly higher in group P.
  
  
  CONCLUSIONS
  The use of LVAD improved renal and hepatic function in our series. Patients in group P had more decreased hepatic function and presented slower regeneration.
authors: Department of Cardiac Anaesthesia and Intensive Care SUM, Silesian Center for Heart Diseases, Zabrze, Poland. Electronic address: nadziakiewicz@wp.pl.
authors: P
authors: P
authors: Nadziakiewicz
authors: 3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
authors: B
authors: B
authors: Szygula-Jurkiewicz
authors: Department of Cardiac Surgery and Transplantation SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: T
authors: T
authors: Niklewski
authors: Department of Cardiac Surgery and Transplantation SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: J
authors: J
authors: Pacholewicz
authors: Department of Cardiac Surgery and Transplantation SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: M
authors: M
authors: Zakliczynski
authors: Department of Cardiac Anaesthesia and Intensive Care SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: J
authors: J
authors: Borkowski
authors: Department of Cardiac Surgery and Transplantation SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: T
authors: T
authors: Hrapkowicz
authors: Department of Cardiac Surgery and Transplantation SUM, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: M
authors: M
authors: Zembala
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008099:Liver / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult