title: Trends in the use of mechanical circulatory support as a bridge to heart transplantation across different age groups.
abstract: BACKGROUND
  Numerous cohort analyses suggest rapidly increasing use of mechanical circulatory support (MCS) as a bridge to heart transplantation (HTx), but the role of age in selection for MCS remains unknown.
  
  
  METHODS
  We assessed adult HTx in the International Society for Heart And Lung Transplantation Registry between 2005 and 2013 and we determined MCS use by recipient age group and transplant year. Multivariable logistic regression models were constructed to identify variables associated with continuous flow (CF) left ventricular assist device (LVAD) use within each age group.
  
  
  RESULTS
  Among 16,480 HTx recipients the percentage of overall MCS use increased from 23% to 38%, 21% to 41%, and 17% to 42% in age groups 18-39 years, 40-59 years and over 60 years, respectively. This effect was mainly due to an increase in CF LVAD use and primarily in HTx recipients aged over 60. In multivariable analyses, male gender and blood group O were significantly associated with CF LVAD use in all age groups.
  
  
  CONCLUSIONS
  Bridge to transplant MCS use increased dramatically between 2005 and 2013 primarily due to increased use of CF LVAD and primarily in higher ages. Pre-HTx CF LVAD use was more frequent in men and blood group O.
authors: Department of Cardiovascular Diseases, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: Agnieszka.Ciarka@uzleuven.be.
authors: Agnieszka
authors: A
authors: Ciarka
authors: United Network for Organ Sharing (UNOS), Richmond, US.
authors: Leah
authors: L
authors: Edwards
authors: Cardiology Department, Lund University, Sweden.
authors: Johan
authors: J
authors: Nilsson
authors: Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors: Josef
authors: J
authors: Stehlik
authors: Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors: Lars H
authors: LH
authors: Lund
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Continuous flow left ventricular assist device; Heart failure; Heart transplantation; Mechanical circulatory support