title: New role of ventricular assist devices as bridge to transplantation: European perspective.
abstract: OBJECTIVE
  Progress of ventricular assist devices (VAD) technology led to improved survival and apparently low morbidity. However, from the European perspective, updated analysis of EUROMACS reveals a somewhat less impressive picture with respect to mortality and morbidity.
  
  
  RESULTS
  We describe the great demand of cardiac allografts versus the lack of donors, which is larger in Europe than in the United States. Technical progress of VADs made it possible to work out a modern algorithm of bridge-to-transplant, which is tailored to the need of the particular patient. We analyze the burden of patients undergoing bridge-to-transplant therapy. They are condemned to an intermediate step, coupled with additional major surgery and potential adverse events during heart transplantation.
  
  
  CONCLUSIONS
  Based on current registry data, we do have to question the increasingly popular opinion, that the concept of heart transplantation is futureless, which seems to be for someone who treats and compares both patients (VAD and heart transplantation) in daily practice, questionable. Up to now, left ventricular assist device therapy remains a bridge to a better future, which means a bridge to technical innovations or to overcome the dramatic lack of donors in Europe.
authors.affiliation: aDepartment of Cardiovascular Surgery bDepartment of Cardiology, Swiss Cardiovascular Center, Inselspital, University Hospital Bern, University of Bern, Switzerland.
authors.forename: David C
authors.initials: DC
authors.lastname: Reineke
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mohacsi
mesh_terms: D005060:Europe; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation / Q000379:methods*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male