title: Temporary mechanical circulatory support after orthotopic heart transplantation: a single-centre experience.
abstract: There are various strategies in the use of temporary mechanical circulatory support following orthotopic heart transplant (OHT). We sought to examine the outcomes following different temporary mechanical circulatory support strategies for acute graft failure.
  
  
  
  Patients who received an OHT between 2001 and 2015 at a single institution were retrospectively reviewed. Patients were divided into 2 groups based on the need for temporary mechanical circulatory support (TMCS).
  
  
  
  A total of 9.9% (19 of 192) of patients required TMCS following OHT. There were no significant differences in the preoperative demographics between groups. Six patients (32%) required a biventricular assist device, 9 patients (47%) required a right ventricular assist device and 4 patients (21%) required a veno-arterial extracorporeal membrane oxygenator. Perioperative morbidity was comparable between all groups. Our entire TMCS cohort had 94.7% 30-day and 61.1% 1-year survival. When compared with the OHT patients with no TMCS (97.1% at 30 days and 92.8% at 1 year), survival was inferior in TMCS patients ( P  = 0.01 at 30 days, P  < 0.001 at 1 year, P  < 0.001 overall).
  
  
  
  Acute graft failure requiring TMCS has inferior overall survival. Larger, multi-institutional studies are needed to further elucidate these differences and identify the best TMCS mode.
authors.affiliation: Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Vakhtang
authors.initials: V
authors.lastname: Tchantchaleishvili
authors.affiliation: Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Wood
authors.affiliation: Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Carlson
authors.affiliation: Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Barrus
authors.affiliation: Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Swartz
authors.affiliation: Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Himabindu
authors.initials: H
authors.lastname: Vidula
authors.affiliation: Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Lehoux
authors.affiliation: Division of Cardiothoracic Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Todd Massey
authors.affiliation: Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Leway
authors.initials: L
authors.lastname: Chen
mesh_terms: D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010107:Oxygenators, Membrane; D011182:Postoperative Care / Q000379:methods*; D055031:Primary Graft Dysfunction / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: BiVAD; Heart transplant; Mechanical circulatory support; RVAD; Temporary cardiac support