Outcomes in Heart Transplant Recipients by Bridge to Transplant Strategy When Using the SherpaPak Cardiac Transport System

Author:

Silvestry Scott1ORCID,Leacche Marzia2,Meyer Dan M.3,Shudo Yasuhiro4,Kawabori Masashi5,Mahesh Balakrishnan6,Zuckermann Andreas7,D’Alessandro David8,Schroder Jacob9

Affiliation:

1. From the Department of Cardiothoracic Surgery, AdventHealth Transplant Institute, Orlando, Florida

2. Division of Cardiothoracic Surgery, Corewell Health (Formerly Spectrum Health), Grand Rapids, Michigan

3. Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Texas

4. Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California

5. Cardiovascular Center, Department of Surgery, Tufts Medical Center, Boston Massachusetts

6. Division of Cardiac Surgery, Heart & Vascular Institute, Milton S. Hershey Medical Center, Hershey, Pennsylvania

7. Department for Cardiac Surgery, Medical University of Vienna, Vienna, Austria

8. Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts

9. Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.

Abstract

The last several years have seen a rise in use of mechanical circulatory support (MCS) to bridge heart transplant recipients. A controlled hypothermic organ preservation system, the SherpaPak Cardiac Transport System (SCTS), was introduced in 2018 and has grown in utilization with reports of improved posttransplant outcomes. The Global Utilization And Registry Database for Improved heArt preservatioN (GUARDIAN)-Heart registry is an international, multicenter registry assessing outcomes after transplant using the SCTS. This analysis examines outcomes in recipients bridged with various MCS devices in the GUARDIAN-Heart Registry. A total of 422 recipients with donor hearts transported using SCTS were included and identified. Durable ventricular assist devices (VADs) were used exclusively in 179 recipients, temporary VADs or intra-aortic balloon pump (IABP) in 197, and extracorporeal membrane oxygenation (ECMO) in 14 recipients. Average ischemic times were over 3.5 hours in all cohorts. Severe primary graft dysfunction (PGD) posttransplant increased across groups (4.5% VAD, 5.1% temporary support, 21.4% ECMO), whereas intensive care unit (ICU) length of stay (18.2 days) and total hospital stay (39.4 days) was longer in the ECMO cohort than the VAD and IABP groups. A comparison of outcomes of MCS bridging in SCTS versus traditional ice revealed significantly lower rates of both moderate/severe right ventricular (RV) dysfunction and severe PGD in the SCTS cohort; however, upon propensity matching only the reductions in moderate/severe RV dysfunction were statistically significant. Use of SCTS in transplant recipients with various bridging strategies results in excellent outcomes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Cold precision: Enhancing organ preservation with controlled hypothermia;The Journal of Heart and Lung Transplantation;2024-09

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