Favorable Impact of a Multidisciplinary Team Approach on Heart Transplantation Outcomes in a Mid-Volume Center

Abstract

Although a multidisciplinary team (MDT) approach is recommended for advanced heart failure and heart transplantation (HTx), no studies have investigated the impact of the team approach on post-HTx survival. Thus, we implemented an MDT approach in our HTx program in 2014, with the active involvement of critical care and extracorporeal life support (ECLS) teams and the use of a real-time online information sharing system. We hypothesized that this MDT approach would result in improved survival of patients who had undergone HTx. We enrolled 250 adult patients who underwent HTx between December 2003 and June 2018. They were divided into non-MDT (n = 120; before 2014) and MDT (n = 130; since 2014) groups. The primary outcome was overall mortality. In terms of donor age, diabetes, dialysis, ECLS, and waiting time, the MDT group had more high-risk patients. The MDT approach was found to be an independent predictor of overall survival using a variety of multivariable analytic methods, including inverse probability of treatment weighting analysis. An HF team, a critical care team, and an ECLS team collaboration may improve survival following HTx. To improve the efficiency of the MDT approach, we recommend using a real-time online information sharing system.