Recent Advances in TransplantationThoracic transplantationAdult Heart Transplantation Following Ventricular Assist Device Implantation: Early and Late Outcomes
Section snippets
Patients
From December 1988 to June 2012, our center performed 704 adult orthotopic heart transplantation (OHT) procedures, excluding multiple-organ and redo-cardiac transplantations; there were 345 (49.0%) recipients without prior sternotomy and 359 (51.0%) recipients with 1 or more prior sternotomies. To analyze the effect of VAD implantation prior to HTx, we divided the 359 recipients with prior sternotomies into 2 groups: HTx patients with a history of VAD implantation (VAD group, n = 90) and HTx
Preoperative Characteristics
Table 1 shows the baseline characteristics of the HTx patients in the VAD and Non-VAD groups and their organ donors. Recipients in the VAD group were younger on average at the time of HTx (P < .0001). They also had higher weight and body mass index (BMI) compared with recipients in the Non-VAD group (P = .003 and P = .023, respectively). However, donor-to-recipient weight ratio was similar between HTx patients in both groups (P = .71). The distribution of gender was similar between both groups
Preoperative Characteristics
HTx patients with prior VAD were younger on average compared with those with no prior VAD (Table 1), similar to observations in other studies [20], [21], [22], [23]. However, Drakos et al showed similar average ages between both groups, but it should be noted that only 14.5% of recipients in the No-MCS group had previous cardiac surgery, whereas all of our study patients had at least 1 previous cardiac surgery [24]. We tended to use larger donors for HTx patients with prior VAD (Table 1)
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