Relation of Left Ventricular Assist Device Infections With Cardiac Transplant Outcomes

Left ventricular assist device (LVAD)–specific infections (LSIs) are common in patients on LVAD support awaiting heart transplant (HT), yet their impact on post-HT outcomes is not completely understood. We hypothesized that LSIs would result in vasoplegia and negatively affect post-HT 30-day and 1-y...

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Bibliographic Details
Published in:The American journal of cardiology 2021-12, Vol.160, p.67-74
Main Authors: Parikh, Aditya, Halista, Michael, Raymond, Samantha, Feinman, Jason, Mancini, Donna, Mitter, Sumeet, Barghash, Maya, Trivieri, Maria, Contreras, Johanna, Taimur, Sarah, Roldan, Julie, Murphy, Joseph, Pawale, Amit, Anyanwu, Anelechi, Moss, Noah, Lala, Anuradha, Pinney, Sean
Format: Article
Language:English
Subjects:
Antibiotics
Antibodies
Creatinine
Death
Dopamine
Graft rejection
Heart failure
Heart transplantation
Infections
Mortality
Patients
Pulmonary arteries
Rejection
Renal failure
Transplants & implants
Ventricle
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Summary:Left ventricular assist device (LVAD)–specific infections (LSIs) are common in patients on LVAD support awaiting heart transplant (HT), yet their impact on post-HT outcomes is not completely understood. We hypothesized that LSIs would result in vasoplegia and negatively affect post-HT 30-day and 1-year outcomes. LSI was defined as driveline, pump, or pocket infection. The short-term outcome was a composite of acute renal failure, allograft rejection, and mortality at 30 days after HT. The long-term outcome was a composite of allograft rejection and death within 1 year after HT. We performed a retrospective analysis of 111 HT recipients bridged with durable LVAD support at our institution from May 2012 to August 2019. Of these, 63 patients had LSIs, with 94% of the infections being driveline infections. Vasoplegia was more prevalent in the LSI group but not significantly (7 vs 2 persons, p = 0.3). There was no difference in the composite end point of acute renal failure, rejection, or death at 30 days (30% vs 25%, p = 0.55) or 1-year end point of rejection and death (38% vs 40%, p = 0.87) in patients with LSI versus those without LSI. In conclusion, LSIs were common in patients on LVAD who underwent HT in our single-center contemporary cohort. However, LSI was not associated with adverse outcomes at 30 days or at 1 year after HT.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2021.08.044