Abstract 20210: Comparison of Infectious Complications Encountered in Heart Transplant Recipients With and Without Pre-Transplant LVAD Therapy
Background: Due to growing discrepancy between the number of candidates for heart transplant therapy and the available donor organs in the United States, implantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation and also as destination myocardial surrogate therapy. However, little is known about the impact of pre-heart transplant LVAD therapy on the risk of post-transplant infectious complications.
Objective: To assess the differences in the types of infections encountered in heart transplant recipients who receive pre-transplant LVAD therapy compared to those who do not receive any assist device.
Methods: We retrospectively reviewed medical records of all patients undergoing heart transplantation at three Mayo Clinic sites in Minnesota, Arizona and Florida, from January 2007 to June 2013. Patients were included in this study if 1) had a heart transplant without any assist device or 2) if they had a Heartmate II device as a bridge to transplant. Patients who received other LVAD models, RVADs or total artificial hearts were excluded from current analysis. Variables including patient demographics, co-morbid conditions, details of infections pre and post transplant were collected.
Results: Overall, 296 patients were found to be eligible for the study. Among these, 22% of the patients had received LVAD therapy prior to heart transplantation. The mean age of our study cohort was 54 years and 69% of the patients were male. The two most common infectious syndromes encountered in both groups were bloodstream infection (18.6% in non-LVAD compared to 17% in the LVAD group) and lower respiratory tract infections (16.5% in the non-LVAD versus 18.9% in the LVAD group). 9 episodes of LVAD related infections were seen (2 pump related and 7 drive-line infections). Bacterial infections were the most frequent type of infection, with gram-positive organisms being the most common pathogen in both groups. No statistically significant differences were observed in the incidence of bacterial, viral, fungal or mycobacterial infections between the two groups.
Conclusions: Use of LVAD therapy as a bridge to heart transplantation does not impact the type and severity of infectious complications encountered after the transplant.
Author Disclosures: S. Arif: None. R. Walker: None. M.P. Wihelm: None. M.R. Keating: None. L. Brumble: None. H.R. Vikram: None. S. Kusne: None. J.M. Stulak: None. R.C. Daly: None. D. Yip: None. M.A. Hathcock: None. J. Nienaber: None. M. Sohail: None.
- © 2014 by American Heart Association, Inc.