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Comparative Study
. 2014 Feb;97(2):506-12.
doi: 10.1016/j.athoracsur.2013.08.048. Epub 2013 Oct 17.

HeartWare and HeartMate II left ventricular assist devices as bridge to transplantation: a comparative analysis

Veli K Topkara  1 , James K O'Neill  2 , Adam Carlisle  2 , Eric Novak  2 , Scott C Silvestry  3 , Gregory A Ewald  2
Affiliations
Comparative Study

HeartWare and HeartMate II left ventricular assist devices as bridge to transplantation: a comparative analysis

Veli K Topkara et al. Ann Thorac Surg. 2014 Feb.

Abstract

Background: The purpose of this study is to comparatively analyze outcomes of heart transplant patients bridged to transplantation with HeartWare (HW-VAD) versus HeartMate II (HMII-VAD) left ventricular assist devices.

Methods: The United Network for Organ Sharing Database was reviewed to identify first-time heart transplant recipients who were bridged to transplantation with either HW-VAD (n=141) or HMII-VAD (n=1824) from January 2009 through July 2012.

Results: Recipients of HW-VAD had a higher proportion of female patients (27.0% versus 18.9%; p=0.019), a lower body surface area (2.01±0.25 m2 versus 2.06±0.25 m2; p=0.035), and a trend toward a higher peak percentage of panel reactive antibody against human leukocyte class I antigens (40.4%±32.8% versus 33.0%±30.4%; p=0.070). Pretransplantation recipient cardiac index (2.33±0.66 L⋅min(-1)⋅m(-2) versus 2.33±0.68 L⋅min(-1)⋅m(-2)), serum creatinine (1.21±0.43 mg/dL versus 1.26±0.57 mg/dL), and total bilirubin (1.34±3.45 mg/dL versus 1.06±1.84 mg/dL) were comparable between the two groups (p>0.05 for all comparisons). After transplantation, there were no significant differences in freedom from rejection or freedom from cardiac allograft vasculopathy. Posttransplant graft survival rates were similar between the HW-VAD group and the HMII-VAD group at 1, 2, and 3 years (88.4% versus 87.8%, 79.9% versus 83.8%, and 77.4% versus 79.9%, respectively; p=0.843).

Conclusions: These findings suggest similar hemodynamic unloading, pretransplant end-organ function, and posttransplant outcomes in patients bridged to transplantation with both the HW-VAD and HMII-VAD.

Keywords: 27; 34.

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Figures

Figure 1
Figure 1. Device Implants by Transplant Year
A) Number of Heartware and Heartmate II LVAD implants by transplant year. * Data until 6/2012. B) Percentage of Heartware LVAD implants by transplant year
Figure 2
Figure 2. Post-transplant Graft Survival
Figure 3
Figure 3. Freedom from Cardiac Allograft Vasculopathy and Hospitalization for Rejection
See this image and copyright information in PMC

Comment in

  • Invited commentary.
    Ghodsizad A, Brehm C, Koerner MM, Elbanayosy A. Ghodsizad A, et al. Ann Thorac Surg. 2014 Feb;97(2):512-3. doi: 10.1016/j.athoracsur.2013.09.037. Ann Thorac Surg. 2014. PMID: 24484793 No abstract available.

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