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. 2023 Oct;37(10):e15066.
doi: 10.1111/ctr.15066. Epub 2023 Jul 1.

Impella 5.5 as a bridge to heart transplantation: Waitlist outcomes in the United States

Marisa Cevasco  1 , Max Shin  2 , William Cohen  2 , Mark R Helmers  1 , Noah Weingarten  1 , David Rekhtman  2 , Joyce W Wald  3 , Amit Iyengar  1
Affiliations

Impella 5.5 as a bridge to heart transplantation: Waitlist outcomes in the United States

Marisa Cevasco et al. Clin Transplant. 2023 Oct.

Abstract

Objectives: The 2018 United Network for Organ Sharing allocation policy change has led to a significant increase in the use of mechanical circulatory support devices in patients listed for orthotopic heart transplantation. However, there has been a paucity of data regarding the newest generation Impella 5.5, which received FDA approval in 2019.

Methods: The United Network for Organ Sharing registry was queried for all adults awaiting orthotopic heart transplantation who received Impella 5.5 support during their listing period. Waitlist, device, and early post-transplant outcomes were assessed.

Results: A total of 464 patients received Impella 5.5 support during their listing period with a median waitlist time of 19 days. Among them, 402 (87%) patients were ultimately transplanted, with 378 (81%) being directly bridged to transplant with the device. Waitlist death (7%) and clinical deterioration (5%) were the most common reasons for waitlist removal. Device complications and failure were uncommon (<5%). The most common post-transplant complication was acute kidney injury requiring dialysis (16%). Survival at 1-year post-transplant survival was 89.5%.

Conclusion: Since its approval, the Impella 5.5 has been increasingly used as a bridge to transplant. This analysis demonstrates robust waitlist and post-transplant outcomes with minimal device-related and postoperative complications.

Keywords: ECMO; Impella 5.5; heart transplantation; temporary LVAD.

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References

REFERENCES

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