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The Largest Single Center Experience with Total Artificial Heart Implantation: Characterization of Outcome.

F. Arabia, M. Kittleson, L. Czer, D. Chang, T. Aintablian, E. Passano, G. Rodriguez, C. Runyon, J. Kobashigawa, J. Moriguchi.

Cedars-Sinai Heart Institute, Los Angeles, CA.

Meeting: 2016 American Transplant Congress

Abstract number: 19

Keywords: Heart/lung transplantation, Mechnical assistance

Session Information

Date: Sunday, June 12, 2016

Session Name: Concurrent Session: Challenges in Hearts and VADs - Striking Back

Session Time: 2:30pm-4:00pm

 Presentation Time: 3:42pm-3:54pm

Location: Room 309

Related Abstracts
  • The Selection Process for Total Artificial Heart
  • Impact of Transfusion Requirements on Likelihood of Heart Transplantation After Total Artificial Heart.

Background: Patients with severe irreversible biventricular heart failure may require support with the total artificial heart (TAH). These patients are usually Intermacs level 1 or 2 and are high risk for morbidity and mortality before and after heart transplantation. As we have one of the largest experiences with TAH implantation, we chose to describe our experience with our patients using similar protocols.

Methods: Between January 2012 and December 2014 we identified 48 heart failure patients (average Intermacs level 1.9 ± 0.9) who required TAH support. Characterization of these patients included 6-month survival and/or transplantation, complications including stroke, bleeding, driveline infection, gastrointestinal (GI) bleed. The prevalence of discharge home with Freedom Driver was also assessed. Furthermore, for those patients who underwent heart transplantation, outcomes assessed included post-transplant survival, pre-transplant sensitization, rejection and primary graft dysfunction (PGD).

Results: 48 patients underwent TAH implantation with a 72.9% (35/48) 6-month survival and/or transplantation rate. Complications were as follows: there was 22.9% post-implant stroke, 8.3% post-implant bleeding (brain), 25.0% post-implant GI bleeding, and 6.3% (3/48) post-implant driveline infection (see table). 53.3% (24/48) of the patients were discharged home on a Freedom Driver. 12 patients underwent heart transplantation with a 6-month and 12-month survival of 100.0%. Pre transplant sensitization with a PRA > 10% was 22.9% (11/48). No patient developed rejection or developed moderate to severe PGD post-transplant.

Conclusion: Patients undergoing TAH implantation have acceptable survival/transplantation, but complications are frequent. Post-transplant outcome appears respectable.

Endpoints % (N)
6-Month Survival and/or Transplantation 72.9% (35/48)
6-Month Survival Post-Transplant 100.0% (12/12)
12-Month Survival Post-Transplant 100.0% (12/12)
Pre- Transplant PRA >10% 22.9% (11/48)
Post Implant Stroke 22.9% (11/48)
Post Implant Bleeding: Brain 8.3% (4/48)
Post Implant Bleeding: GI 25.0% (12/48)
Driveline Infection 6.23% (3/48)
Discharched Home on Freedom Driver 53.3% (24/48)

CITATION INFORMATION: Arabia F, Kittleson M, Czer L, Chang D, Aintablian T, Passano E, Rodriguez G, Runyon C, Kobashigawa J, Moriguchi J. The Largest Single Center Experience with Total Artificial Heart Implantation: Characterization of Outcome. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Arabia F, Kittleson M, Czer L, Chang D, Aintablian T, Passano E, Rodriguez G, Runyon C, Kobashigawa J, Moriguchi J. The Largest Single Center Experience with Total Artificial Heart Implantation: Characterization of Outcome. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-largest-single-center-experience-with-total-artificial-heart-implantation-characterization-of-outcome/. Accessed April 20, 2021.

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