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Timing of Infections after Total Artificial Heart Implantation. What Did We Learn?

H. Chambers, A. Kalil, D. Florescu.

Transplant Infectious Diseases, University of Nebraska Medical Center, Omaha, NE.

Meeting: 2018 American Transplant Congress

Abstract number: C351

Keywords: Heart assist devices, Infection

Session Information

Date: Monday, June 4, 2018

Session Name: Poster Session C: Transplant Infectious Diseases

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Related Abstracts
  • The Largest Single Center Experience with Total Artificial Heart Implantation: Characterization of Outcome.
  • Impact of Transfusion Requirements on Likelihood of Heart Transplantation After Total Artificial Heart.

Background: The total artificial heart (TAH) has become a reliable bridge to heart transplantation. There are no studies describing the timing of infections post-TAH implantation. Our study sought to assess timing of infections after TAH.

Methods: This is a retrospective study of patients who underwent a TAH implantation at our institution. All continuous variables were reported as medians and respective ranges. All categorical variables were analyzed as proportions.

Results: Nine patients were included in the study with median age of 48 years (21-61 years), BMI of 26.0 (22.3-39.4), and BSA of 2.04 (1.63-2.50). 78% of patients had an infection. The median time from TAH implantation to the first infection was 15 days (5-32 days), and the median time to the last infection was 59 days (36-152 days). The median EF prior to implantation was 15% (0-40%). These patients were at a high risk for infection with pre-TAH diabetes 2/9 (22%), chronic renal failure 5/9 (56%), IABP 3/9 (33%), and ECMO 2/9 (22%). After TAH implantation, patients had a median of 8 days (2-65 days) on ventilator support with a median ICU stay of 44 days (5-65 days).

Type of Infection Median Time to Infection (range in days) Number of Patients Organisms
Surgical Wound 36 days 1 C. albicans
Mediastinitis 24 (20-28) 2 S. epidermidis

not identified

Urinary Tract Infections 19 (5-32) 2 E. faecalis

C. albicans

Gastrointestinal Infections 84 (16-152) 2 C. difficile

C. difficile

Bloodstream Infections 58 (16-127) 5 MRSA

C. glabrata

E faecalis, C. dubliniensisin same patient

C. albicans x 2 episodes in same patient

S. epidermidis x 2 episodes in same patient

Pneumonia 102 (11-125) 4 MRSA

not identified x 3 patients

HSV Viremia 42 days 1 HSV-1
Sinusitis 57 days 1 No organism
CMV viremia 21 days 1 CMV

Four patients experienced 7 episodes of pneumonia. Five patients had 8 episodes of bloodstream infections. The median time from the TAH implantation-to-death was 2 months (0-16 months); the median time-to-transplantation was 3.5 months (2-6 months).

Conclusion: Infections are common in patients who receive a TAH. Most of the infections are due colonizers. Extending perioperative antibiotics would not reduce infection rates but might promote emergence of multidrug resistant organisms.

CITATION INFORMATION: Chambers H., Kalil A., Florescu D. Timing of Infections after Total Artificial Heart Implantation. What Did We Learn? Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Chambers H, Kalil A, Florescu D. Timing of Infections after Total Artificial Heart Implantation. What Did We Learn? [abstract]. https://atcmeetingabstracts.com/abstract/timing-of-infections-after-total-artificial-heart-implantation-what-did-we-learn/. Accessed March 8, 2021.

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