Author/Editor     Radovancevic, Branislav; Golino, Alessandro; Vrtovec, Bojan; Thomas, Cyntia D; Radovancevic, Rajko; Odegaard, Peggy; Van Rossem, Charles C; Gaemers, Sebastiaan JM; Vaughn, William K; Smart, Frank W; Frazier, OH
Title     Is bridging to transplantation with a left ventricular assist device a risk factor for transplant coronary artery disease?
Type     članek
Source     J Heart Lung Transplant
Vol. and No.     Letnik 24, št. 6
Publication year     2005
Volume     str. 703-7
Language     eng
Abstract     Background: Left ventricular assist device (LVAD) support is associated with coagulopathy, bleeding, increased blood transfusion, and increased anti-HLA antibody production. Increased anti-HLA antibody production is associated with early transplant rejection, transplant coronary artery disease (CAD), and decreased post-transplant survival rates. We asked whether bridging to transplantation with an LVAD increases the risk of transplant CAD. Methods: We reviewed data for all adults (> 18 years old) who underwent heart transplantation at our institution between 1988 and 2000. After exclusion of transplant recipients who survived <3 years, we divided the remaining cohort into 2 groups: those bridged to transplantation with LVADs (mean duration of support, 149 ± 107 days, n = 29) and those in United Network for Organ Sharing Status 1 bridged to transplantation without LVADs (controls, n = 86). We compared groups in terms of disease cause, age, sex, donor age, panel-reactive antibody testing, crossmatching, pre- and post-transplant cholesterol concentrations, diagnosis of diabetes mellitus or treated hypertension, infections, calcium channel blocker use, transplant rejection, ischemic time, cytomegalovirus infection, pre-transplant transfusion, and incidence of transplant CAD (defined as any coronary lesion identified by coronary angiography). We considered p < 0.05 to be significant. (Abstract truncated at 2000 characters)
Descriptors     CORONARY ARTERIOSCLEROSIS
HEART TRANSPLANTATION
HEART-ASSIST DEVICES
CHOLESTEROL
GRAFT REJECTION
SEX FACTORS
ADULT
MIDDLE AGE
BLOOD TRANSFUSION
FOLLOW-UP STUDIES
HLA ANTIGENS
RISK FACTORS
RETROSPECTIVE STUDIES