Destination Therapy With Left Ventricular Assist Devices: For Whom and When?

Porepa, Liane; Starling, Randall C.

doi:10.1016/j.cjca.2013.12.017

Cited by 33 publications

(18 citation statements)

References 30 publications

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“…Most studies have used continuous flow as opposed to a pulsatile flow in the hepatic artery, but there are no data available supporting the superiority of either flow setting. However, clinical experiences from left ventricular assist devices demonstrate a decreased technical liability of the continuous flow technique with comparable functional results [28], suggesting similar implications for normothermic liver perfusion. For liver NMP, the venous blood can drain openly into the organ basin [29] from where it is recirculated or it can pass through a closed tubing system toward a reservoir coming from both supra-and infrahepatic vena cava outflow [30,31] or one vena cava cannula [21,32].…”

Section: Technical Aspects Of Normothermic Liver Perfusionmentioning

confidence: 86%

Early Clinical Results Using Normothermic Machine Liver Preservation

et al. 2015

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The ongoing shortage of donor organs for liver transplantation results in high mortality rates for those on the waiting list. This has triggered considerable interest in the use of marginal liver grafts to increase the donor pool. Unfortunately, marginal grafts poorly tolerate preservation by cold storage (CS), resulting in an increased risk of liver injury and poor graft function after transplantation. Better preservation techniques are needed to fully utilize marginal grafts and to expand the number of organ donors. Animal studies have demonstrated normothermic ex vivo liver perfusion to be superior to conventional CS. Recently, the first clinical trial of normothermic ex vivo liver perfusion was completed with promising results. Similarly, in situ recirculation after cardiac arrest as the initial preservation method before organ procurement has proven to be a valuable technique to make more liver grafts available for transplantation. Though technically more complex and economically more expensive, normothermic liver perfusion is a promising and innovative technique that is able to positively impact current transplant practice and outcomes.

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Section: Technical Aspects Of Normothermic Liver Perfusionmentioning

confidence: 86%

Early Clinical Results Using Normothermic Machine Liver Preservation

et al. 2015

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“…Perhaps the greatest contributors to patient satisfaction with these therapies are the frequency and severity of adverse medical events following transplant or VAD implant [14], which directly impact time away from the hospital, patient apprehension about their overall condition, and the likelihood of death from these complications.…”

Section: Life Satisfactionmentioning

confidence: 99%

Terminal heart failure

Kirklin

2014

Current Opinion in Organ Transplantation

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“…In recent years, implantation of continuous flow left ventricular assist device (LVAD) has grown in terms of patients' number and postoperative survival. LVAD is a valid treatment for patients with advanced heart failure, either as temporary (Bridge‐To‐Transplant—BTT) or permanent (Destination Therapy—DT) support …”

Section: Introductionmentioning

confidence: 99%

Psychological outcomes of left ventricular assist device long‐term treatment: A 2‐year follow‐up study

et al. 2019

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Left ventricular assist device (LVAD) is an effective therapy for patients with advanced or refractory heart failure. It may represent a temporary treatment in heart transplant (HTX) candidates (Bridge‐To‐Transplant—BTT), or a permanent therapy for patients unsuitable for HTX (Destination Therapy—DT). Living with the device may be stressful for both the patients and their caregivers. Currently, evidence on the psychological assessment of LVAD recipients, and factors influencing the patients' psychological adaptation to the device in the long‐term period is limited. Here, we explored the quality of life in 20 patients who were treated with LVAD with BTT (n = 13) or DT indication (n = 7) before (T0), 1 year (T1) and 2 years (T2) after implantation, using the EuroQoL‐5D‐5L test. We also analyzed the influence of sociodemographic (eg, age, gender) and clinical variables (eg, the INTERMACS level and number of hospital admissions) on the quality of life at T2. We found a significant improvement in the self‐perceived quality of life 2 years after LVAD implantation. Patients significantly improved in the domains of physical activity and anxiety and depression symptoms. Interestingly, we also demonstrated that the treatment indication was related to changes in self‐assessed quality of life, which improved over time in patients implanted with DT indication, whereas it decreased from T1 to T2 in patients with BTT indication. Taken together, these findings suggest that LVAD‐related emotional distress and coping strategies need to be carefully evaluated before and in the long‐term after LVAD implantation.

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Destination Therapy With Left Ventricular Assist Devices: For Whom and When?

Cited by 33 publications

References 30 publications

Early Clinical Results Using Normothermic Machine Liver Preservation

Early Clinical Results Using Normothermic Machine Liver Preservation

Terminal heart failure

Psychological outcomes of left ventricular assist device long‐term treatment: A 2‐year follow‐up study

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