Rinse, Wash, Repeat

Silvestry, Scott C.; Rogers, Joseph G.

doi:10.1016/j.jchf.2021.10.010

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…First, to reduce waitlist mortality by prioritizing high-risk patients in cardiogenic shock on mechanical circulatory support [3]. Second, to provide equitable opportunities for sicker patients and broaden geographical sharing of organs for higher priority status [4]. Third, to offer patients with longer waitlist times and relatively higher mortality rates such as patients with congenital heart disease and restrictive cardiomyopathies, better chances to receive heart transplant offers [5].…”

Section: Introductionmentioning

confidence: 99%

Destination LVAD therapy in the current era of the heart transplant allocation system

Toro

Patel

Guha

2023

Current Opinion in Cardiology

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Purpose of reviewThis article aims to shed light on the major implications of the new allocation system by discussing the observed outcomes and complications and suggesting a few steps to prevent and manage those potential challenges.Recent findingsThe new allocation system implemented in 2018 aimed to prioritize high-risk patients and provide a better equitable opportunity for heart transplantation. However, despite the success in reducing wait-list mortality, this change brought up many direct and indirect challenges to patient care, such as worsening ischemic time and an increase in the use of temporary mechanical support at the expense of durable LVADs. Moreover, the parallel advancement in LVAD technology and the associated improvement in patient outcomes added another layer to the complexity of shared decision-making in the advanced heart failure population.SummaryLVAD patient population is expected to continue to expand. This growth will also be accompanied by longer wait-time and a higher prevalence of LVAD complications. Advanced technologies such as wireless devices and remote monitoring are quite promising in that regard. Also, advanced artificial intelligence algorithms might help to improve patient selection, ameliorate early detection of complications, and offer further guidance to manage those complications.

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Section: Introductionmentioning

confidence: 99%

Destination LVAD therapy in the current era of the heart transplant allocation system

Toro

Patel

Guha

2023

Current Opinion in Cardiology

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show abstract

“…Human donor organ allocation rules have evolved under circumstances of continued excess demand and are structured as a process of distributing a scarce resource. 4 Selection of candidates for heart transplant is made by individual institutions, informed by published guidelines, federal regulations, and insurers. Patients who were not selected may be offered a durable left ventricular assist device if anatomically and hemodynamically suitable.…”

mentioning

confidence: 99%