Outcomes of mechanical support for cardiogenic shock associated with late cardiac allograft failure

J Card Surg. 2020 Dec;35(12):3381-3386. doi: 10.1111/jocs.15089. Epub 2020 Oct 12.

Abstract

Background: Late graft failure (LGF) is an unresolved issue after orthotopic heart transplant (OHT). In this study, we report characteristics and outcomes of severe LGF requiring mechanical circulatory support (MCS).

Methods: All patients undergoing OHT from 2000 to 2018 at our center were reviewed. Patients re-admitted to the hospital for late graft failure (>3 months after initial discharge) and developing cardiogenic shock requiring MCS were identified. Outcomes and mortality were evaluated.

Results: Twenty-six patients were identified. Median age was 37.3 years (interquartile range: 28.2-47.6) and 69% were male. Median time from initial transplant to MCS was 2.9 years. Etiology of graft failure was rejection in 19 patients (73%), transplant coronary artery disease (tCAD) in 3 (12%), with mixed tCAD or rejection in 4 (15%).

Keywords: heart transplantation; late allograft failure; mechanical circulatory support.

MeSH terms

  • Adult
  • Allografts
  • Female
  • Heart Failure* / therapy
  • Heart Transplantation*
  • Heart-Assist Devices*
  • Humans
  • Male
  • Retrospective Studies
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy