Short-Term Mechanical Circulatory Support Before Heart Transplantation and Early Outcomes: Insights From the International Primary Graft Dysfunction Consortium.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rivas-Lasarte Mercedes, Rodenas-Alesina Eduard, Moayedi Yasbanoo, Truby Lauren K, Foroutan Farid, Henricksen Erik, Signorile Marisa, Dhingra Nitish K, Hastenteufel Laura, Fan Chun-Po S, Guzman-Bofarull Joan, Farrero-Torres Marta, Khush Kiran K, Couto-Mallon David, Moayedifar Roxana, Kim Gene, Crespo-Leiro Maria Generosa, Chih Sharon, Devore Adam D, Takeda Koji, Lerman Joseph B, Sabatino Mario, Potena Luciano, Tremblay-Gravel Maxime, Noly Pierre-Emmanuel, Miller Robert J H, Zuckermann Andreas, Farr Maryjane A, Ross Heather J, Martin Archer K, Segovia-Cubero Javier, Hall Shelley A
Аннотация
METHODS: We analyzed data from the Primary Graft Dysfunction Consortium, a retrospective registry including 3800 adult HTs at 14 centers in the United States, Canada, and Europe between 2010 and 2020. Primary outcomes were severe PGD (according to International Society for Heart and Lung Transplantation criteria) and 1-year mortality. Multivariable logistic regression and Cox models were used, with multiple imputation for missingness.
RESULTS: Overall, 669 patients (17.6%) received pre-HT ST-MCS. Among them, 16.9% were supported with extracorporeal membrane oxygenation (ECMO), 60.4% with an intra-aortic balloon pump, 9.1% with a percutaneous left ventricular assist device, 9.1% with surgical ventricular assist devices, and 4.5% with other devices. ST-MCS use increased over time and varied by region, with the intra-aortic balloon pump predominating in the United States and ECMO more frequently used in Canada and Europe. Overall, ST-MCS was not associated with severe PGD after adjustment; however, ECMO was independently associated with greater PGD risk (adjusted odds ratio 3.28, 95% confidence interval 1.90-5.66). One-year mortality was 11.0% and did not differ significantly according to ST-MCS use after multivariable adjustment.
CONCLUSIONS: In this large contemporary multinational cohort, pretransplant ST-MCS use has increased, with geographic heterogeneity observed. Although ECMO is associated with a greater risk of severe PGD, ST-MCS does not independently increase 1-year mortality after HT, supporting its use as a bridge in high-risk patients.