Heart failure & cardiomyopathies
Impact of Heart Transplant Allocation Change on Waitlist Mortality and Posttransplant Mortality in Patients With Left Ventricular Assist Devices
Authors' conclusion
Among patients with LVAD, lower waitlist mortality postallocation change was likely driven by improved LVAD technology. Higher posttransplant mortality following the allocation change was largely attributable to longer ischemic times and patient acuity.
Study context
- Population
- Patients with left ventricular assist device (LVAD) listed for or undergoing heart transplant (HT), US, October 2016–October 20213,835 listed
- Exposure
- HT listing/transplant postallocation change vs preallocation change
- Outcome
- Waitlist mortality and posttransplant mortality
Methodological detailsUNOS registry
- UNOS registry
Main finding
As reported in the abstract
Waitlist mortality
- Preallocation change vs Postallocation change: Gray P=0.0058
- Competing risks analysis
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Waitlist mortality by LVAD brand (adjusted)HM3vs HMII | 0.38 (0.21–0.69) | P = 0.002 | |
| Waitlist mortality by LVAD brand (adjusted)HVADvs HMII | 0.79 (0.48–1.30) | P = 0.36 | |
| Posttransplant mortality predictors (multivariable)Status 1-3vs Status 4Status at time of HT | 1.29 (1.04–1.61) | P = 0.02 | |
| 0.20.5125Hazard ratio (log scale) |
Posttransplant mortality predictors (multivariable)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Ischemic time | 1.16 (1.07–1.26) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Posttransplant mortalityPostallocation change vs Preallocation change | log-rank P=0.0172 |
- Waitlist mortality by LVAD brand (adjusted): overall P=0.004
- Posttransplant mortality: increased mortality postallocation change; attenuated in multivariable analysis
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of Heart Transplant Allocation Change on Waitlist Mortality and Posttransplant Mortality in Patients With Left Ventricular Assist Devices. Circ Heart Fail. Published 17 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →