Heart failure & cardiomyopathies
Primary Graft Dysfunction in Patients Supported With Durable Left Ventricular Assist Devices Before Heart Transplantation
Authors' conclusion
HT recipients supported by durable LVADs before HT are at increased risk of PGD, but they experience less mortality associated with this post-transplant complication.
Study context
- Population
- Heart transplantation (HT) recipients of donation-after-brain-death hearts at 14 HT centres
- Participants
- 4,125 recipients14 HT centres
- Exposure
- Durable left ventricular assist device (LVAD) support vs no LVAD support at the time of HT
- LVADn = 1,091
- Outcome
- Severe primary graft dysfunction (PGD)
Methodological detailsmulticentre, registry (International Consortium on primary graft dysfunction (PGD))
- Multicentre
- Registry (International Consortium on PGD)
Main finding
As reported in the abstract
Severe PGD
P < 0.001
- Severe PGD overall
- 365 patients (8.6%)
Observational data: associations, not effects.
Further findings
| Outcome | LVAD | No LVAD | P value |
|---|---|---|---|
| 1-year mortality among patients with severe PGD | 28.8% (95% CI 22.0%–37.1%) | 40.7% (95% CI 34.6%–47.7%) | log-rank P = 0.025 |
Risk factors for severe PGD among LVAD-supported patients
- Pre-HT creatinine, CVP/PCWP ratio and overall donor ischemic time were risk factors
- Multivariable logistic regression
Original publication
Primary Graft Dysfunction in Patients Supported With Durable Left Ventricular Assist Devices Before Heart Transplantation. JACC Heart Fail. Published 11 October 2025. doi:10.
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