000			03732nam a22005297a 4500
008			211101s20212021 xxu||||| |||| 00| 0 eng d
022			_a1053-2498
040			_aOvid MEDLINE(R)
099			_a34404571
245			_aLong-term survival on LVAD support: Device complications and end-organ dysfunction limit long-term success.
251			_aJournal of Heart & Lung Transplantation. 41(2):161-170, 2022 02.
252			_aJ Heart Lung Transplant. 41(2):161-170, 2022 02.
252			_zJ Heart Lung Transplant. 2021 Jul 24
253			_aThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
260			_c2022
260			_fFY2022
265			_sppublish
266			_d2021-11-01
268			_aJournal of Heart & Lung Transplantation. 2021 Jul 24
520			_aBACKGROUND: Preoperative variables can predict short term left ventricular assist device (LVAD) survival, but predictors of extended survival remain insufficiently characterized.
520			_aCONCLUSIONS: Success with LVAD therapy hinges on achieving long term survival in more recipients. After 1 year, extended survival is heavily constrained by the occurrence of adverse events and postoperative end-organ dysfunction. The growth of destination therapy intent mandates that future LVAD studies be designed with follow up sufficient for capturing outcomes beyond 24 months. Copyright (c) 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
520			_aMETHOD: Patients undergoing LVAD implant (2012-2018) in the Intermacs registry were grouped according to time on support: short-term (<1 year, n = 7,483), mid-term (MT, 1-3 years, n = 5,976) and long-term (LT, >=3 years, n = 3,015). Landmarked hazard analyses (adjusted hazard ratio, HR) were performed to identify correlates of survival after 1 and 3 years of support.
520			_aRESULTS: After surviving 1 year of support, additional LVAD survival was less likely in older (HR 1.15 per decade), Caucasian (HR 1.22) and unmarried (HR 1.16) patients (p < 0.05). After 3 years of support, only 3 preoperative characteristics (age, race, and history of bypass surgery, p < 0.05) correlated with extended survival. Postoperative events most negatively influenced achieving LT survival. In those alive at 1 year or 3 years, the occurrence of postoperative renal (creatinine HR MT = 1.09; LT HR = 1.10 per mg/dl) and hepatic dysfunction (AST HR MT = 1.29; LT HR = 1.34 per 100 IU), stroke (MT HR = 1.24; LT HR = 1.42), infection (MT HR = 1.13; LT HR = 1.10), and/or device malfunction (MT HR = 1.22; LT HR = 1.46) reduced extended survival (all p <= 0.03).
546			_aEnglish
650			_a*Heart Failure/th [Therapy]
650			_a*Heart-Assist Devices/ae [Adverse Effects]
650			_a*Multiple Organ Failure/mo [Mortality]
650			_a*Registries
650			_aEquipment Failure
650			_aFemale
650			_aFollow-Up Studies
650			_aHeart Failure/mo [Mortality]
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aMultiple Organ Failure/et [Etiology]
650			_aRetrospective Studies
650			_aSurvival Rate/td [Trends]
650			_aTime Factors
650			_aUnited States/ep [Epidemiology]
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aMolina, Ezequiel
790			_aCogswell R, Cowger JA, Dardas T, Gosev I, Hariri IM, Kanwar M, Kirklin JK, Molina E, Myers SL, Pagani FD, Shah P
856			_uhttps://dx.doi.org/10.1016/j.healun.2021.07.011 _zhttps://dx.doi.org/10.1016/j.healun.2021.07.011
942			_cART _dArticle
999			_c6796 _d6796