Primary Graft Failure is More Common in Patients Bridged to Heart Transplant with LVAD: Role of Early Peripheral ECMO

An increased incidence of primary graft failure requiring mechanical circulatory support has been reported by multiple large volume heart transplantation (HTX) centers, many of which are also high volume LVAD centers. Due to donor shortage, use of donor organs with initial left ventricular systolic dysfunction (< 40%) with improvement during donor management has been reported to yield excellent results. We examined the association of improved donor LV systolic dysfunction (LVEF < 40% to > 55% during donor management), pre transplant left ventricular assist device support, and primary graft failure.