(792) Does Right Ventricular Support with Mechanical Assist Devices Compromise Outcome for Heart Transplantation?

PurposeRight ventricular (RV) failure is uncommon in patients awaiting heart transplantation (HTx). However, this small group of patients may require the placement of a durable RVAD or temporary RVAD (tRVAD). It has not been well-established as to the waitlist mortality or post-transplant course for these patients.MethodsBetween 2012 and 2020, we assessed 20 patients who developed RV failure requiring durable RVAD (n=3) or temporary RVAD (tRVAD, n=17). The tRVAD included the following: Impella RP (n=6), CentriMag RVAD (n=6), and TandemHeart RVAD (n=5). These patients were assessed for 3- and 6-month mortality on the waitlist, and if transplanted, survival at 30-days and 1-year post-transplant. A group of case-controlled patients matched for age, gender and era without mechanical circulatory support (MCS) prior to transplant was used as control.ResultsPatients with RV failure requiring assist devices compared to patients without MCS (control) had similar mortality on the waitlist. Post-transplant, these patients had comparable survival at 30 days and 1-year post-transplant compared to control patients.ConclusionRV failure on the waitlist supported with mechanical support is not a significant risk for transplant candidacy (waitlist mortality) or post-transplant outcome. Larger studies are needed to confirm these findings. Right ventricular (RV) failure is uncommon in patients awaiting heart transplantation (HTx). However, this small group of patients may require the placement of a durable RVAD or temporary RVAD (tRVAD). It has not been well-established as to the waitlist mortality or post-transplant course for these patients. Between 2012 and 2020, we assessed 20 patients who developed RV failure requiring durable RVAD (n=3) or temporary RVAD (tRVAD, n=17). The tRVAD included the following: Impella RP (n=6), CentriMag RVAD (n=6), and TandemHeart RVAD (n=5). These patients were assessed for 3- and 6-month mortality on the waitlist, and if transplanted, survival at 30-days and 1-year post-transplant. A group of case-controlled patients matched for age, gender and era without mechanical circulatory support (MCS) prior to transplant was used as control. Patients with RV failure requiring assist devices compared to patients without MCS (control) had similar mortality on the waitlist. Post-transplant, these patients had comparable survival at 30 days and 1-year post-transplant compared to control patients. RV failure on the waitlist supported with mechanical support is not a significant risk for transplant candidacy (waitlist mortality) or post-transplant outcome. Larger studies are needed to confirm these findings.