Mechanical circulatory support is an alternative strategy as a bridge to transplantation for critical situations such as circulatory shock or graft shortage. The purpose of this study was to evaluate long-term results and outcome after heart transplantation performed in patients with ventricular assistance device (VAD) versus no mechanical circulatory support.

All the patients who underwent heart transplantation between 2005 and 2012 were included in this monocentric retrospective study. We compared 52 VAD patients who underwent heart transplantation to 289 patients transplanted without VAD.

Mean age was 46±11 years in the VAD group vs 51±13 years in the standard group (p=0.01) and 17% of the VAD patients were women vs 25% (p=0.21). Ischemic time was longer in the VAD group (207±54 vs 169±60 min, p<0.01). There was no difference of primary graft failure (33% vs 25%, p=0.22) and 1-year mortality (17% vs 28%, p=0.12). Independent risk factors for 1-year mortality were preoperative VAD (OR 0.40 [0.17-0.97], p=0.04), recipient age>60 years (OR 0.2.35 [1.34-4.14], p<0.01), recipient creatinine (OR 1.005 [1.001-1.010], p=0.02), BSA mismatch (OR 4.85 [1.34-17.54], p=0.02) and ischemic time (OR 1.005 [1.001-1.010], p=0.02). Five-year survival was 66% in VAD group vs 60% in standard group (p=0.72). Independent risk factors for 5-years survival recipient age>60 years (HR 1.570 [1.05-2.34], p=0.02), recipient creatinin (HR 1.005 [1.002-1.008], p=0.02), and ischemic time (HR 1.004 [1.001-1.007], p=0.01).

Bridge to transplantation by ventricular assistance device reduced one-year mortality and improved mid-term survival rate after heart transplantation.