Abstract：
OBJECTIVE: We aimed to describe the clinical outcomes of the use of the CentriMag acute circulatory support system as a bridge to emergency heart transplantation (HTx).
METHODS: We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival.
RESULTS: The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for> 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke.
CONCLUSIONS: In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes.
METHODS: We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival.
RESULTS: The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for> 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke.
CONCLUSIONS: In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes.
摘要：
目的：我们旨在描述使用CentriMag急性循环支持系统作为紧急心脏移植（HTx）桥梁的临床结果。
方法：我们对接受CentriMag设备治疗的多中心回顾性注册中纳入的连续HTx候选患者的临床结果进行了描述性分析。配置为左心室支持（LVS）或双心室支持（BVS）。所有患者均被列为高优先级HTx。该研究评估了2010年至2020年期间，涉及西班牙各地的16个移植中心。我们排除了接受孤立的右心室支持或无LVS的静脉动脉体外膜氧合治疗的患者。主要终点是HTx后1年生存。
结果：研究人群包括在CentriMagLVS上桥接的213名紧急HTx候选人和在CentriMagBVS上桥接的145名紧急HTx候选人。总的来说,303例（84.6％）患者接受了移植，其中53例（14.8％）在住院期间没有器官捐献者死亡。设备的中位时间是15天,66例（18.6%）患者的支持时间>30天。移植后一年生存率为77.6%。单变量和多变量分析显示，使用BVS与LVS治疗的患者在HTx前或后生存率上没有统计学上的显着差异。用BVS管理的患者有更高的出血率，需要输血，溶血和肾功能衰竭比LVS管理的患者，而后者显示缺血性卒中的发生率较高。
结论：在等待列表时间短的候选优先级设置中，使用CentriMag系统桥接HTx是可行的,可获得可接受的支持和移植后结局.
方法：我们对接受CentriMag设备治疗的多中心回顾性注册中纳入的连续HTx候选患者的临床结果进行了描述性分析。配置为左心室支持（LVS）或双心室支持（BVS）。所有患者均被列为高优先级HTx。该研究评估了2010年至2020年期间，涉及西班牙各地的16个移植中心。我们排除了接受孤立的右心室支持或无LVS的静脉动脉体外膜氧合治疗的患者。主要终点是HTx后1年生存。
结果：研究人群包括在CentriMagLVS上桥接的213名紧急HTx候选人和在CentriMagBVS上桥接的145名紧急HTx候选人。总的来说,303例（84.6％）患者接受了移植，其中53例（14.8％）在住院期间没有器官捐献者死亡。设备的中位时间是15天,66例（18.6%）患者的支持时间>30天。移植后一年生存率为77.6%。单变量和多变量分析显示，使用BVS与LVS治疗的患者在HTx前或后生存率上没有统计学上的显着差异。用BVS管理的患者有更高的出血率，需要输血，溶血和肾功能衰竭比LVS管理的患者，而后者显示缺血性卒中的发生率较高。
结论：在等待列表时间短的候选优先级设置中，使用CentriMag系统桥接HTx是可行的,可获得可接受的支持和移植后结局.
