Clinical Outcomes of Heart Transplant Recipients in Non-transplant Institution

Background: The numbers of heart transplant recipients are growing in japan. It is important to manage advanced heart failure patients not only in transplant institutions but also in non-transplant institutions. We evaluated clinical outcomes of heart transplant recipients in our institution. Method: We retrospectively reviewed 25 potential heart transplant candidates in our institution from 2005 to 2017. Result: Underlying disease of the patients were dilated cardiomyopathy (n = 10, 56%), fulminant myocarditis (n = 4, 22%), and the others (ischemic cardiomyopathy, secondary cardiomyopathy and valvular heart disease). 18 patients (72%) were INTERMACS Profile 1 at the first visit. 24 (96%) patients were judged as eligible for candidates, but 2 patients died before the registration of the waiting list. 21 (84%) patients required paracorporeal left ventricular assist device (LVAD), and 9 of them switched to the implantable LVAD after registration. Only 3 patients directory implanted implantable LVAD. As of the end of May 2017, 5 patients underwent heart transplantation (mean support duration 997 ± 82 days), 5 patients died (402 ± 260 days), 15 patients were waiting for heart transplantation (672 ± 260 days). Conclusion: 80% of patients considered as candidates for heart transplantation have been surviving in our institution. Even in the critical characteristics of the patients, appropriate management of LVAD can contribute to improve prognosis of patients who are waiting for heart transplantation.