Ventricular assist devices as bridge to heart transplantation: impact on post-transplant infections.

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Serval ID
serval:BIB_F0F12B5AC40F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ventricular assist devices as bridge to heart transplantation: impact on post-transplant infections.
Journal
Bmc Infectious Diseases
Author(s)
Héquet D., Kralidis G., Carrel T., Cusini A., Garzoni C., Hullin R., Meylan P.R., Mohacsi P., Mueller N.J., Ruschitzka F., Tozzi P., van Delden C., Weisser M., Wilhelm M.J., Pascual M., Manuel O.
Working group(s)
Swiss Transplant Cohort Study (STCS)
Contributor(s)
Achermann R., Amico P., Aubert JD., Baumann P., Beldi G., Benden C., Berger C., Binet I., Bochud PY., Boely E., Bucher H., Bühler L., Carell T., Catana E., Chalandon Y., de Geest S., de Rougemont O., Dickenmann M., Duchosal M., Elkrief L., Fehr T., Ferrari-Lacraz S., Garzoni C., Soccal P., Gaudet C., Giostra E., Golshayan D., Hadaya K., Halter J., Heim D., Hess C., Hillinger S., Hirsch H., Hofbauer G., Huynh-Do U., Immer F., Klaghofer R., Koller M., Laesser B., Lehmann R., Lovis C., Manuel O., Marti HP., Martin P., Martinolli L., Meylan P., Mohacsi P., Morel P., Mueller U., Mueller N., Mueller-McKenna H., Müller A., Müller T., Müllhaupt B., Nadal D., Pascual M., Passweg J., Ziegler C., Rick J., Roosnek E., Rosselet A., Rothlin S., Ruschitzka F., Schanz U., Schaub S., Schnyder A., Seiler C., Stampf S., Steiger J., Stirnimann G., Toso C., Van Delden C., Venetz JP., Villard J., Wick M., Wilhelm M., Yerly P.
ISSN
1471-2334 (Electronic)
ISSN-L
1471-2334
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
16
Pages
321
Language
english
Abstract
BACKGROUND: Ventricular assist devices (VAD) are valuable options for patients with heart failure awaiting cardiac transplantation. We assessed the impact of pre-transplant VAD implantation on the incidence of post-transplant infections in a nationwide cohort of heart transplant recipients.
METHODS: Heart transplant recipients included in the Swiss Transplant Cohort Study between May 2008 and December 2012 were analyzed. Cumulative incidence curves were used to calculate the incidence of bacterial or Candida infections (primary endpoint) and of other infections (secondary endpoint) after transplant. Cox regression models treating death as a competing risk were used to identify risk factors for the development of infection after transplant.
RESULTS: Overall, 119 patients were included in the study, 35 with a VAD and 84 without VAD. Cumulative incidences of post-transplant bacterial or Candida infections were 37.7 % in VAD patients and 40.4 % in non-VAD patients. In multivariate analysis, the use of cotrimoxazole prophylaxis was the only variable associated with bacterial/Candida infections after transplant (HR 0.29 [95 % CI 0.15-0.57], p < 0.001), but presence of a VAD was not (HR 0.94, [95 % CI 0.38-2.32], p = 0.89, for continuous-flow devices, and HR 0.45 [0.15 - 1.34], p = 0.15, for other devices). Risk for post-transplant viral and all fungal infections was not increased in patients with VAD. One-year survival was 82.9 % (29/35) in the VAD group and 82.1 % (69/84) in the non-VAD group. All 6 patients in the VAD group that died after transplant had a history of pre-transplant VAD infection.
CONCLUSION: In this nationwide cohort of heart transplant recipients, the presence of VAD at the time of transplant had no influence on the development of post-transplant infections.
Pubmed
Open Access
Yes
Create date
19/07/2016 18:50
Last modification date
20/08/2019 17:18
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