PMID- 25345547
OWN - NLM
STAT- MEDLINE
DCOM- 20160106
LR  - 20220408
IS  - 1525-1594 (Electronic)
IS  - 0160-564X (Linking)
VI  - 39
IP  - 4
DP  - 2015 Apr
TI  - Continuous-flow left ventricular assist device therapy in patients with 
      preoperative hepatic failure: are we pushing the limits too far?
PG  - 336-42
LID - 10.1111/aor.12375 [doi]
AB  - The purpose of this study was to evaluate the effects and outcome of 
      continuous-flow left ventricular assist device (cf-LVAD) therapy in patients with 
      preoperative acute hepatic failure. The study design was a retrospective review 
      of prospectively collected data. Included were 42 patients who underwent cf-LVAD 
      implantation (64.3% HeartMate II, 35.7% HeartWare) between July 2007 and May 2013 
      with preoperative hepatic failure defined as elevation of greater than or equal 
      to two liver function parameters above twice the upper normal range. Mean patient 
      age was 35 +/- 12.5 years, comprising 23.8% females. Dilated cardiomyopathy was 
      present in 92.9% of patients (left ventricular ejection fraction 17.3 +/- 5.9%). 
      Mean support duration was 511 +/- 512 days (range: 2-1996 days). Mean preoperative 
      laboratory parameters for blood urea nitrogen, serum creatinine, total bilirubin, 
      and alanine aminotransferase were 9.5 +/- 5.4 mg/dL, 110.3 +/- 42.8 mumol/L, 51.7 +/- 
      38.3 mmol/L, and 242.1 +/- 268.6 U/L, respectively. All parameters decreased 
      significantly 1 month postoperatively. The mean preoperative modified Model for 
      Endstage Liver Disease excluding international normalized ratio score was 16.03 +/- 
      5.57, which improved significantly after cf-LVAD implantation to 10.62 +/- 5.66 (P 
      < 0.001) at 7 days and 5.83 +/- 4.98 (P < 0.001) at 30 days postoperatively. 
      One-year and 5-year survival was 75.9 and 48.1%, respectively. 21.4% of the 
      patients underwent LVAD explantation for myocardial recovery, 16.7% were 
      successfully transplanted, and 7.1% underwent LVAD exchange for device failure 
      over the follow-up period. Patients with preexisting acute hepatic failure are 
      reasonable candidates for cf-LVAD implantation, with excellent rates of recovery 
      and survival, suggesting that cf-LVAD therapy should not be denied to patients 
      merely on grounds of "preoperative elevated liver enzymes/hepatopathy."
CI  - Copyright (c) 2014 International Center for Artificial Organs and Transplantation 
      and Wiley Periodicals, Inc.
FAU - Weymann, Alexander
AU  - Weymann A
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton and Harefield NHS Foundation Trust, London, UK; Department of 
      Cardiac Surgery, Heart Center, University of Heidelberg, Heidelberg, Germany.
FAU - Patil, Nikhil P
AU  - Patil NP
FAU - Sabashnikov, Anton
AU  - Sabashnikov A
FAU - Mohite, Phrashant N
AU  - Mohite PN
FAU - Garcia Saez, Diana
AU  - Garcia Saez D
FAU - Bireta, Christian
AU  - Bireta C
FAU - Wahlers, Thorsten
AU  - Wahlers T
FAU - Karck, Matthias
AU  - Karck M
FAU - Kallenbach, Klaus
AU  - Kallenbach K
FAU - Ruhparwar, Arjang
AU  - Ruhparwar A
FAU - Fatullayev, Javid
AU  - Fatullayev J
FAU - Amrani, Mohamed
AU  - Amrani M
FAU - De Robertis, Fabio
AU  - De Robertis F
FAU - Bahrami, Toufan
AU  - Bahrami T
FAU - Popov, Aron-Frederik
AU  - Popov AF
FAU - Simon, Andre R
AU  - Simon AR
LA  - eng
PT  - Journal Article
DEP - 20141027
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
SB  - IM
MH  - Adult
MH  - Device Removal
MH  - Female
MH  - Heart Failure/complications/diagnosis/mortality/physiopathology/*therapy
MH  - Heart Transplantation
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Failure, Acute/*complications/diagnosis/mortality/physiopathology
MH  - Liver Function Tests
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - Predictive Value of Tests
MH  - Prosthesis Design
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, 
      Left/complications/diagnosis/mortality/physiopathology/*therapy
MH  - *Ventricular Function, Left
MH  - Young Adult
OTO - NOTNLM
OT  - Bridge-to-recovery
OT  - Bridge-to-transplantation
OT  - Continuous-flow left ventricular assist device
OT  - End-organ dysfunction
OT  - Hepatic failure
EDAT- 2014/10/28 06:00
MHDA- 2016/01/07 06:00
CRDT- 2014/10/28 06:00
PHST- 2014/10/28 06:00 [entrez]
PHST- 2014/10/28 06:00 [pubmed]
PHST- 2016/01/07 06:00 [medline]
AID - 10.1111/aor.12375 [doi]
PST - ppublish
SO  - Artif Organs. 2015 Apr;39(4):336-42. doi: 10.1111/aor.12375. Epub 2014 Oct 27.