Key result
Impella 5.5 support in adults awaiting heart transplantation resulted in an 87% transplant rate and 89.5% 1-year post-transplant survival, with low rates of device complications (<5%).
Why the study?
Following the 2018 UNOS allocation policy change, data regarding the newest generation Impella 5.5 as mechanical circulatory support for patients awaiting heart transplantation remained limited.
What are the waitlist and post-transplant outcomes of using Impella 5.5 as a bridge to heart transplantation in adults?
Observational (n=464)
Yes
What are the waitlist and post-transplant outcomes of using Impella 5.5 as a bridge to heart transplantation in adults?
Impella 5.5 provides a robust bridge to heart transplantation with high rates of successful transplantation and excellent 1-year post-transplant survival.
OBJECTIVES: The 2018 United Network for Organ Sharing allocation policy change has led to a significant increase in the use of mechanical circulatory support devices in patients listed for orthotopic heart transplantation. However, there has been a paucity of data regarding the newest generation Impella 5.5, which received FDA approval in 2019. METHODS: The United Network for Organ Sharing registry was queried for all adults awaiting orthotopic heart transplantation who received Impella 5.5 support during their listing period. Waitlist, device, and early post-transplant outcomes were assessed. RESULTS: A total of 464 patients received Impella 5.5 support during their listing period with a median waitlist time of 19 days. Among them, 402 (87%) patients were ultimately transplanted, with 378 (81%) being directly bridged to transplant with the device. Waitlist death (7%) and clinical deterioration (5%) were the most common reasons for waitlist removal. Device complications and failure were uncommon (<5%). The most common post-transplant complication was acute kidney injury requiring dialysis (16%). Survival at 1-year post-transplant survival was 89.5%. CONCLUSION: Since its approval, the Impella 5.5 has been increasingly used as a bridge to transplant. This analysis demonstrates robust waitlist and post-transplant outcomes with minimal device-related and postoperative complications.
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Cevasco et al. (2023) conducted an observational in Awaiting orthotopic heart transplantation (n=464). Impella 5.5 support was evaluated on Transplantation rate. Impella 5.5 support in adults awaiting heart transplantation resulted in an 87% transplant rate and 89.5% 1-year post-transplant survival, with low rates of device complications (<5%).
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