Incidence and impact of on-cardiopulmonary bypass vasoplegia during heart transplantation

Lauren K. Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C. Colombo, Veli K. Topkara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm5 despite a high pressor requirement (>1,500 μg neosynephrine bolused). The primary outcome of interest was 30 day post-transplant survival. There were 138 patients included in the current study. A total of 16% (n = 22) patients were identified as having developed on-cardiopulmonary bypass vasoplegia. Vasoplegic patients had a significantly higher body mass index (BMI) (30.1 ± 5.0 vs. 26.5 ± 4.7; p = 0.005) and were more likely to be male (95.5% vs. 66.4%; p = 0.004). Use of continuous-flow left ventricular assist device (CF-LVAD) as bridge-to-transplant (BTT) was prevalent among vasoplegic patients (81.8% vs. 57.8%; p = 0.033). These patients had significantly decreased survival at 30 and 60 days (86.4% vs. 99.1% at 30 days; 77.3% vs. 92.8% at 60 days). Bridge-to-transplant with CF-LVAD was an independent predictor of on-cardiopulmonary bypass (CPB) vasoplegia. On-CPB vasoplegia complicated 16% of HTs in the current study and was associated with increased mortality. Bridge-to-transplant with CF-LVAD was an independent predictor of this phenomenon.

Original languageEnglish (US)
Pages (from-to)43-51
Number of pages9
JournalASAIO Journal
Volume64
Issue number1
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • Heart transplant
  • Left ventricular assist device
  • Vasoplegia

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Fingerprint

Dive into the research topics of 'Incidence and impact of on-cardiopulmonary bypass vasoplegia during heart transplantation'. Together they form a unique fingerprint.

Cite this