One-Year Clinical Outcome in End-Stage Heart Failure: Comparison of "High Urgent" Listing for Heart Transplantation with Mechanical Circulatory Support Implantation.

Background  Heart transplantation (HTx) is still considered the therapeutic gold standard in end-stage heart failure. Methods  In “high urgent” (HU)-listed patients for HTx ( n  = 274) and patients receiving left ventricular assist device (LVAD) implants ( n  = 332), we compared 1-year overall survival (primary endpoint) and 1-year probability of HTx and therapy failure (the need for LVAD implantation in HU-listed patients or the need for HU listing in LVAD patients) (secondary endpoints). Results  In the HU and LVAD group, 1-year survival was 86.8 and 64.7%, respectively ( p p  = 0.198). The PS-adjusted hazard ratio for the failure to receive HTx for the LVAD group (reference = HU group) was = 9.77 (95% CI: 6.00–15.89; p p Conclusion  Despite considerable differences in the probability of HTx and therapy failure, 1-year overall survival was similar in HU and LVAD patients.