Early Outcomes Following Heart Transplantation in Recipients Bridged with a HeartMate 3 Device

Abstract Background Left ventricular assist devices (LVAD) are being increasingly used as bridge-to-transplantation (BTT) in eligible patients. The HeartMate 3 (HM3) is the latest device to obtain FDA-approval as BTT. This study examines early outcomes of transplant recipients following HM3 in comparison to recipients bridged with the HeartMate 2 (HM2) and HeartWare (HVAD) devices. Methods Utilizing the Organ Procurement and Transplantation Network database, we identified all adult patients who were BTT with a continuous-flow LVAD (HM2, HVAD, or HM3) between 1 April 2015 and 31 January 2018. The primary endpoint was all-cause mortality 6-months after transplantation. The independent influence of bridging device on outcomes was determined using Cox proportional hazard models. Results 1,978 patients were successfully bridged to transplantation with either a HM2 (n=881), HVAD (n=920), or HM3 device (n=177). Six-month mortality rates were similar across these devices (HM2=5.9%, HVAD=7.7%, HM3=4.7%, log-rank p=0.30). On average, HM2 patients were on an LVAD for 2 months longer (p Conclusions The HeartMate 3 device provides excellent early outcomes as a bridge to transplantation and may be associated with a reduction in comorbidities. Longer follow-up is needed to better define differences between durable left ventricular assist devices.