Evidence map›Paper›PMID 34969492›Full record

ArticleJACC. Heart failure2022

Impact of Temporary Percutaneous Mechanical Circulatory Support Before Transplantation in the 2018 Heart Allocation System.

Kevin J Clerkin, Oluwafeyijimi Salako, Justin A Fried, Jan M Griffin, Jayant Raikhelkar, Rashmi Jain, Susan Restaino, Paolo C Colombo, Koji Takeda, Maryjane A Farr and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
6.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 37 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Kidney health and function with left ventricular assist devices.Current opinion in nephrology and hypertension · 2023
    Review
  6. Review
  7. Article
  8. Review
  9. UNOS policy change benefits high-priority patients without harming those at low priority.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Kevin J ClerkinMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Oluwafeyijimi SalakoMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Justin A FriedMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Jan M GriffinMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Jayant RaikhelkarMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Rashmi JainMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Susan RestainoMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Paolo C ColomboMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Koji TakedaDivision of Cardiac Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Maryjane A FarrMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Gabriel SayerMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Nir UrielMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
Veli K TopkaraMilstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA. Electronic address: vt2113@cumc.columbia.edu.
Columbia University · US

Funding

Identifying Novel Diagnostics and Mechanisms for Cardiac Allograft VasculopathyK23HL148528 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CLERKIN, KEVIN J · 2020 to 2024
$852k
NHLBI NIH HHS K23 HL148528
6 · The paper itself

Abstract

objectivesThis analysis sought to investigate the waitlist and post-transplant outcomes of individuals bridged to transplantation by using temporary percutaneous endovascular mechanical circulatory support (tMCS) through a status 2 designation (cardiogenic shock and exception).

backgroundThe 2018 donor heart allocation policy change granted a status 2 designation to patients supported with tMCS.

methodsAdult patients in the United Network for Organ Sharing registry after October 18, 2018 who received a status 2 designation for tMCS were included and grouped by their status 2 criteria: cardiogenic shock with hemodynamic criteria (CS-HD), cardiogenic shock without hemodynamic criteria before tMCS (CS-woHD), and exception. Baseline characteristics, waitlist events (death and delisting), and post-transplant outcomes were compared.

resultsA total of 2,279 patients met inclusion criteria: 68.6% (n = 1,564) with CS-HD, 3.2% (n = 73) with CS-woHD, and 28.2% (n = 642) with exceptions. A total of 64.2% of patients underwent heart transplantation within 14 days of status 2 listing or upgrade, and 1.9% died or were delisted for worsening clinical condition. Among the 35.8% who did not undergo transplantation following 14 days, only 2.8% went on to receive a left ventricular assist device (LVAD). The 30-day transplantation likelihood was similar among groups: 80.1% for the CS-HD group vs 79.7% for the exception group vs 73.3% for the CS-woHD group; P = 0.31. However, patients who met criteria for CS-woHD had 2.3-fold greater risk of death or delisting (95% CI: 1.10-4.75; P = 0.03) compared with CS-HD patients after multivariable adjustment. Pre-tMCS hemodynamics were not associated with adverse waitlist events.

conclusionsThe use of tMCS is an efficient, safe, and effective strategy as a bridge to transplantation; however, patients with CS-woHD may represent a high-risk cohort. Transition to a durable LVAD was a rare event in this group.

Indexed as

Extracorporeal Membrane OxygenationHeart-Assist DevicesHeart FailureHeart TransplantationAdultHumansIntra-Aortic Balloon PumpingRetrospective StudiesShock, CardiogenicTissue Donors2018 allocation policyheart transplantmechanical circulatory supportoutcomesUNOS

Identifiers

PMID34969492
PMCPMC8724562
OpenAlexW3213734392

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.