Korean J Transplant.  2022 Nov;36(Supple 1):S142. 10.4285/ATW2022.F-2615.

Risk analysis of waiting list mortality for heart transplantation: multicenter study in Korea

• Kim JH
• Cho YH
• Hwang HY
• Jung SH
• Youn YN

• KMID: 2535658
• DOI: http://doi.org/10.4285/ATW2022.F-2615

Abstract

Background
There were little national studies about the waiting list mortality of heart transplantation (HT) in Korea. We per-formed a multicenter study investigated the waiting list mortality for HT and its risk factors.
Methods
A retrospective analysis of 1,101 consecutive patients who were list for HT between 2012 and 2017 in the four high-volume Korean centers was performed. Time on the waiting list was defined as time from initial listing for HT to the time of delisting from the waiting list due to heart transplant, death, or recovery. Subjects were censored at the time of transplantation or recovery.
Results
In whole cohort, 327 (29.7%) patients needed mechanical circulatory support (MCS) during waiting list; 314 were treated with extracorporeal membrane oxygenation (ECMO) bridge, 13 were treated with ventricular assist device (VAD) bridge. Overall survival rate in patients who underwent ECMO bridge was significantly lower than patients who underwent VAD bridge or did not underwent MCS bridge. Overall survival rate in patients with initial status 0 and 1 was significantly lower than patients with initial status 2 or 3. In the last follow-up urgent grade, survival rate in patients with status 0 showed significantly lower than status 1, 2, or 3. In multivariate analysis, independent risk factors for waiting list mortality were congenital heart disease and restrictive car-diomyopathy compared with dilated cardiomyopathy; status 0 compared with status 2 and 3; low hemoglobin; history of ventricu-lar arrhythmia; high model for end-stage liver disease score; and ECMO bridge during waiting period.
Conclusions
This study showed ECMO as bridge to transplantation and status 0 showed significantly high waiting list mortality. And advanced end-organ damage at the time of listing and ventricular arrhythmia were found to be independent risk factors for waiting list mortality.