Korean J Transplant.  2023 Nov;37(Suppl 1):S54. 10.4285/ATW2023.F-6203.

Two-year real-word outcomes in HeartMate 3 versus heart transplant patients in Taiwan

• Tsao CI
• Yung YW
• Wang CH
• Chi NH
• Yu HY
• Huang SC
• Chen YS

• KMID: 2551641
• DOI: http://doi.org/10.4285/ATW2023.F-6203

Abstract

Background
The durable left ventricular assist device (LVAD) and heart transplantation (HTx) are the most advanced surgical treatment modalities for end-stage of heart failure (HF), that can improve survival and quality of life. Many trials have demonstrated the durable HeartMate 3 (HM3) LVAD is associated with similar 2-year survival at 2 years as compared with HTx. The purpose of our study is to compare real-world outcomes between HM3 and HTx in Taiwan.
Methods
We retrospectively adult patients (aged from 18 to 70 years old) who received HM3 or HT between October 2019 and April 2023 in this study. To minimize crossover bias, HTx patients bridged with Heartware, Heartmate 2, and Heartmate 3 LVAD were excluded. Two years of survival on HM3 was benchmarked against HTx over the same period.
Results
Our study consisted of 41 (39.8%) HM3 patients and 62 (60.2%) HTx. The median follow-up was 22.9±18.8 months. For the primary HM3 implant group, 31.7% (13/41) is in Intermacs Profile 1 and 39.0% (16/41) in Intermacs Profile 2. 64.5% (40/62) of HTx recipients were bridged using a extracorporeal ventricular assist device, 3.2% (2/62) using an extracorporeal membrane oxygenation, and 6.5% (4/62) using an intra-aortic balloon pump. Overall survival at 2 years was 79.1%. There was no statistical difference in 2-year survival (HM3 71.3% vs. HTx 83.3%, P=0.171).
Conclusions
Our data suggest that HM3 provided comparable 2-year survival to HTx as a primary treatment for end-stage HF. However, HM3 patients had a lower likelihood of reaching transplantation, which may be a reflection of the implant Intermacs status.