Our Summary

This study looked at patients who had heart transplants between 2008 and 2020 in Switzerland. Many of these patients had used a device called continuous-flow mechanical circulatory support (CF-MCS) before their transplant, due to long waiting times for a new heart. This device helps the heart pump blood, but its use can also lead to complications. The researchers wanted to see if those who used CF-MCS before their transplant had a different survival rate or more issues with their new heart compared to those who didn’t use the device. They found that despite the increased use of CF-MCS, the survival rate and issues after the transplant were similar for both groups. This suggests that using CF-MCS before a heart transplant does not negatively impact the outcome after the transplant, even though patients are using the device for longer periods.

FAQs

  1. What is the purpose of the continuous-flow mechanical circulatory support (CF-MCS) device used by patients awaiting heart transplants?
  2. Does the use of CF-MCS before a heart transplant impact the survival rate or lead to more issues with the new heart?
  3. What were the findings of the study on patients who had heart transplants between 2008 and 2020 in Switzerland?

Doctor’s Tip

One helpful tip a doctor might tell a patient about heart transplant is to closely follow their post-transplant medication regimen. This includes taking immunosuppressant medications as prescribed to prevent rejection of the new heart. It is important to attend all follow-up appointments with healthcare providers and report any concerning symptoms promptly. Additionally, adopting a healthy lifestyle with regular exercise, a balanced diet, and avoiding tobacco and excessive alcohol consumption can help support the success of the transplant.

Suitable For

Patients who are typically recommended for a heart transplant are those with end-stage heart failure who have not responded to other treatments such as medication, lifestyle changes, or other types of surgeries. These patients often have severe symptoms such as shortness of breath, fatigue, chest pain, and fluid retention, and have a significantly reduced quality of life. They may also have a poor prognosis without a transplant.

In addition, patients who have certain types of heart conditions such as dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, or certain congenital heart defects may also be recommended for a heart transplant. These conditions can lead to severe heart failure and may not be effectively treated with other interventions.

Patients who have experienced a heart attack or have severe coronary artery disease that cannot be treated with other procedures such as angioplasty or bypass surgery may also be candidates for a heart transplant. These patients may have significant damage to their heart muscle and may not be able to function normally without a transplant.

Overall, patients who are recommended for a heart transplant are those who have severe heart failure that is not responding to other treatments, have a poor prognosis without a transplant, and are otherwise healthy enough to undergo the surgical procedure and post-transplant care.

Timeline

Before heart transplant:

  1. Patient is diagnosed with end-stage heart failure and is evaluated by a transplant team.
  2. Patient is placed on the waiting list for a new heart.
  3. Patient may undergo testing and preparation for surgery.
  4. Patient may be placed on continuous-flow mechanical circulatory support (CF-MCS) to help the heart pump blood while waiting for a new heart.

After heart transplant:

  1. Patient undergoes heart transplant surgery.
  2. Patient is monitored closely in the intensive care unit (ICU) for any complications.
  3. Patient begins recovery and rehabilitation process.
  4. Patient may experience side effects from immunosuppressant medications to prevent rejection of the new heart.
  5. Patient undergoes regular follow-up appointments and monitoring to ensure the new heart is functioning properly.
  6. Patient may need to make lifestyle changes and adhere to a strict medication regimen for the rest of their life to maintain the health of the new heart.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with using CF-MCS before a heart transplant?

  2. How long will I need to use CF-MCS before I can receive a heart transplant?

  3. How will using CF-MCS affect my recovery after the heart transplant surgery?

  4. Will using CF-MCS increase my chances of rejection or other complications after the heart transplant?

  5. How often will I need to be monitored while using CF-MCS and after the heart transplant surgery?

  6. Are there any alternative treatments or devices available that could be used instead of CF-MCS?

  7. What is the success rate of heart transplants in patients who have used CF-MCS compared to those who have not?

  8. How will using CF-MCS impact my quality of life before and after the heart transplant?

  9. What level of physical activity will I be able to engage in while using CF-MCS and after the heart transplant?

  10. Are there any long-term effects or considerations I should be aware of if I choose to use CF-MCS before my heart transplant?

Reference

Authors: Hullin R, Abdurashidova T, Pitta-Gros B, Schukraft S, Rancati V, Lu H, Zurbuchen A, Marcucci C, Ltaief Z, Lefol K, Huber C, Pascual M, Tozzi P, Meyer P, Kirsch M. Journal: Swiss Med Wkly. 2023 Dec 4;153:3500. doi: 10.57187/s.3500. PMID: 38579299