23 March 2011
Left ventricular assist device as ‘bridge to weight loss’ prior to transplantation in obese patients with advanced heart failure
Pavittarpaul DhesiABCDEF, Sinan A. SimsirAE, Daniel DaneshvarBC, Asim RafiqueBC, Anita PhanADEF, Ernst R. SchwarzADEFAnn Transplant 2011; 16(1): 5-13 :: ID: 881632
Abstract
Background: Obesity is a risk factor for heart failure (HF) and associated with poor outcomes after cardiac transplantation.
We assessed change in total body weight, morbidity and mortality in obese heart failure patients after implantation of a left ventricular assist device (LVAD) compared to medical management.
Material/Methods: Nineteen patients (9 females, age 51.3±10 years) with a body mass index (BMI) ≥30.0 kg/m2 and advanced HF (NYHA class III–IV, stage D) were evaluated. Thirteen (group 1) received insertion of a LVAD as bridge to transplantation. The remaining patients (group 2) were medically managed. All were advised on lifestyle modification.
Results: At baseline, group 1 (49.1±10.7 years) had a total body weight (BW) of 246.6±34.9 pounds (mean ±SD) and a BMI of 36.1±4 kg/m2. Group 2 (56±6.7 yrs) had a BW of 238.8±73.6 pounds and a BMI of 39.1±9.3 kg/m2 (n.s. compared to group 1). All patients were alive at 12 months. At 6 months, BW in group 1 was reduced to 216.3±20.8 pounds, and BMI to 31.8±3.3 kg/m2 (p<0.05). At 6 months, BW in group 2 was 238.2±84.6 pounds, and BMI was 39.1±11.6 kg/m2 (n.s. vs. baseline, p<0.05 compared to group 1). The decrease in BW in group 1 was 12.3±12% (30.3±28.5 pounds). There was no change in BW in group 2 (0.3±8.7%, 0.6±21 pounds, p<0.05 vs. group 1). At 12 months, 7 patients in group 1 (54%) underwent cardiac transplantation.
Conclusions: LVAD insertion resulted in weight loss in obese patients not considered for heart transplantation compared to medically managed patients.
Keywords: left ventricular assist device, obesity, Weight Loss, cardiac transplantation
In Press
08 Mar 2024 : Original article
Association of Coronary Calcium Score on Cardiac PET During Pre-Kidney Transplant Assessment with Persisten...Ann Transplant In Press; DOI: 10.12659/AOT.943532
14 Mar 2024 : Original article
Impact of Blood Products Transfusion on Patients in the Immediate Post-Lung Transplant Period: A Cohort StudyAnn Transplant In Press; DOI: 10.12659/AOT.943652
14 Mar 2024 : Case report
Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...Ann Transplant In Press; DOI: 10.12659/AOT.942358
15 Mar 2024 : Review article
Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...Ann Transplant In Press; DOI: 10.12659/AOT.941185
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860