Impact of Prolonged Impella 5.5 Support on Post‐Transplant Outcomes: An Institutional Study

OBJECTIVES: Microaxial flow pump devices are utilized as a bridge to heart transplantation for patients in advanced cardiogenic shock. Little is known about the impact of device duration on post-transplant outcomes. This study aims to compare post-transplantation outcomes based on duration of support with the Impella 5.5. METHODS: All patients who were successfully bridged to transplant on the Impella 5.5 platform were included and stratified based on support duration (≤ 14 days vs. > 14 days). Baseline clinical characteristics were collected throughout the index admission. Outcomes included 1-year mortality, complications during the index admission, graft rejection, and rehospitalization within the first year. RESULTS: Of the 72 patients successfully bridged to transplant, 64% (n = 46) were supported for more than 14 days. When stratified by duration of Impella 5.5 use, there were no differences in pretransplantation clinical status. Length of stay (26 vs. 20 days, p = 0.316) and rates of home discharges (65% vs. 67%, p = 0.524) were similar. Despite a high prevalence of rehospitalization at 1 year (75%), the 1-year survival was 96% and similar between the two cohorts (p = 0.289). CONCLUSIONS: Use of a prolonged microaxial flow pump may be a safe bridging strategy for heart transplantation given comparable post-transplant outcomes for patients stratified by support duration.