Feasibility of Outpatient Hemodialysis for Patients with Total Artificial Heart: A Case Series

Radha Gopalan; Hayley Mitchel; Sarah Matushinec; Rabia Kerr; Amanda Bolton; Amy Kamin; Lucinda Sutphen; Francisco Arabia

doi:10.1097/MAT.0000000000001850

Feasibility of Outpatient Hemodialysis for Patients with Total Artificial Heart: A Case Series

Radha Gopalan, Hayley Mitchel, Sarah Matushinec, Rabia Kerr, Amanda Bolton, Amy Kamin, Lucinda Sutphen, Francisco Arabia

Research output: Contribution to journal › Article › peer-review

Abstract

Total artificial hearts (TAH) are used in patients with end-stage heart failure as a bridge-to-transplant. AKI is a common postoperative complication associated with TAH implant. Patients requiring temporary dialysis are denied implantation of TAH due to the inability to provide outpatient (OP) dialysis in the long term. Here we discuss four cases of TAH patients from a single center who were successfully maintained on OP hemodialysis (HD). All four patients were implanted with a 70cc Syncardia^TMTAH for NICM. Two patients were implanted as bridge-to-transplant (BTT); one received a heart/kidney transplant and the other received a heart transplant. Two patients were implanted as destination therapy; one was maintained on OP HD until end-of-life, and the other received a heart transplant after becoming transplant eligible. These cases confirm that OP HD is a feasible option for TAH patients with post-implant chronic renal dysfunction provided that the dialysis centers are trained and supported by the implanting program.

Original language	English
Pages (from-to)	E270-E273
Journal	ASAIO Journal
Volume	69
Issue number	6
DOIs	https://doi.org/10.1097/MAT.0000000000001850
State	Published - 1 Jun 2023
Externally published	Yes

Keywords

cardiomyopathy
cardiorenal syndrome
chronic kidney disease
heart failure
heart transplant
hemodialysis
mechanical circulatory support
renal failure
total artificial heart

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10.1097/MAT.0000000000001850

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title = "Feasibility of Outpatient Hemodialysis for Patients with Total Artificial Heart: A Case Series",

abstract = "Total artificial hearts (TAH) are used in patients with end-stage heart failure as a bridge-to-transplant. AKI is a common postoperative complication associated with TAH implant. Patients requiring temporary dialysis are denied implantation of TAH due to the inability to provide outpatient (OP) dialysis in the long term. Here we discuss four cases of TAH patients from a single center who were successfully maintained on OP hemodialysis (HD). All four patients were implanted with a 70cc SyncardiaTMTAH for NICM. Two patients were implanted as bridge-to-transplant (BTT); one received a heart/kidney transplant and the other received a heart transplant. Two patients were implanted as destination therapy; one was maintained on OP HD until end-of-life, and the other received a heart transplant after becoming transplant eligible. These cases confirm that OP HD is a feasible option for TAH patients with post-implant chronic renal dysfunction provided that the dialysis centers are trained and supported by the implanting program.",

keywords = "cardiomyopathy, cardiorenal syndrome, chronic kidney disease, heart failure, heart transplant, hemodialysis, mechanical circulatory support, renal failure, total artificial heart",

author = "Radha Gopalan and Hayley Mitchel and Sarah Matushinec and Rabia Kerr and Amanda Bolton and Amy Kamin and Lucinda Sutphen and Francisco Arabia",

year = "2023",

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doi = "10.1097/MAT.0000000000001850",

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T1 - Feasibility of Outpatient Hemodialysis for Patients with Total Artificial Heart

T2 - A Case Series

AU - Gopalan, Radha

AU - Mitchel, Hayley

AU - Matushinec, Sarah

AU - Kerr, Rabia

AU - Bolton, Amanda

AU - Kamin, Amy

AU - Sutphen, Lucinda

AU - Arabia, Francisco

PY - 2023/6/1

Y1 - 2023/6/1

N2 - Total artificial hearts (TAH) are used in patients with end-stage heart failure as a bridge-to-transplant. AKI is a common postoperative complication associated with TAH implant. Patients requiring temporary dialysis are denied implantation of TAH due to the inability to provide outpatient (OP) dialysis in the long term. Here we discuss four cases of TAH patients from a single center who were successfully maintained on OP hemodialysis (HD). All four patients were implanted with a 70cc SyncardiaTMTAH for NICM. Two patients were implanted as bridge-to-transplant (BTT); one received a heart/kidney transplant and the other received a heart transplant. Two patients were implanted as destination therapy; one was maintained on OP HD until end-of-life, and the other received a heart transplant after becoming transplant eligible. These cases confirm that OP HD is a feasible option for TAH patients with post-implant chronic renal dysfunction provided that the dialysis centers are trained and supported by the implanting program.

AB - Total artificial hearts (TAH) are used in patients with end-stage heart failure as a bridge-to-transplant. AKI is a common postoperative complication associated with TAH implant. Patients requiring temporary dialysis are denied implantation of TAH due to the inability to provide outpatient (OP) dialysis in the long term. Here we discuss four cases of TAH patients from a single center who were successfully maintained on OP hemodialysis (HD). All four patients were implanted with a 70cc SyncardiaTMTAH for NICM. Two patients were implanted as bridge-to-transplant (BTT); one received a heart/kidney transplant and the other received a heart transplant. Two patients were implanted as destination therapy; one was maintained on OP HD until end-of-life, and the other received a heart transplant after becoming transplant eligible. These cases confirm that OP HD is a feasible option for TAH patients with post-implant chronic renal dysfunction provided that the dialysis centers are trained and supported by the implanting program.

KW - cardiomyopathy

KW - cardiorenal syndrome

KW - chronic kidney disease

KW - heart failure

KW - heart transplant

KW - hemodialysis

KW - mechanical circulatory support

KW - renal failure

KW - total artificial heart

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AN - SCOPUS:85160970004

SN - 1058-2916

VL - 69

SP - E270-E273

JO - ASAIO Journal

JF - ASAIO Journal

IS - 6

ER -

Feasibility of Outpatient Hemodialysis for Patients with Total Artificial Heart: A Case Series

Abstract

Keywords

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