The interaction of age and time on durable left ventricular assist device and its effect on heart transplant outcomes.
- 1Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC.
- 2Department of Medicine, Medical University of South Carolina, Charleston, SC.
- 3Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC.
Abstract
Objective
This study aims to assess the interaction between age and left ventricular assist device duration on heart transplant outcomes in the modern era.Methods
All heart transplantation in adults with a fully magnetically levitated centrifugal flow left ventricular assist device between October 2018 and June 2025 were identified from the United Network for Organ Sharing database. Groups were stratified primarily by age less than 55 years and 55 years or more and secondarily by age less than 2 years and 2 years or more of left ventricular assist device support. The primary outcome was post-heart transplant survival.Results
A total of 1005 patients were aged less than 55 years, with 608 having a left ventricular assist device for less than 2 years and 397 having a left ventricular assist device for 2 years or more. There was no significant difference in post-heart transplant survival between left ventricular assist device duration groups at 90 days (95.3% vs 94.4%, P = .57), 1 year (93.7% vs 90.2%, P = .07), or 3 years (88.0% vs 83.9%, P = .061). A total of 1411 patients were aged 55 years or more, with 935 having a left ventricular assist device for less than 2 years and 476 having a left ventricular assist device for 2 years or more. Patients having a left ventricular assist device for less than 2 years exhibited improved survival at 90 days (92.4% vs 89.2%, P = .046), 1 year (87.8% vs 81.9%, P = .0051), and 3 years (81.4% vs 72.7%, P = .0011). Multivariable adjustment showed a significant impact of age 55 years or more on post-heart transplant mortality (hazard ratio, 1.96; 95% CI, 1.34-2.86; P < .001); however, having a left ventricular assist device for 2 years or more showed no significant impact (hazard ratio, 1.47; 95% CI, 0.91-2.36; P = .116). Formal testing revealed no significant interaction of age and left ventricular assist device duration (hazard ratio, 1.1; 95% CI, 0.63-1.91; P = .735).Conclusions
Although there is a lower observed post-heart transplant survival in patients aged 55 years or more and supported by a left ventricular assist device for 2 years or more, formal testing reveals no significant interaction of these variables on mortality.
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BibTeX
@article{sollie2026interaction,
title = {{The interaction of age and time on durable left ventricular assist device and its effect on heart transplant outcomes.}},
author = {Zachary W Sollie and Jennie H Kwon and Caroline C Miller and Jingwen Zhang and Brett A Welch and Chakradhari Inampudi and Arman Kilic},
journal = {JTCVS open},
year = {2026},
month = aug,
doi = {10.1016/j.xjon.2026.102068},
url = {https://europepmc.org/article/MED/42948138},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The interaction of age and time on durable left ventricular assist device and its effect on heart transplant outcomes.
AU - Zachary W Sollie
AU - Jennie H Kwon
AU - Caroline C Miller
AU - Jingwen Zhang
AU - Brett A Welch
AU - Chakradhari Inampudi
AU - Arman Kilic
PY - 2026
DA - 2026/08/22
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102068
UR - https://europepmc.org/article/MED/42948138
AB - Objective This study aims to assess the interaction between age and left ventricular assist device duration on heart transplant outcomes in the modern era.Methods All heart transplantation in adults with a fully magnetically levitated centrifugal flow left ventricular assist device between October 2018 and June 2025 were identified from the United Network for Organ Sharing database. Groups were stratified primarily by age less than 55 years and 55 years or more and secondarily by age less than 2 years and 2 years or more of left ventricular assist device support. The primary outcome was post-heart transplant survival.Results A total of 1005 patients were aged less than 55 years, with 608 having a left ventricular assist device for less than 2 years and 397 having a left ventricular assist device for 2 years or more. There was no significant difference in post-heart transplant survival between left ventricular assist device duration groups at 90 days (95.3% vs 94.4%, P = .57), 1 year (93.7% vs 90.2%, P = .07), or 3 years (88.0% vs 83.9%, P = .061). A total of 1411 patients were aged 55 years or more, with 935 having a left ventricular assist device for less than 2 years and 476 having a left ventricular assist device for 2 years or more. Patients having a left ventricular assist device for less than 2 years exhibited improved survival at 90 days (92.4% vs 89.2%, P = .046), 1 year (87.8% vs 81.9%, P = .0051), and 3 years (81.4% vs 72.7%, P = .0011). Multivariable adjustment showed a significant impact of age 55 years or more on post-heart transplant mortality (hazard ratio, 1.96; 95% CI, 1.34-2.86; P < .001); however, having a left ventricular assist device for 2 years or more showed no significant impact (hazard ratio, 1.47; 95% CI, 0.91-2.36; P = .116). Formal testing revealed no significant interaction of age and left ventricular assist device duration (hazard ratio, 1.1; 95% CI, 0.63-1.91; P = .735).Conclusions Although there is a lower observed post-heart transplant survival in patients aged 55 years or more and supported by a left ventricular assist device for 2 years or more, formal testing reveals no significant interaction of these variables on mortality.
SN - 2666-2736
ER -