Principal Investigator, Chair, J-MACS Operating Committee, Maki Hospital, Osaka, Japan.
Co-principal Investigator, J-MACS Operating Committee, Juntendo University, Tokyo, Japan.
J Heart Lung Transplant. 2017 Oct;36(10):1087-1096. doi: 10.1016/j.healun.2017.08.002. Epub 2017 Aug 12.
In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers.
The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) is a prospective registry designed to be harmonized with the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS). Participation in J-MACS is mandatory for device manufacturers to meet the conditions of approval as well as for hospitals to obtain authorization for reimbursement from the national health insurance system.
From June 2010 to April 2015, 476 patients were registered at 31 hospitals. Of these, analysis of primary VAD patients (n = 332) revealed that their overall 360-day survival was 91% (implantable 93%, extracorporeal 84%).
This initial report from J-MACS focuses on patients' demographics, device types, survival, competing outcomes, adverse events and successful examples of system failure detection.
自 1992 年以来,日本已将心室辅助装置(VAD)用于严重心力衰竭患者作为移植桥(BTT)。然而,直到 1997 年《器官移植法》颁布后,医疗器械才获得国家健康保险系统对此类用途的批准。为了鼓励创新医疗器械的研发,药品和医疗器械管理局与学术团体、医院和制造商合作建立了公私合作伙伴关系。
日本机械循环支持注册(J-MACS)是一项前瞻性注册,旨在与机械循环支持机构间注册(INTERMACS)相协调。对于设备制造商而言,参与 J-MACS 是获得批准条件的强制性要求,对于医院而言,也是从国家健康保险系统获得报销授权的强制性要求。
从 2010 年 6 月至 2015 年 4 月,31 家医院共登记了 476 名患者。其中,对原发性 VAD 患者(n = 332)的分析显示,他们的总体 360 天生存率为 91%(可植入式为 93%,体外式为 84%)。
J-MACS 的这份初步报告重点介绍了患者的人口统计学、设备类型、生存率、竞争结果、不良事件以及系统故障检测的成功案例。