James Les, Smith Deane E
Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY 10010, USA.
Rev Cardiovasc Med. 2024 Feb 20;25(2):68. doi: 10.31083/j.rcm2502068. eCollection 2024 Feb.
As we approach the five-year anniversary of the 2018 heart allocation system in the United States, it is imperative to consider the changing landscape of mechanical circulatory support and the strategies used to bridge patients into heart transplants. This manuscript reviews the history of the heart allocation system, as well as the conditions that led to its multiple revisions. We discuss initial outcomes following the implementation of the new allocation system, including the impact on waitlist mortality and post-transplant outcomes. We also give special consideration to changes in bridging strategies using venoarterial extracorporeal membrane oxygenation (VA ECMO), intra-aortic balloon pumps, and durable left ventricular assist devices (LVADs).
随着我们临近美国2018年心脏分配系统启用五周年，必须考虑机械循环支持不断变化的格局以及用于帮助患者过渡到心脏移植的策略。本文回顾了心脏分配系统的历史，以及导致其多次修订的情况。我们讨论了新分配系统实施后的初步结果，包括对等待名单死亡率和移植后结果的影响。我们还特别关注了使用静脉-动脉体外膜肺氧合（VA ECMO）、主动脉内球囊泵和耐用左心室辅助装置（LVAD）的过渡策略的变化。
