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

## TL;DR

This study finds that using the Impella 5.5 heart pump for more than 14 days before a transplant does not worsen post-transplant outcomes.

## Contribution

The study provides new evidence on the safety of prolonged Impella 5.5 use as a bridge to heart transplantation.

## Key findings

- Prolonged Impella 5.5 support did not affect 1-year survival or hospital discharge rates.
- There was no difference in post-transplant complications between short and long support durations.
- One-year rehospitalization rates were high but not linked to support duration.

## Abstract

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.

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.

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).

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.