Mechanical Circulatory Support as an Alternative Solution in
Circumstances Leading to a Shortage of Organ Donors
Background. Mechanical circulatory support (MCS) has been applied as an
effective therapy for patients with end stage heart failure (HF). The
existing donor organ shortage issue in Kazakhstan, and hence long
waiting times, have resulted in left ventricular assist device (LVAD)
implantation being the predominant surgical treatment method for this
condition. The purpose of this study is to analyze clinical outcomes of
MCS program data in our Center. Methods. This study involves a
retrospective analysis of 324 patients with different types of
implantable MCS including LVAD (n=319), fully implantable LVAD (FIVAD,
n=2), and total artificial heart (TAH, n=3). FIVAD and TAH cases were
analyzed separately from other VAD types due to their small numbers.
Results. Initially, LVADs were implanted as bridge-to-transplant (BTT)
in 214 (67.1%) of patients and as a destination therapy (DT) in 105
(32.9%) cases, but only 30 (9.4%) patients proceeded to transplant.
The overall survival rate of all LVAD patients at years 1, 2, 3, and 4
was 84.3%, 69.7%, 62.8%, and 52.5%, respectively. The distance from
the clinic (Nur-Sultan) to patients’ cities of residence (average 1015 ±
668 kilometers) was not associated with patient survival. Conclusions.
Developing MCS programs is crucial in providing care for patients with
HF. Using LVAD as DT produced satisfactory outcomes with favorable
survival rates, which are comparable to the outcomes reported in other
studies. Further trials are needed to investigate the results of TAH and
FIVAD implantation in order to establish them as an acceptable
alternative treatment to heart transplantation.