• Anna Bovill Shapiro, Ashley Virginia Fritz, Sean Kiley, Shriya Sharma, Parag Patel, Alexander Heckman, Archer Kilbourne Martin, and Rohan Goswami.
• Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL; Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL. Electronic address: shapiro.anna@mayo.edu.
• J. Cardiothorac. Vasc. Anesth. 2024 Nov 1; 38 (11): 256725752567-2575.

ObjectiveTo determine if the intraoperative transfusion requirements differ based on the mechanical circulatory device used as a bridge to heart transplantation.DesignA single-center retrospective analysis of intraoperative transfusion requirements in all patients undergoing heart or heart/kidney transplantation between November 2018 and July 2021 who were bridged with a temporary (Impella 5.5) or durable left ventricular assist device (LVAD).SettingA tertiary care hospital.ParticipantsForty-three adult patients bridged to heart or heart/kidney transplantation with a temporary or durable LVAD between 2018 and 2021 INTERVENTIONS: Recording of baseline characteristics and intraoperative transfusion requirements, including packed red blood cells, fresh frozen plasma, cryoprecipitate, autologous blood salvage, and platelets. The difference in cardiopulmonary bypass times, intensive care unit length of stay, and the vasoactive inotrope score following transplantation were also recorded.Measurements And Main ResultsThe primary outcome was the volume of blood products transfused intraoperatively. Patients who underwent bridge to transplantation using the Impella 5.5 had statistically significant lower median transfusions of cryoprecipitate (155 mL versus 200 mL, p = 0.015), autologous blood salvage (675 mL versus 1,125 mL, p ≤ 0.01), and platelets (412 mL versus 675 mL, p ≤ 0.01). Additionally, there was a trend toward lower transfusion of intraoperative packed red blood cells (4.5 units versus 6.5 units, p = 0.29) and fresh frozen plasma (675 mL versus 800 mL, p = 0.11), but these were not statistically significant.ConclusionsThe results suggest a reduction in certain intraoperative transfusion requirements in patients undergoing heart transplantation bridged with the Impella 5.5 versus durable left ventricular assist device.Copyright © 2024 Elsevier Inc. All rights reserved.

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