Jennifer A. Cowger, MD, Matthew A

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Presentation transcript:

Hemolysis: A harbinger of adverse outcome after left ventricular assist device implant Jennifer A. Cowger, MD, Matthew A. Romano, MD, Palak Shah, MD, MS, Neha Shah, MBBS, CCRP, Vivek Mehta, BS, Jonathan W. Haft, MD, Keith D. Aaronson, MD, MS, Francis D. Pagani, MD, PhD The Journal of Heart and Lung Transplantation Volume 33, Issue 1, Pages 35-43 (January 2014) DOI: 10.1016/j.healun.2013.08.021 Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions

Figure 1 Frequency of hemolysis episodes. The percentage of patients in the study cohort experiencing any hemolysis episode based on biochemical parameters (sfHg > 40 mg/dL or LDH ≥ 600 IU/L), INTERMACS-defined hemolysis (sfHg > 40 mg/dL with signs/symptoms), LDH-defined hemolysis (LDH ≥ 600 IU/L), or dual-hemolysis (simultaneous sfHg > 40 mg/dL and LDH ≥ 600 IU/L). The Journal of Heart and Lung Transplantation 2014 33, 35-43DOI: (10.1016/j.healun.2013.08.021) Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions

Figure 2 Time to onset of index hemolysis episode based on Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS; red) and lactate dehydrogenase (LDH; blue) criteria after ventricular assist device implant. The Journal of Heart and Lung Transplantation 2014 33, 35-43DOI: (10.1016/j.healun.2013.08.021) Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions

Figure 3 Event-free survival after left ventricular assist device implant in patients with and without hemolysis. Kaplan-Meier survival free of death, device exchange for thrombosis, urgent United Network of Organ Sharing 1A transplant for device thrombosis, or peripheral embolism/stroke after device implant is shown in patients with and without Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)-defined hemolysis (serum free hemoglobin > 40 mg/dL plus symptoms) and with and without lactate dehydrogenase (LDH)-defined hemolysis (LDH ≥ 600 IU/L). The Journal of Heart and Lung Transplantation 2014 33, 35-43DOI: (10.1016/j.healun.2013.08.021) Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions

Figure 4 Event-free survival after hemolysis onset. Kaplan-Meier survival free of death, peripheral embolism, urgent United Network of Organ Sharing 1A transplant for device thrombosis, or device exchange for thrombosis is shown in patients with and without Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)-defined hemolysis (serum free hemoglobin > 40 mg/dl plus symptoms) and in patients with and without lactate dehydrogenase (LDH)-defined hemolysis (LDH ≥ 600 IU/L). *Days represents days from onset of INTERMACS or LDH-defined hemolysis (LDH ≥600 IU/L) or from device implant (in non-hemolyzers) to an event. The Journal of Heart and Lung Transplantation 2014 33, 35-43DOI: (10.1016/j.healun.2013.08.021) Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions

Figure 5 This graphic shows the median time-to-event onset after left ventricular assist device (LVAD) implant and the median time-to-event occurrence after onset of Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)-defined (red) and lactate dehydrogenase (LDH)-defined (blue) hemolysis. XC, exchange. The Journal of Heart and Lung Transplantation 2014 33, 35-43DOI: (10.1016/j.healun.2013.08.021) Copyright © 2014 International Society for Heart and Lung Transplantation Terms and Conditions