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Volume 13
Issue 8
10.3390/biomedicines13081959
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Article

Mortality Predictors in Short-Term Mechanical Circulatory Support as a Bridge to Heart Transplantation

by
Carlos Domínguez-Massa
1,*,
Manuel Pérez-Guillén
1,
Iratxe Zarragoikoetxea-Jauregui
2,
Eduardo Tébar-Botí
1,
María José Dalmau-Sorlí
1,
Salvador Torregrosa-Puerta
1,
Francisco José Valera-Martínez
1,
Claudia Marissa Aguirre-Ramón
1,
Alexandra Margoth Merino-Orozco
1,
Gerardo Andrés Diéguez-Palacios
1,
Raquel López-Vilella
3,
Ricardo Gimeno-Costa
4 and
Juan Bautista Martínez-León
1,5
1
Department of Cardiovascular Surgery, University and Polytechnic Hospital La Fe, Avenida de Fernando Abril Martorell 106, 46026 Valencia, Spain
2
Department of Anesthesiology, University and Polytechnic Hospital La Fe, Avenida de Fernando Abril Martorell 106, 46026 Valencia, Spain
3
Department of Cardiology, University and Polytechnic Hospital La Fe, Avenida de Fernando Abril Martorell 106, 46026 Valencia, Spain
4
Intensive Care Unit, University and Polytechnic Hospital La Fe, Avenida de Fernando Abril Martorell 106, 46026 Valencia, Spain
5
Department of Surgery, University of Valencia, Avenida de Blasco Ibáñez 15, 46010 Valencia, Spain
*
Author to whom correspondence should be addressed.
Biomedicines 2025, 13(8), 1959; https://doi.org/10.3390/biomedicines13081959
Submission received: 15 July 2025 / Revised: 4 August 2025 / Accepted: 9 August 2025 / Published: 12 August 2025
(This article belongs to the Section Molecular and Translational Medicine)
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Abstract

Background/Objectives: This study evaluates the outcomes of extracorporeal membrane oxygenation (ECMO), in venoarterial configuration, and short-term ventricular assist devices (VADs) used as a bridge to heart transplantation (HT). The primary objective was to identify predictors of in-hospital mortality among patients on the urgent HT waiting list receiving short-term mechanical circulatory support, including direct ECMO-to-HT, direct short-term VAD-to-HT, and ECMO as a bridge to short-term VAD followed by HT (ECMO bridge-to-bridge). Secondary objectives included identifying predictors of in-hospital mortality in transplanted patients and assessing their long-term survival. Methods: A single-center, retrospective, observational, and analytical study conducted at a tertiary care hospital, including patients supported with ECMO and short-term VAD support as a bridge to HT between 2007 and 2024. Results: A total of 183 patients were included: 110 in the ECMO-to-HT group, 51 in the VAD-to-HT group, and 22 in the ECMO bridge-to-bridge group. Among them, 147 underwent HT (80.3%). Overall in-hospital mortality was 37.2% (115 of 183 patients survived), while in-hospital mortality among transplanted patients was 21.8% (115 of 147 survived). Independent predictors of in-hospital mortality included infection, ECMO bridge-to-bridge strategy, higher body mass index (BMI), older age, and neurological complications. In the transplanted subgroup, predictors of both in-hospital and long-term mortality were ECMO support and older recipient age. Notably, a donor BMI exceeding that of the recipient by more than 10% was associated with improved survival. Conclusions: The complexity of patients requiring mechanical circulatory support and the physiological effects of different devices necessitate early, individualized management based on the etiology of cardiogenic shock and urgency status.
Keywords: heart failure; heart transplantation; devices; extracorporeal membrane oxygenation; prognostic factors; mortality heart failure; heart transplantation; devices; extracorporeal membrane oxygenation; prognostic factors; mortality
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MDPI and ACS Style

Domínguez-Massa, C.; Pérez-Guillén, M.; Zarragoikoetxea-Jauregui, I.; Tébar-Botí, E.; Dalmau-Sorlí, M.J.; Torregrosa-Puerta, S.; Valera-Martínez, F.J.; Aguirre-Ramón, C.M.; Merino-Orozco, A.M.; Diéguez-Palacios, G.A.; et al. Mortality Predictors in Short-Term Mechanical Circulatory Support as a Bridge to Heart Transplantation. Biomedicines 2025, 13, 1959. https://doi.org/10.3390/biomedicines13081959

AMA Style

Domínguez-Massa C, Pérez-Guillén M, Zarragoikoetxea-Jauregui I, Tébar-Botí E, Dalmau-Sorlí MJ, Torregrosa-Puerta S, Valera-Martínez FJ, Aguirre-Ramón CM, Merino-Orozco AM, Diéguez-Palacios GA, et al. Mortality Predictors in Short-Term Mechanical Circulatory Support as a Bridge to Heart Transplantation. Biomedicines. 2025; 13(8):1959. https://doi.org/10.3390/biomedicines13081959

Chicago/Turabian Style

Domínguez-Massa, Carlos, Manuel Pérez-Guillén, Iratxe Zarragoikoetxea-Jauregui, Eduardo Tébar-Botí, María José Dalmau-Sorlí, Salvador Torregrosa-Puerta, Francisco José Valera-Martínez, Claudia Marissa Aguirre-Ramón, Alexandra Margoth Merino-Orozco, Gerardo Andrés Diéguez-Palacios, and et al. 2025. "Mortality Predictors in Short-Term Mechanical Circulatory Support as a Bridge to Heart Transplantation" Biomedicines 13, no. 8: 1959. https://doi.org/10.3390/biomedicines13081959

APA Style

Domínguez-Massa, C., Pérez-Guillén, M., Zarragoikoetxea-Jauregui, I., Tébar-Botí, E., Dalmau-Sorlí, M. J., Torregrosa-Puerta, S., Valera-Martínez, F. J., Aguirre-Ramón, C. M., Merino-Orozco, A. M., Diéguez-Palacios, G. A., López-Vilella, R., Gimeno-Costa, R., & Martínez-León, J. B. (2025). Mortality Predictors in Short-Term Mechanical Circulatory Support as a Bridge to Heart Transplantation. Biomedicines, 13(8), 1959. https://doi.org/10.3390/biomedicines13081959

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