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Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant.

Publication ,  Journal Article
Rushakoff, JA; Tam, PCK; Kothadia, SM; Heldman, MR; Spahillari, A; Trichon, B; Keenan, JE; Schroder, JN; Milano, CA; Patel, CB; DeVore, AD ...
Published in: J Heart Lung Transplant
November 13, 2025

BACKGROUND: Infectious complications are common in patients implanted with HeartMate 3 (HM3) left ventricular assist devices (LVAD). Despite these issues, some patients with LVAD-specific infection are ultimately considered for heart transplant (HT). The impact of HM3 LVAD-associated infection on postHT outcomes remains unclear. METHODS: We reviewed all adult patients who were listed for HT at Duke University Hospital between 1/1/2014 and 12/31/2024 (n = 1267) and identified 115 patients with a HM3 device who underwent HT. These 115 patients were further stratified based on pre-HT LVAD-specific infection. We assessed the impact of LVAD-specific infection on short-term postHT complications, including length of hospitalization, primary graft dysfunction (PGD), episodes of acute rejection, and occurrences of postHT hospitalization with infection up to 1-year. Kaplan-Meier analysis was used to assess risk of death after HT. RESULTS: Of the 115 patients, 59 patients (51%) had HM3 LVAD-specific infection prior to HT. Compared to patients without pre-HT LVAD-specific infection, there was no difference in 1 year post-HT survival (p = 0.14). Similarly, there was no difference in postHT length of stay (p = 0.435), treated acute rejection (p = 0.536), or severe PGD (p = 0.166). CONCLUSIONS: For carefully selected patients with HM3 LVAD-specific infections, HT appears to be a safe option without excess short-term morbidity or mortality HT.

Duke Scholars

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

November 13, 2025

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Rushakoff, J. A., Tam, P. C. K., Kothadia, S. M., Heldman, M. R., Spahillari, A., Trichon, B., … Lerman, J. B. (2025). Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant. J Heart Lung Transplant. https://doi.org/10.1016/j.healun.2025.10.014
Rushakoff, Joshua A., Patrick C. K. Tam, Sonya M. Kothadia, Madeleine R. Heldman, Aferdita Spahillari, Benjamin Trichon, Jeffrey E. Keenan, et al. “Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant.J Heart Lung Transplant, November 13, 2025. https://doi.org/10.1016/j.healun.2025.10.014.
Rushakoff JA, Tam PCK, Kothadia SM, Heldman MR, Spahillari A, Trichon B, et al. Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant. J Heart Lung Transplant. 2025 Nov 13;
Rushakoff, Joshua A., et al. “Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant.J Heart Lung Transplant, Nov. 2025. Pubmed, doi:10.1016/j.healun.2025.10.014.
Rushakoff JA, Tam PCK, Kothadia SM, Heldman MR, Spahillari A, Trichon B, Keenan JE, Schroder JN, Milano CA, Patel CB, DeVore AD, Russell SD, Lerman JB. Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant. J Heart Lung Transplant. 2025 Nov 13;
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

November 13, 2025

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology