Introduction: lntra-aortic balioon pump (IABP) is certainly one of the oldest forms of Mechanical Circulatory Support (MCS) for recipients awaiting for Heart Transplantation (HTX). It has outpaced eligibility criteria for HTX, in particular, due to its low cost, ease of management and care. In addition, it is part of the prioritization criteria for the distribution of hearts in Brazil, being this therapy still widely used as a bridge to HTX in our country. The characteristics and survival of HTX prioritazed with IABP, and supported for long time on waiting list (WL) were studied.
Objective: Evaluate 510 consecutive HTX, from 2013 to 2024, in retrospective observational cross-sectional study.
Material and Methods: The inclusion criteria for this study was: adult patients, awaiting for HTX, using IABP as only mechanical support available (priority status (PS) 2 over 3) were included as comparison reference. All recipients received hearts recovered using cold static preservation, with the Bretschneider's HTK solution, as the solution of choice for preservation.
Results: From 2013 to 2024, a total of 510 consecutive HTX were made. 277 HTX were from recipients supported with IABP. 60% were male, and mean age was 47 years (SD= 13); 76% were transplanted in 30 days, 16% between 30 and 90 days, and 8%, waited for more than 90 days. Mortaiity rate was 40% (n= 10). 24% (n=6) of these HTX on IABP died within 30 days (50% multiple organ failure, 33% had infection and 17% had cardiogenic shock - possible graft failure). The leading cause of death after 30 days was infections (75% of HTx).
Conclusion: The use of the IABP as bridge to HTX is a very effective and a safe option for patients undergoing (HTX), even when inserted through subclavian or axillaryaccess, and should be part of the strategic treatment arsenal when supporting severe sick recipients on the waiting list, specially ln LATAM countries, such as Brazil, where mechanical circulatory support (MCS) is still very expensive. In our opinion, the IABP support may be used more widely, even in coutries that have many other types of MCS. Our exoerience, where almost 90% of our recipients are prioritized, 53% of them supported by the IABP, proving that this approach is useful and feasible, even for long periods and shows good results after HTX in the long term follow up. This data may suggest that the IABP group have better outcomes than to receptors supported only with inotropes.