Human immunodeficiency virus infection and left ventricular assist devices: A case series

• Published in: The Journal of heart and lung transplantation Vol. 30; no. 9; pp. 1060 - 1064
• Main Authors: Sims, Daniel B., MD, Uriel, Nir, MD, González-Costello, José, MD, Deng, Mario C., MD, Restaino, Susan W., MD, Farr, Maryjane A., MD, Takayama, Hiroo, MD, Mancini, Donna M., MD, Naka, Yoshifumi, MD, PhD, Jorde, Ulrich P., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2011; Elsevier
• Subjects: Adult; allosensitization; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antiretroviral Therapy, Highly Active; Biological and medical sciences; Cardiology. Vascular system; chronic heart failure; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Heart Failure - therapy; Heart-Assist Devices; HIV Infections - complications; HIV Infections - drug therapy; human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infectious diseases; Intensive care medicine; left ventricular assist device; Male; Medical sciences; Middle Aged; Opportunistic Infections - epidemiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; thrombosis; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; human immunodeficiency virus; chronic heart failure; thrombosis; left ventricular assist device; allosensitization; Artificial heart; Immunopathology; Intensive cardiocirculatory care; Artificial ventricle; Cardiocirculatory support; AIDS; Immune deficiency; Phlebology; Infection; Case study; Viral disease; Auxiliary ventricule; Circulatory system; Cardiology
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2011.03.004

Historically, advanced heart failure therapies were considered inappropriate for patients infected with human immunodeficiency virus (HIV). As HIV has become a chronic illness with the advent of highly active anti-retroviral therapy (HAART), cardiac transplantation has been used for selected HIV patients with end-stage heart failure. We present a case series describing the clinical outcomes with left ventricular assist device (LVAD) use in 4 patients with HIV. Three of the patients are alive: 1 after a successful bridge to transplant and the other 2 on continued device support at 18 and 13 months after implantation. No infectious complications occurred in 3 patients, and no opportunistic infections occurred in the fourth patient. De novo allosensitization did not occur in our patients after LVAD implantation. With the ongoing donor shortage, implantation of an LVAD in advanced heart failure patients with HIV with controlled viremia on HAART represents a viable option.