LVAD implantation for destination therapy demonstrated favorable clinical outcomes in a Japanese cohort, with on-device survival rates of 82.3%, 73.3%, and 49.8% at 1, 3, and 5 years, and no significant differences in primary or secondary outcomes compared to bridge-to-transplant patients.
On-device survival rates for destination therapy LVAD patients were 82.3%, 73.3%, and 49.8% at 1, 3, and 5 years, respectively.
The majority of DT patients (90.6%) experienced rehospitalization during the follow-up period, most commonly due to LVAD-related infection.
One-quarter of DT patients (10 cases) required LVAD pump exchange, most commonly due to LVAD-related infection.
Comparative analysis between DT and bridge-to-transplant (BTT) patients revealed no significant differences in primary or secondary outcomes.
The study authors concluded that LVAD implantation for DT demonstrated favorable clinical outcomes in this Japanese cohort.
This research examines the outcomes of patients in Japan who received a left ventricular assist device (LVAD) — a mechanical pump that helps a failing heart — as a permanent treatment (called 'destination therapy' or DT), meaning they were not expected to receive a heart transplant. Japan only approved this use of LVADs in 2021, so this study from Osaka University Medical Hospital provides one of the first looks at how Japanese patients fare with this treatment over time. Forty DT patients were followed for up to five years, and roughly half were still alive and supported by their device at the five-year mark, with better survival rates at one and three years. The study found that living with an LVAD long-term comes with significant challenges: nearly all patients (about 91%) had to be rehospitalized at some point, and infections related to the device were the most common reason. One in four patients also needed their pump replaced, again most often because of infection. Despite these complications, when the researchers compared DT patients to 213 patients who received an LVAD as a bridge to a heart transplant, they found no statistically significant differences in survival or complication rates between the two groups. This research suggests that destination therapy with an LVAD is a clinically viable long-term option for Japanese heart failure patients who are not candidates for transplantation, with outcomes comparable to those of patients awaiting a transplant. However, the high rate of device-related infections points to an important area for improvement in managing these patients over the long term.
Inoue K, Yoshioka D, Misumi Y, Kawamura A, Yajima S, Kawamura T, et al.. (2026). Clinical differences between destination therapy and bridge-to-transplant left ventricular assist device implantation: a 17-year single-center experience in Japan.. Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs. https://doi.org/10.1007/s10047-026-01581-8