Effect of left ventricular assist device bridging to transplantation on donor waiting time and outcomes in Canada.
Bibliographic record
Abstract
BACKGROUND: The Thoratec left ventricular assist device (LVAD; Thoratec Laboratories Corporation, USA) was used as a bridge to transplantation at the Montreal Heart Institute. LVAD patients were activated on the waiting list as soon as they were in suitable clinical status. OBJECTIVE: To analyze the effect of introducing the Thoratec LVAD in the heart transplantation program at the Montreal Heart Institute. METHODS: The results of 16 LVAD patients and 20 patients who underwent heart transplantation without LVAD support between January 2000 and February 2002 were reviewed. RESULTS: Sixteen patients in cardiogenic shock underwent emergency implantation of a Thoratec LVAD following acute myocardial infarction (five patients), acute viral cardiomyopathy (five patients), idiopathic cardiomyopathy (three patients), postpartum cardiomyopathy (two patients) and failure to wean from cardiopulmonary bypass (one patient). Thirteen of 16 (81%) LVAD patients underwent heart transplantation, and three LVAD patients were not listed and died from multiorgan failure. The wait for transplantation averaged 17+/-19 days in LVAD patients compared with 87+/-66 days for the 20 patients undergoing transplantation without LVAD support (P=0.01). Survival 12 months following transplantation averaged 84+/-10% in LVAD supported patients and 90+/-7% in those without LVAD support (P=0.6). CONCLUSION: The use of Thoratec LVAD as a bridge to transplantation did not prolong the wait for a donor of patients without LVAD support (United Network Organ Sharing status II). Moreover, listing patients as soon as they appear suitable for transplantation resulted in a short period of LVAD support and a good rate of survival one year after transplantation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".