Case Report: LVAD as a Bridge to Heart Transplantation. Technical and Infectious Challenges

O.  Samchuk; R.  Domashych; I.  Miskiv; B.  Hel; Y.  Yakymovych; I.  Iliasevych

doi:10.63181/2788-4740.4.1.2026.70-78

O. Samchuk Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine http://orcid.org/0000-0002-8710-1271
R. Domashych Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine https://orcid.org/0000-0001-7860-0231
I. Miskiv Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine https://orcid.org/0000-0001-7979-6117
B. Hel Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine https://orcid.org/0009-0004-3122-9622
Y. Yakymovych Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine https://orcid.org/0000-0002-7174-0028
I. Iliasevych Municipal Non-Profit Enterprise “Lviv Territorial Medical Association Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medicine”, Lviv, Ukraine https://orcid.org/0009-0001-8175-8379

DOI: https://doi.org/10.63181/2788-4740.4.1.2026.70-78

Keywords: heart transplantation, left ventricular assist device, LVAD, bridge to transplantation, infectious complications, case report

Abstract

Abstract: Mechanical circulatory support devices, particularly left ventricular assist devices (LVADs), are widely used as a bridge to transplantation in patients with end-stage heart failure. Despite their significant clinical benefits, LVAD use is associated with the risk of infectious complications that can complicate the post-transplant period and affect the outcome of heart transplantation.

In recent decades, the development of mechanical circulatory support devices, particularly left ventricular assist devices (LVADs), has significantly improved the interim management of patients awaiting heart transplantation. LVADs serve as a bridge to transplantation by stabilizing hemodynamics, improving end-organ perfusion, reducing the symptoms of heart failure, and, ideally, enhancing post-transplant outcomes.

However, the use of LVADs as a pre-transplant bridge is associated with specific risks and challenges. According to recent reviews and clinical studies, these include infectious complications, bleeding events, and immunological sensitization, which may adversely affect the post-transplant course.

In this clinical case, we present a patient in whom an LVAD was implanted as a bridge to transplantation, followed by successful heart transplantation. We describe the clinical course as well as the challenges encountered in the management of this patient.

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