Authors' objectives:

To assess the use of ventricular assistance devices as a mechanical bridge to cardiac transplantation.

Authors' recommendations: Generally, medium term mechanical ventricular assistance is not considered to be in proportion with the needs arising in Spain. The fact that this technology is being used experimentally, makes it appropriate to seek new applications, even though much caution must be taken when doing this, given the lack of predictable factors to help define the relevant risk levels. Thus, the systematic implantation of a medium duration mechanical support may daringly be considered, prior to carrying out transplants in critical patients. In reality, any measure that may mean 'redefining the Spanish heart transplantation programme', i.e., changing the criteria currently in force, both in the selection of candidates as well as in their handling and the pertinent clinical practice, would have to be based on far more consistent scientific evidence instead of the precarious evidence currently available. Likewise, it would need to be sustained by a profound ethical debate that guaranteed public acceptance of the new basic principles. It would also be possible to affirm the use of mechanical support as an alternative to transplants in patients who would in no case qualify for transplants.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.isciii.es/aets/

Year Published: 1997

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias, 1997