Authors

K Avison¹;  ¹ Queen Elizabeth Birmingham, UK

Discusssion

With the epidemic nature of heart failure around the world and the ever increasing problem of organ donor shortages worldwide, the field of mechanical circulatory support is rapidly expanding. Over the last 5 decades, the technology of Left Ventricular Assist Devices (LVADs) has drastically transformed. With the primary indication of LVADs to be used as a Bridge to Transplant (BTT), debates began as to whether these devices could be used as a longer term treatment solution, in the form of Destination Therapy (DT). Currently within the UK, the NHS runs an LVAD programme with a BTT indication only, due to restricted financial funds and the high costs associated with DT. LVAD programmes in other countries, such as the USA, Canada and Germany, do allow for implantation as DT, however most economic evaluations indicate that this is not a cost-effective treatment strategy. Therefore, whilst LVAD technology is clinically superior than ever before and the ongoing problem of donor organ availability persists, it seems unlikely that DT will become a reality for end-stage heart failure treatment in the UK at any point within the near future, as a result of the financial burden it may present to the NHS.