As Alabama’s first and only destination therapy facility, UAB implants a number of mechanical circulatory support devices as a bridge to heart transplant each year. But the role of these devices in long-term or permanent use is yet to be established; meanwhile, more than 700,000 die each year from advanced heart failure because the number of hearts available available for transplant is little more than 2,000.

Now, UAB heart transplant surgeon James Kirklin, MD, awarded a 5–year, $6.3 million grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health, will lead a study consortium that will establish a multi-institutional registry and database to determine the role of such devices, including ventricular assist devices (VADs) and total artificial heart devices (TAHs), as therapies for advanced heart failure.

UAB implants approximately 12-15 VADs each year. These implantable assistive devices are employed to assume the natural pumping function of a diseased heart that can no longer effectively circulate blood on its own. Previous studies at UAB and elsewhere have demonstrated that VADs improve survival and cardiac function when compared with medical treatment alone for patients with end-stage heart failure who are not candidates for heart transplantation. .

“For many of these heart-failure patients there is no other therapy,” Kirklin said. “Without it, most would die from progressive heart failure. Through this study we will examine data to see if we can improve current-use outcomes and extend the use of these devices to people who are not transplant candidates so that we can improve survival.” will coordinate efforts of 60 to 70 institutions to guide evolution of these devices from a bridge to transplant to permanent therapy for selected patients, plus provide a platform for introduction of new technology and additional study into the physiology of mechanical circulatory support, interactions between device and patient, and the potential for myocardial recovery in those with advanced heart failure. Professor David Naftel, PhD, (Cardiovascular Surgery) is the head statistician for this effort. . Dr. Kirklin’s experience in establishing and maintaining large registries for pediatric and adult heart transplantation was a significant factor in receiving the award.

“The task is large, but it is manageable, and we hope to change the lives of many who have advanced heart failure,” Dr. Kirklin says. “We are encouraged by the newer studies that show increasing effectiveness of this therapy and also the ongoing efforts to develop new generations of better, smaller and more transportable technologies.”