Dr. Park asked Dr. Kirklin if it would ever make sense to consider VAD as primary therapy and reserve heart transplant as a secondary therapy.
"Of course the goal in the future will be to have an array of therapies which maximize long-term survival for patients, so whether that means initial VAD therapy followed by transplant or initial transplant followed by total artificial heart of course depends upon the rigorous analyses we will need to do in the future," Dr. Kirklin replied.
Although permanent treatment is the intention of destination therapy, the clinical situation may evolve over time and some patients may be considered for cardiac transplantation or device explant, Dr. Kirklin said. "These outcomes can be tracked. In the current era, less than 5% of DT [destination therapy] patients underwent transplant or explant within 2 years."
Dr. Kirklin is the principal investigator of the INTERMACS NHLBI contract.