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Consensus Report on Destination Therapy in Japan - From the DT Committee of the Council for Clinical Use of Ventricular Assist Device Related Academic Societies.

Abstract
Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan. To initiate the DT program in Japan, revision of the LVAD indication from BTT is necessary. Also, in-depth discussion of caregiver issues as well as end-of-life care is indispensable. For that purpose, we assembled a DT committee of multidisciplinary members in August 2020, and started monthly discussions via web-based communication during the COVID-19 pandemic. This is a summary of the consensus reached after 6 months' discussion, and we have included as many relevant topics as possible. Clinical application of DT has just started, and we are willing to revise this consensus to meet the forthcoming issues raised during real-world clinical experience.
AuthorsKoichiro Kinugawa, Yasushi Sakata, Minoru Ono, Shinichi Nunoda, Koichi Toda, Norihide Fukushima, Akira Shiose, Shogo Oishi, Dai Yumino, Teruhiko Imamura, Miyoko Endo, Yumiko Hori, Koichi Kashiwa, Kaoruko Aita, Hiroyuki Kojin, Yutaka Tejima, Yoshiki Sawa
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 85 Issue 10 Pg. 1906-1917 (09 24 2021) ISSN: 1347-4820 [Electronic] Japan
PMID34433758 (Publication Type: Journal Article, Review)
Topics
  • COVID-19 (epidemiology)
  • Consensus
  • Heart Failure (epidemiology, therapy)
  • Heart Transplantation
  • Heart-Assist Devices
  • Humans
  • Japan (epidemiology)
  • Pandemics
  • SARS-CoV-2

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