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

  • Kinugawa Koichiro
    Second Department of Internal Medicine, Faculty of Medicine, University of Toyama
  • Sakata Yasushi
    Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
  • Ono Minoru
    Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
  • Nunoda Shinichi
    Department of Therapeutic Strategy for Severe Heart Failure, Graduate School of Medicine, Tokyo Women’s Medical University
  • Toda Koichi
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
  • Fukushima Norihide
    Department of Transplant Medicine, National Cerebral and Cardiovascular Center
  • Shiose Akira
    Department of Cardiovascular Surgery, Faculty of Medical Sciences, Kyushu University
  • Oishi Shogo
    Department of Cardiology, Himeji Brain and Heart Center
  • Yumino Dai
    Yumino Heart Clinic
  • Imamura Teruhiko
    Second Department of Internal Medicine, Faculty of Medicine, University of Toyama
  • Endo Miyoko
    Department of Nursing, The University of Tokyo Hospital
  • Hori Yumiko
    Department of Transplant Medicine, National Cerebral and Cardiovascular Center
  • Kashiwa Koichi
    Department of Medical Engineering, The University of Tokyo Hospital
  • Aita Kaoruko
    Graduate School of Humanities and Sociology, The University of Tokyo
  • Kojin Hiroyuki
    Department of Quality and Patient Safety, Graduate Faculty of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi
  • Tejima Yutaka
    Graduate School of Law, Kobe University
  • Sawa Yoshiki
    Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine

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Abstract

<p>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.</p>

Journal

  • Circulation Journal

    Circulation Journal 85 (10), 1906-1917, 2021-09-24

    The Japanese Circulation Society

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