Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
JCS Statement
Consensus Report on Destination Therapy in Japan ― From the DT Committee of the Council for Clinical Use of Ventricular Assist Device Related Academic Societies ―
Koichiro KinugawaYasushi SakataMinoru OnoShinichi NunodaKoichi TodaNorihide FukushimaAkira ShioseShogo OishiDai YuminoTeruhiko ImamuraMiyoko EndoYumiko HoriKoichi KashiwaKaoruko AitaHiroyuki KojinYutaka TejimaYoshiki Sawa
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2021 Volume 85 Issue 10 Pages 1906-1917

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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.

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© 2021, THE JAPANESE CIRCULATION SOCIETY

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