Left ventricular assist devices: An ethical analysis

United States statistics continue to indicate that the human donor heart po ol does not and will not meet the gl-eat demand for hearts. For those patie nts unresponsive to maximal medical therapy (approximately 60,000 patients per year), cardiac transplantation is currently their best hope for increas ed survival. To address the need for additional end-stage congestive heart failure (CHF) therapy options, three medical device manufacturers have deve loped implantable left ventricular assist devices (LVRD) which act as a pum p for hemodynamic support of the patient's diseased heart. Although LVADs h ave been shown to improve patient disease state prior to organ transplantat ion, LVADs do nothing to increase the pool of human donor-hearts ts, and th ey negatively impact the United Network for Organ Sharing (UNOS) waiting li st by increasing the size of the waiting pool. This paper identifies and ex plores the ethical challenges presented by the use of LVADs as a bridging t echnology for heart transplant candidates. Although LVADs raise some ethica l concerns, these concerns are outweighed by the proven medical efficacy of these devices. Thus, this technology should continue to be used and furthe r developed.