An evaluation of driveline dressing protocols and infection rates for left ventricular assist devices across UK transplant centres

Abstract

Left ventricular assist devices are used to improve the quality of life of people waiting for heart transplantation. Driveline infections are a significant complication of these devices, occurring in 30–40% of cases, which could lead to life threatening sepsis. This study aimed to review UK driveline dressing protocols and infection rates to determine if national standardisation is possible. Six UK heart transplant centres were asked to share their driveline dressing protocols for comparison. National driveline infection data were obtained from the NHS Blood and Transplant database. Infection rates, patient demographics and device types were compared using Chi squared tests, with a P value of <0.05 indicating statistical significance. The study found 38 driveline infections over a 3-year period, with an average infection rate was 4.4% per year. There were no significant difference in infection rates between device types. Dressing protocols varied between centres, but all centres followed international guidance. The timepoint where the highest number of infections were diagnosed was 12 months post implantations, accounting for 23.7% of infections. There were no significant differences in infection rates between centres in 2019–20 or 2021–22, but a significant difference was observed for 2020–21 (P=0.013). UK driveline infection rates are below the average reported in the literature. Despite some differences in dressing protocols, all centres examined in this study maintained a level of infection comparable to reported rates. The feasibility of national standardisation remains uncertain, and further research is needed to determine the most effective dressing protocols for preventing driveline infections.