 - Briefly, prior to VAD, patients must have a normal cardiac ejection fraction of 50 on ECHO cardiography or MUGGA scan, and fairly normal liver function tests bilirubin 2 mg and serum transaminase levels less than 2 x normal. Screening for viral hepatitis should be negative for acute or chronic active hepatitis. Positive antibody anti-HAV, HBSAb suggestive of remote exposure is acceptable. However, patients who test positive for Hepatitis C antibody anti-HCV or HIV are ineligible. Those with renal failure are eligible and should start VAD promptly and receive additional medical measures as needed. Patients presenting with infections upon presentation shall receive proper medical management prior to starting therapy. Patients performance status is not a criterion for entry on the VAD portion of this program. 