JHLT Open最新文献

{"title":"Prognostic significance of atrial fibrillation resolution after left ventricular assist device implantation","authors":"Daisuke Yakabe,&nbsp;Kazuo Sakamoto,&nbsp;Komei Mizokami,&nbsp;Tsukasa Watanabe,&nbsp;Hirotake Yokoyama,&nbsp;Sayana Kuraoka,&nbsp;Kayo Misumi,&nbsp;Tomomi Nagayama,&nbsp;Keisuke Shinohara,&nbsp;Takeo Fujino,&nbsp;Toru Hashimoto,&nbsp;Shouji Matsushima,&nbsp;Akira Shiose,&nbsp;Kohtaro Abe","doi":"10.1016/j.jhlto.2026.100624","DOIUrl":"10.1016/j.jhlto.2026.100624","url":null,"abstract":"<div><h3>Background</h3><div>The clinical impact of atrial fibrillation (AF) in patients undergoing left ventricular assist device (LVAD) implantation remains uncertain, particularly regarding whether the post-LVAD rhythm status carries prognostic value.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed consecutive LVAD recipients at our institution between 2008 and 2023. Patients were categorized as no AF, new-onset AF, resolved AF, or recurrent AF according to rhythm status before and after implantation. The primary endpoint was hospitalization for heart failure, and the secondary endpoints were all-cause death, stroke, and major bleeding. Left atrial (LA) reverse remodeling was quantified as the percent reduction in LA diameter.</div></div><div><h3>Results</h3><div>Among 115 patients (mean age 46 years; 69.6% male; 14.8% ischemic etiology), 44 (38.3%) had AF before implantation. Over a median follow-up of 50.8 months, 29 of 44 patients (65.9%) had no AF recurrence by 3 months after implantation (resolved AF group), whereas 15 had AF (recurrent AF group); among the 71 patients without pre-LVAD AF, three developed new-onset AF. Compared with the recurrent AF group, the resolved AF group had a significantly lower risk of heart failure hospitalization (hazard ratio, 0.25; 95% confidence interval, 0.07–0.86; P = 0.027). LA diameter decreased to a greater extent in the resolved AF group than in the recurrent AF group (LA reduction rate: 24.5% vs. 10.8%; P = 0.032).</div></div><div><h3>Conclusions</h3><div>LVAD implantation was associated with LA reduction through reverse remodeling and led to AF resolution in a subset of patients. Patients with AF resolution experienced fewer heart failure events during LVAD support.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"13 ","pages":"Article 100624"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of lung transplantation using TorEx ex-vivo lung perfusion","authors":"Haruchika Yamamoto MD PhD,&nbsp;Aadil Ali PhD,&nbsp;Gabriel Siebiger MD,&nbsp;Elliot Wakeam MD, MPH,&nbsp;Laura Donahoe MD,&nbsp;Jonathan C. Yeung MD PhD,&nbsp;Andrew Pierre MD,&nbsp;Marc de Perrot MD,&nbsp;Kazuhiro Yasufuku MD, PhD,&nbsp;Thomas K. Waddell MD,&nbsp;Shaf Keshavjee MD MSc,&nbsp;Marcelo Cypel MSc, FACS, FRCSC","doi":"10.1016/j.jhlto.2026.100615","DOIUrl":"10.1016/j.jhlto.2026.100615","url":null,"abstract":"<div><h3>Purpose</h3><div>Ex-vivo lung perfusion (EVLP) has expanded donor lung utilization, with over 1000 cases performed at our center since 2008. A next-generation Toronto EVLP system (TorEx EVLP) was introduced in December 2022, enabling simplified circuit setup by loading an organ chamber into an all‑in‑one device, potentially facilitating EVLP use at less experienced centers. This study reports the initial experience with TorEx EVLP and compares outcomes with (1) first‑generation EVLP and (2) conventional lung transplantation without EVLP.</div></div><div><h3>Methods</h3><div>In this single-center retrospective cohort study, 1067 EVLP procedures were performed from September 2008 to September 2024 (first-generation EVLP [G1], n=874; TorEx EVLP [G2], n=193). Post-transplant short- and long-term outcomes were compared among G1, G2, and contemporaneous direct transplants without EVLP (direct, n=1575).</div></div><div><h3>Results</h3><div>Of 1067 EVLP cases, 684 were accepted for transplant (utilization: G1 64.4%, G2 62.7%), and 700 transplants were performed (including 16 split singles). G1 and G2 had significantly higher DCD donor use (direct vs G1 vs G2: 17% vs 48% vs 60%, p&lt;0.001) and lower donor P/F ratios (422 vs 368 vs 368 mmHg, p&lt;0.001). Recipients in G1 and G2 were older than direct recipients (59 vs 61 vs 65 years, p&lt;0.05). Post‑transplant outcomes were similar across groups, including PGD3 at 72 h (15% vs 16% vs 10%, p=0.21), extubation within 72 h (65% vs 64% vs 68%, p=0.67), overall survival, and CLAD‑free survival.</div></div><div><h3>Conclusions</h3><div>Despite higher-risk donor use, outcomes with both first- and next-generation Toronto EVLP systems were comparable to direct transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"13 ","pages":"Article 100615"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiogenic shock in pregnancy: Prolonged axillary Impella 5.5 support during pregnancy and postpartum as bridge to heart transplantation","authors":"Shahar Laks MD,&nbsp;Rebecca Pierce-Williams DO,&nbsp;Ngina Connors MD,&nbsp;Kelecia Brown MD,&nbsp;Jennifer Philips MD,&nbsp;Diane Holmes FNP-BC,&nbsp;Catarina Canha MD,&nbsp;Nicole Cyrille-Superville MD,&nbsp;Esther Kim MD,&nbsp;Monique Oye DO","doi":"10.1016/j.jhlto.2026.100620","DOIUrl":"10.1016/j.jhlto.2026.100620","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock during pregnancy carries substantial maternal and fetal morbidity and mortality, and guidance on temporary mechanical circulatory support (tMCS) in this setting remains limited.</div></div><div><h3>Case summary</h3><div>A 36-year-old woman at 21 weeks' gestation presented with severe dilated cardiomyopathy (ejection fraction 20%, LVIDd 8.0 cm), cardiogenic shock (cardiac index 1.7<!--> <!-->L/min/m²), and recurrent ventricular arrhythmias. She declined termination of pregnancy. An axillary Impella 5.5 was placed for hemodynamic stabilization with rapid improvement in cardiac output and filling pressures. Progressive ventricular arrhythmias at 23 weeks and 3 days necessitated urgent cesarean delivery; the neonate did not survive. The patient was supported with the Impella 5.5 for 66 days and underwent successful orthotopic heart transplantation.</div></div><div><h3>Discussion</h3><div>To our knowledge, this is one of the longest reported durations of Impella 5.5 support initiated during pregnancy and continued into the postpartum period. This case highlights important considerations that may inform individualized multidisciplinary decision-making on temporary mechanical circulatory support selection in pregnancy-associated cardiogenic shock.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"13 ","pages":"Article 100620"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eliminating circulating donor passenger leukocytes during clinical ex vivo lung perfusion does not attenuate inflammation","authors":"M.A. Hu MD,&nbsp;Z.L. Zhang MD,&nbsp;R.F. Hoffmann PhD,&nbsp;C.T. Gan MD PhD,&nbsp;E.A.M. Verschuuren MD PhD,&nbsp;C. Van De Wauwer MD PhD,&nbsp;H.G.D. Leuvenink PhD,&nbsp;M.E. Erasmus MD PhD","doi":"10.1016/j.jhlto.2026.100619","DOIUrl":"10.1016/j.jhlto.2026.100619","url":null,"abstract":"<div><h3>Purpose</h3><div>During Ex Vivo Lung Perfusion (EVLP), it is standard practice to incorporate a leukocyte filter to remove donor passenger leukocytes and attenuate their inflammatory effects. The widely used leukocyte filter, LeukoGuard 6, seems to be ineffective in reducing circulating leukocytes during EVLP. Therefore, we performed contemporary leukocyte filtration using BioR 02 plus leukocyte filters to reduce these leukocytes and investigate whether inflammation could be reduced.</div></div><div><h3>Methods</h3><div>EVLP was performed for a minimum of 180 min with 15 bilateral donor lungs. Perfusate samples were taken from the in- and outlet of the leukocyte filter, which was subsequently clamped after 60 min. Contemporary parallel leukocyte filtration was performed in 9 EVLPs (intervention group) and in 6 EVLPs without (control group).</div></div><div><h3>Results</h3><div>After EVLP, 6/6 donor lungs were transplanted in the control group and 6/9 in the intervention group. Leukocytes increased significantly from 30 to 180 min in the standard group compared with the intervention group. During EVLP IL-1, IL-6, IL-8, TNF-α, neutrophil elastase, CD-14, syndecan-1, hyaluronan and VCAM-1, levels were not significantly different between the groups at 90 and 180 min. Post-transplant, primary graft dysfunction (PGD) and 1-month survival were similar.</div></div><div><h3>Conclusion</h3><div>The intervention group showed significantly lower circulating donor passenger leukocytes. However, this did not lead to attenuated inflammatory cytokines, leukocyte activation, glycocalyx shedding or endothelial activation. Clinical outcomes were similar between groups. Further research is needed to determine the exact effect of these donor passenger leukocytes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"13 ","pages":"Article 100619"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rescuing lung transplant candidates with rapidly progressive interstitial lung disease who fail V-V ECMO: A case series of dual veno-arterial and veno-venous extracorporeal membrane oxygenation circuits","authors":"Enock Adjei MD ,&nbsp;Blaine Sklar DNP, AGACNP-BC ,&nbsp;John W. Stokes MD ,&nbsp;Whitney D. Gannon MSN, MS ,&nbsp;Amir Teimouri Dereshgi MD ,&nbsp;Anil J. Trindade MD ,&nbsp;Caitlin T. Demarest MD, PhD ,&nbsp;Matthew Bacchetta MD, MBA ,&nbsp;Konrad Hoetzenecker MD, PhD","doi":"10.1016/j.jhlto.2026.100495","DOIUrl":"10.1016/j.jhlto.2026.100495","url":null,"abstract":"<div><h3>Background</h3><div>Providing adequate, awake and ambulatory mechanical circulatory support to patients with rapidly progressive advanced intersitial lung disease (ILD) remains challenging. In a subset of ILD patients with refractory hypoxemia or hemodynamic instability, despite optimal veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) support, the addition of a veno-arterial (V-A) ECMO circuit may avoid the need for mechanical ventilation and protect against right ventricular dysfunction and subsequent end-organ dysfunction.</div></div><div><h3>Methods</h3><div>We herein report the first case series of three patients with ILD who received dual VV-VA ECMO support as a bridge to transplantation.</div></div><div><h3>Results</h3><div>All patients survived until lung transplantation 2 to 8 days after V-A ECMO initiation and had an unremarkable post-transplant recovery.</div></div><div><h3>Conclusion</h3><div>Although the addition a second ECMO circuit is a complex and resource-intensive strategy, it is a feasible approach to stabilze a subset of ILD patients who are indequately supported with V-V ECMO.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100495"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in primary graft dysfunction and early mortality following lung transplantation: A single center experience","authors":"Yuriko Terada ,&nbsp;Michael K. Pasque ,&nbsp;Chad A. Witt ,&nbsp;Ruben G. Nava ,&nbsp;Benjamin D. Kozower ,&nbsp;G. Alexander Patterson ,&nbsp;Daniel Kreisel ,&nbsp;Varun Puri ,&nbsp;Ramsey R. Hachem ,&nbsp;Tsuyoshi Takahashi","doi":"10.1016/j.jhlto.2026.100488","DOIUrl":"10.1016/j.jhlto.2026.100488","url":null,"abstract":"<div><h3>Objectives</h3><div>Although the long-term prognosis after lung transplantation has improved recently, primary graft dysfunction (PGD) remains the major cause of early mortality. The aim of this study was to elucidate trends in PGD incidence and short-term mortality following lung transplantation in the contemporary era.</div></div><div><h3>Methods</h3><div>We analyzed a single-center database of lung transplantations performed across three periods (Era 1: 2009–2013, Era 2: 2014–2017, and Era 3: 2018–2021). PGD was graded according to the 2016 International Society for Heart and Lung Transplantation definition, and PGD grade 3 within T0–T72 was used as the primary outcome. Trends in PGD incidence, factors associated with PGD, and early mortality rates after lung transplantation were identified.</div></div><div><h3>Results</h3><div>This study included 856 lung transplants: 277 in Era 1, 296 in Era 2, and 283 in Era 3. PGD grade 3 incidence decreased significantly over time: 35.9% (99 cases) in Era 1, 26.4% (78 cases) in Era 2, and 18.4% (52 cases) in Era 3 (P&lt;0.001). During the study period, the lung allocation score (LAS) and intraoperative cardiopulmonary bypass (CPB) use decreased, whereas the use of intraoperative nitric oxide and extracorporeal membrane oxygenation increased. Logistic multivariate modeling identified era, recipient sex (male), underlying disease, race, and blood transfusion as factors associated with PGD. No significant difference was observed in 30-day hospital mortality across the three eras (2.9%, 1.4%, and 1.4% for Era 1, Era 2, and Era 3, respectively; P=0.313).</div></div><div><h3>Conclusion</h3><div>This study demonstrated a significant reduction in PGD incidence over time, which coincided with a decrease in LAS and intraoperative CPB use. However, no significant changes were observed in short-term mortality after lung transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100488"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart transplantation graft survival following donation after circulatory death via thoracoabdominal normothermic regional perfusion","authors":"Sarah Y. Park MD ,&nbsp;Rocio Lopez MS, MPH ,&nbsp;Michael J. Kirsch MD, MSCR ,&nbsp;Elizabeth J. Bashian MD ,&nbsp;Emily Hay-Arthur BA ,&nbsp;Jack Zakrzewski MD ,&nbsp;Jesse D. Schold PhD ,&nbsp;Nicholas R. Teman MD ,&nbsp;Jordan R.H. Hoffman MD, MPH ,&nbsp;Michael T. Cain MD","doi":"10.1016/j.jhlto.2025.100470","DOIUrl":"10.1016/j.jhlto.2025.100470","url":null,"abstract":"<div><h3>Background</h3><div>The impact of thoracoabdominal normothermic regional perfusion (TA-NRP) use in donation after circulatory death (DCD) on rates of graft survival after heart transplantation has yet to be established.</div></div><div><h3>Methods</h3><div>A cohort study of the Scientific Registry of Transplant Recipients was performed identifying all primary adult heart transplants performed in the United States between January 1, 2020, and May 31, 2024, comparing donation after brain death (DBD), DCD with direct procurement and perfusion (DPP) (defined as declaration of circulatory death to cross clamp &lt;30 min), and DCD with TA-NRP (defined as declaration of circulatory death to cross clamp &gt;40 min). The primary outcome was graft loss (re-transplant or death).</div></div><div><h3>Results</h3><div>There were 474 (3.5%) DCD TA-NRP, 899 (6.6%) DCD DPP, and 12,185 (89.9%) DBD heart transplants during the study period, with varying donor and baseline characteristics, including more male and non-Hispanic White DCD TA-NRP recipients, and fewer DCD TA-NRP recipients listed as Status 1. On multivariable analysis, graft survival rates did not significantly differ between cohorts [Adjusted Hazard Ratio (aHR) (95% CI): 0.98 (0.70, 1.37) for DCD TA-NRP vs. DBD; and 1.04 (0.69, 1.56) for DCD TA-NRP vs. DCD DPP].</div></div><div><h3>Conclusion</h3><div>DCD TA-NRP recovery in heart transplantation yields comparable rates of two-year graft survival compared to DCD DPP and DBD recovery, supporting greater utilization of TA-NRP recovery in DCD allografts.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100470"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent change in bridging strategy and improved clinical outcomes following durable left ventricular assist device implantation in Japan","authors":"Makiko Nakamura ,&nbsp;Teruhiko Imamura ,&nbsp;Yoshikatsu Saiki ,&nbsp;Minoru Ono ,&nbsp;Koichiro Kinugawa ,&nbsp;on behalf of J-MACS Investigators","doi":"10.1016/j.jhlto.2026.100499","DOIUrl":"10.1016/j.jhlto.2026.100499","url":null,"abstract":"<div><h3>Background</h3><div>Destination therapy (DT) was approved in Japan in May 2021. Use of Impella device as a bridge to left ventricular assist device (LVAD) implantation has been increasing. The difference of clinical outcomes between Impella-bridge (a conversion from Impella to durable left ventricular assist device [LVAD]), bridge-to-bridge (BTB) (a conversion from extracorporeal LVAD to durable LVAD), and primary LVAD remains unclear especially in Japanese.</div></div><div><h3>Methods</h3><div>Patients who underwent durable LVAD implantation between October 2017 and March 2025 and were prospectively registered in the Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS) were included. The baseline characteristics, cumulative mortality, and adverse events following durable LVAD implantation were retrospectively compared between 2 bridging strategies and primary LVAD cohort.</div></div><div><h3>Results</h3><div>A total of 964 patients who received durable LVAD implantation (median age: 49 years; primary LVAD: 77.4%; Impella-bridge: 11.6%; BTB: 11.0%) were analyzed. The prevalence of Impella-bridge strategy increased especially after DT approval and the introduction of Impella 5.5. The cumulative mortality during durable LVAD support was lowest in Impella-bridge cohort and highest in BTB cohort during a median follow-up of 1053 days (8.0% vs 21.0%). Among the total cohort, an Impella-bridge strategy tended to be associated with a lower mortality following durable LVAD implantation with an adjusted hazard ratio of 0.316 (95% confidence interval 0.095-1.048, <em>p</em> = 0.060).</div></div><div><h3>Conclusions</h3><div>Impella-bridge strategy increased after the introduction of Impella 5.5 in the era of DT and tended to be associated with a lower mortality following durable LVAD implantation. Further studies are warranted to validate the hypothesis.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100499"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expedited Lung Allocation in The Era of Continuous Distribution","authors":"Sajjad Ali ,&nbsp;Robin High ,&nbsp;Marian Urban ,&nbsp;David Axelrod ,&nbsp;Steven Potter ,&nbsp;Aleem Siddique","doi":"10.1016/j.jhlto.2026.100487","DOIUrl":"10.1016/j.jhlto.2026.100487","url":null,"abstract":"<div><h3>Background</h3><div>The frequency of use of expedited offers in lung allocation has increased.</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed lung offers accepted for transplant in the United States for the period from the introduction of continuous distribution in allocation in March 2023 to March 2024 to identify characteristics of donors, recipients, and offers associated with expedited placement. Data were obtained from the Scientific Registry of Transplant Recipients and categorized by expedited vs non-expedited offers.</div></div><div><h3>Results</h3><div>Of the 3,136 lung organ offers transplanted, 9% (284) were expedited. Expedited offers were more likely for male donors with blood type O, while recipients were typically older, male, non-Hispanic, and diagnosed with lung condition category A. These recipients also demonstrated lower composite allocation and medical urgency scores, and were less likely to be hospitalized, ventilated, or on extracorporeal life support. Time on the waitlist and post-transplant 30-day survival rates were similar between expedited and non-expedited groups. One-year survival was higher in recipients of expedited lung placements. Expedited offers had a median sequence number at acceptance of 83.5, bypassing a median of 54.5 listed patients, and were more often placed at centers with higher offer acceptance ratios.</div></div><div><h3>Conclusion</h3><div>Expedited placements are associated with lower-acuity recipients. Further policy reform should aim to ensure equity while optimizing organ placement and recipient outcomes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100487"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First implantation of a bioprosthetic total artificial heart for a mediastinal paraganglioma","authors":"Ali Akamkam MD, MSc ,&nbsp;Marie-Eve Garcia MD ,&nbsp;Elie Fadel MD, PhD ,&nbsp;Julien Guihaire MD, PhD","doi":"10.1016/j.jhlto.2026.100485","DOIUrl":"10.1016/j.jhlto.2026.100485","url":null,"abstract":"<div><div>Resection of cardiac-invasive tumors is challenging, as transplantation is not a viable option for patients with cancer. We report the first implantation of the Aeson total artificial heart (TAH) (Carmat, Vélizy-Villacoublay, France), as a bridge to transplant in a patient with a mediastinal paraganglioma. A 54-year-old man presented with restrictive heart failure related to a paraganglioma. The tumor was invading the right ventricle. No tumor reduction was achieved after chemotherapy. A surgical resection of the tumor combined with the implantation of the Aeson TAH was decided. Embolization of the nutrient vessels of the tumor was performed before surgery to decrease hemorrhagic risk. A positron emission tomography scan at 3 months showed no tumor recurrence. The patient was transplanted 6 months after TAH implantation. No severe primary graft dysfunction or acute rejection was observed. However, the patient developed refractory vasoplegia, which ultimately led to multiorgan failure and death 6 months after transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"12 ","pages":"Article 100485"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}