JHLT Open最新文献

{"title":"Evaluation of target temperature on effectiveness of myocardial preservation during hypothermic machine perfusion","authors":"Guilherme Mainardi Aguiar da Silva MD ,&nbsp;Mitchell J. Wagner ,&nbsp;Sanaz Hatami MD/PhD ,&nbsp;Parham Hassanzadeh ,&nbsp;Xiuhua Wang PhD ,&nbsp;Benjamin A. Adam MD ,&nbsp;Jayan Nagendran MD/ PhD ,&nbsp;Darren H. Freed MD/PhD","doi":"10.1016/j.jhlto.2025.100234","DOIUrl":"10.1016/j.jhlto.2025.100234","url":null,"abstract":"<div><h3>Background</h3><div>Ex-situ heart perfusion (ESHP) has been proposed as an optimal method for preserving donated hearts prior to transplantation. Hypothermic oxygenated perfusion (HOP) is a simple method from a device design perspective, with enhanced safety compared to normothermic perfusion in the event of device failure. However, the optimal temperature for cardiac HOP has yet to be determined. We evaluated the effectiveness of 12-hour HOP using University of Wisconsin Machine Perfusion Solution (UWMPS) in different temperatures compared to static cold storage (SCS) for 6 hours followed by simulated transplantation. Additionally, we sought to determine the impact of oxygen supplementation in hypothermic ESHP in the heart function preservation.</div></div><div><h3>Methods</h3><div>Hearts were procured from Yorkshire pigs (<em>n</em> <!-->=<!--> <!-->35) randomized into 3 preservation therapies: 6<!--> <!-->hours-SCS; 12<!--> <!-->hours-HOP and 12 hours hypothermic non-oxygenated perfusion (HNOP-without oxygen supplementation). For either HOP or HNOP groups, 3 temperatures were tested (5°C; 10°C; 15°C). After the preservation period, hearts had their function assessed in a normothermic perfusion machine capable of working mode, simulating transplantation.</div></div><div><h3>Results</h3><div>All perfusion parameters were stable throughout (mean<!--> <!-->±<!--> <!-->SD): aortic flow 65<!--> <!-->±<!--> <!-->5.57 ml/min, aortic pressure: 11.51<!--> <!-->±<!--> <!-->3.17 mm<!--> <!-->Hg. All HOP hearts presented a better cardiac index than SCS (<em>p</em> <!-->&lt;<!--> <!-->0.05). The HNOP hearts presented similar cardiac function results compared to SCS.</div></div><div><h3>Conclusions</h3><div>HOP for 12 hours had better heart function preservation than SCS for 6 hours. Even HNOP had similar results compared to SCS. Greater edema formation in ESHP hearts did not affect heart function. Hypothermic ESHP safely enhances function preservation compared to SCS.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593236","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":"Advancing the frontier of left ventricular assist device outflow graft stenting: Stenting techniques and outcomes in a landmark case series","authors":"David Gittess MD ,&nbsp;Mohammad A. Al-Ani MD ,&nbsp;Andrew Stein MD ,&nbsp;Juan R. Vilaro MD ,&nbsp;Alex M. Parker MD ,&nbsp;Juan M. Aranda Jr MD ,&nbsp;Mustafa M. Ahmed MD ,&nbsp;Eric Jeng MD ,&nbsp;R. David Anderson MD","doi":"10.1016/j.jhlto.2025.100235","DOIUrl":"10.1016/j.jhlto.2025.100235","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular assist devices (LVADs) have demonstrated a significant mortality and quality-of-life benefit to patients with end-stage heart failure. However, a unique potential complication is outflow graft obstruction (OGO), in which the conduit between the LVAD pump and the aorta is narrowed. Recently, attempts at an endovascular approach with outflow graft stenting have been successful with comparatively low risk relative to surgical replacement of the LVAD. Because of the rarity of this event, optimal stenting technique and periprocedural management are unclear.</div></div><div><h3>Methods</h3><div>In this series of 10 patients, we detail the percutaneous endovascular approach to OGO treatment. All cases were confirmed with contrasted computed tomography.</div></div><div><h3>Results</h3><div>One patient experienced OGO recurrence and one patient had 2 recurrences, making the total interventions analyzed 13. The obstructions were either intrinsic, with accumulation of biodebris between the graft and the outer bend relief in 9 patients, or extrinsic from outflow graft kinking in 4 patients. All patients underwent successful outflow graft stenting confirmed by rapid restoration of pre-obstruction flow (12/13) or elimination of a pressure gradient across a site of suspected obstruction (1/13). Recurrence was observed in 3 instances. We further describe the stenting technique employed and how the unique nature of OGOs impacts the endovascular approach, and post-procedural outcomes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593235","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":"Impact of the angiotensin receptor-neprilysin inhibitor on chronic heart failure due to adult congenital heart disease: A systematic review and meta-analysis","authors":"Bibhuti B. Das MD, MBA, MHA ,&nbsp;Shriprasad Deshpande MD ,&nbsp;Lazaros Nikolaidis MD ,&nbsp;Jianli Niu MD, PhD","doi":"10.1016/j.jhlto.2025.100230","DOIUrl":"10.1016/j.jhlto.2025.100230","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a significant complication in adults with congenital heart disease (ACHD), often requiring advanced therapeutic strategies. Angiotensin receptor-neprilysin inhibitors (ARNIs) have emerged as a promising alternative to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in HF management. However, their safety and efficacy in ACHD-related HF remain unclear. This systematic review and meta-analysis aim to evaluate the impact of ARNIs on functional and safety outcomes in this unique patient population.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of published studies assessing the use of ARNIs in ACHD patients with HF, comparing them to ACEIs/ARBs. The primary outcome was the change in New York Heart Association (NYHA) functional class (FC). Additionally, we assessed the safety profile of ARNIs in this population.</div></div><div><h3>Results</h3><div>Our meta-analysis included 14 studies encompassing 305 patients. Substituting ACEIs/ARBs with ARNIs significantly improved the NYHA functional class (log odds ratio [log OR] 0.67, 95% CI 0.15–1.19; <em>p</em> = 0.01). ARNI therapy was associated with a notable reduction in systolic blood pressure (mean difference [MD] -0.49, 95% CI -0.70 to -0.29, <em>p</em> &lt; 0.001) and an increase in serum creatinine levels (MD 0.30, 95% CI 0.10–0.49, <em>p</em> &lt; 0.001). However, no significant change in serum potassium levels was observed (MD 0.00, 95% CI -0.61–0.61, <em>p</em> = 0.99).</div></div><div><h3>Conclusions</h3><div>The addition of ARNIs to standard HF therapy may enhance functional outcomes in ACHD patients. However, the increased risk of hypotension and elevated serum creatinine levels necessitates careful monitoring. Further research is essential to better define the role of ARNIs in managing ACHD-related HF.</div></div><div><h3>Registration</h3><div>URL: <span><span>https://www.crd.york.ac.uk/prospero</span><svg><path></path></svg></span>; Unique identifier: CRD42024591442.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686701","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":"Radiological distribution patterns in restrictive chronic lung allograft dysfunction: Impact on survival across all phenotypes","authors":"Taiki Fukuda MD, PhD ,&nbsp;Yusei Nakamura MD ,&nbsp;Shu-Chi Tseng MD ,&nbsp;Yuki Ko MD, PhD ,&nbsp;Staci M. Gagne MD ,&nbsp;Takeshi Johkoh MD, PhD ,&nbsp;Yi Li PhD ,&nbsp;David C. Christiani MD, MPH, MS ,&nbsp;Hiroya Ojiri MD, PhD ,&nbsp;Lynette Sholl MD ,&nbsp;Mizuki Nishino MD, MPH ,&nbsp;Hiroto Hatabu MD, PhD","doi":"10.1016/j.jhlto.2025.100232","DOIUrl":"10.1016/j.jhlto.2025.100232","url":null,"abstract":"<div><h3>Background</h3><div>Restrictive chronic lung allograft dysfunction (CLAD) demonstrates poor outcomes after lung transplantation. However, the impact of radiological patterns on survival within a restrictive CLAD under the new International Society for Heart and Lung Transplantation (ISHLT) criteria remains unclear.</div></div><div><h3>Methods</h3><div>We analyzed retrospectively 241 bilateral lung transplant recipients between 2005 and 2021. CLAD was diagnosed and classified per the 2019 ISHLT criteria. Restrictive phenotype included restrictive allograft syndrome (RAS) and mixed phenotype. In these cases, RAS-like opacities (RLOs) were evaluated both qualitatively and semiquantitatively on computed tomography at CLAD diagnosis. RLOs were classified into upper-predominant and diffuse/lower-predominant distribution groups. Overall survival after CLAD diagnosis was assessed using Kaplan-Meier method with log-rank test and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Eighty-three patients were diagnosed with CLAD after transplantation. Twenty-one (25.3%) had restrictive phenotype, which showed shorter survival compared to bronchiolitis obliterans syndrome (median survival: 19.8 vs 68.1 months; hazard ratio [HR], 4.53; 95% confidence interval [CI], 1.96-10.49; <em>p</em> &lt; 0.001). Within the restrictive phenotype, the upper-predominant group demonstrated longer survival than the diffuse/lower-predominant group (median survival: 61.1 vs 15.5 months; <em>p</em> = 0.008). The diffuse/lower-predominant group had shorter survival compared to any other CLAD phenotype (HR, 8.45; 95% CI, 3.40-21.04; <em>p</em> &lt; 0.001). The extent of RLOs within each distribution pattern was not significantly associated with survival.</div></div><div><h3>Conclusions</h3><div>In restrictive phenotype CLAD, RLO distribution patterns determined survival outcomes, with diffuse/lower-predominant showing the poorest prognosis, while the extent of RLOs within each pattern did not correlate with prognosis.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563359","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":"Post lung-transplant predictive value of thermodilution vs estimated Fick cardiac output measurement","authors":"Jose Rivera-Robles MD ,&nbsp;Komal Alam MPH ,&nbsp;Ahmed Abdelmonem MD ,&nbsp;Audrene Edwards MS ,&nbsp;Ahmad Abdelreheim MD ,&nbsp;Susan K. Mathai MD ,&nbsp;Michael Duncan MD ,&nbsp;Chetan Naik MD, MS","doi":"10.1016/j.jhlto.2025.100228","DOIUrl":"10.1016/j.jhlto.2025.100228","url":null,"abstract":"<div><h3>Background</h3><div>Comparison of thermodilution (TD) and indirect Fick (iFick) methods of cardiac output (CO) measurement has not been well described in patients with World Health Organization (WHO) group 3 pulmonary hypertension (PH).</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective chart review of 96 patients with WHO group 3 PH who underwent lung transplantation. For comparison, 32 WHO group 1 pulmonary arterial hypertension patients who were followed in our PH clinic during the same period were also included in the study.</div></div><div><h3>Results</h3><div>TThere was a significant difference between iFick CO and TD CO (5.93+/ -1.5 versus 5.46+/ -1.8 liter/minute, <em>p</em>=0.0061) in WHO group 3 PH. Pulmonary vascular resistance (PVR) calculated using iFick and TD–CO values also differed significantly. TD–PVR was more strongly associated with measures of poor outcomes after lung transplant.</div></div><div><h3>Conclusions</h3><div>iFick-CO and TD-CO can be significantly different in WHO group 3 PH. In cases of discrepancy between iFick and TD-COs, TD-CO correlates better with clinical outcomes after lung transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550794","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":"Single lung transplantation for pulmonary fibrosis: Does side matter?","authors":"Frank Langer ,&nbsp;Ina Starniske ,&nbsp;Bettina Weingard ,&nbsp;Parviz Aliyev ,&nbsp;Migdat Mustafi ,&nbsp;Robert Bals ,&nbsp;Heinrike Wilkens","doi":"10.1016/j.jhlto.2025.100229","DOIUrl":"10.1016/j.jhlto.2025.100229","url":null,"abstract":"<div><h3>Background</h3><div>The implementation of the Lung Allocation Score in the Eurotransplant international collaborative framework decreased waiting list mortality, but organ shortage remains a significant problem. Single lung transplantation (sLTx)—whenever possible—may decrease waiting list mortality. We have consistently employed sLTx for recipients with pulmonary fibrosis. In the current investigation, we sought to analyze if this strategy can lead to an acceptable long-term outcome and if the side of sLTx has an impact on the outcome.</div></div><div><h3>Methods</h3><div>Between 1995 and 2024, we performed 138 sLTx for patients with pulmonary fibrosis (54 ± 9 years, 88 male). Data and outcomes were analyzed retrospectively comparing recipients receiving left sLTX (<em>n</em> = 98) and right sLTx (<em>n</em> = 40).</div></div><div><h3>Results</h3><div>Survival was 83%, 59%, and 29% at 1, 5, and 10 years for the total patient cohort. Survival was similar for left and right sLTx (83 vs 81%, 58 vs 64%, and 29 vs 28% at 1, 5, and 10 years, <em>p</em> = 0.54). Left and right transplantations lead to similar best post-transplant forced expiratory volume per second (74% ± 20% vs 74% ± 21%, <em>p</em> = 0.86). While the total lung capacity (TLC) ratio TLC_donor/predicted TLC_recipient was similar between groups (104% vs 100%), the ratio TLC_donor/actual TLC_recipient was higher in left sLTx (185% vs 158%, <em>p</em> = 0.04). On multivariate regression analysis, postoperative pneumonia (<em>p</em> = 0.003, hazard ratio 3.404) and sepsis (<em>p</em> = 0.002, hazard ratio 10.700) were identified as predictors for early mortality.</div></div><div><h3>Conclusions</h3><div>Performing sLTx for pulmonary fibrosis patients can be an effective strategy to optimize donor utilization and improve outcomes—irrespective of graft side.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508516","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":"Fungal colonization before or after lung transplantation has no negative impact on survival or the development of chronic lung allograft dysfunction","authors":"Embla Bodén ,&nbsp;Fanny Sveréus ,&nbsp;Anna Niroomand ,&nbsp;Hamid Akbarshahi ,&nbsp;Richard Ingemansson ,&nbsp;Hillevi Larsson ,&nbsp;Sandra Lindstedt ,&nbsp;Franziska Olm","doi":"10.1016/j.jhlto.2025.100225","DOIUrl":"10.1016/j.jhlto.2025.100225","url":null,"abstract":"<div><h3>Introduction</h3><div>Long-term survival following lung transplantation (LTx) faces impediments due to chronic lung allograft dysfunction (CLAD), while infections hinder short-term survival. Fungal colonization and invasive fungal infections (IFI) are common within the first year after LTx. There is ongoing debate regarding the impact of such events on CLAD development and mortality. This study aims to investigate this matter further.</div></div><div><h3>Methods</h3><div>A total of 134 LTx recipients transplanted between 2011 and 2020 were included. The median follow-up time was 3.9 years. Fungal colonization and IFI were defined according to international consensus guidelines and were noted if present within the first 12 months after LTx.</div></div><div><h3>Results</h3><div>Postoperative fungal colonization was found in 101 patients, and 14 patients had an IFI within twelve months of transplantation. Nineteen patients were neither colonized nor infected. Out of the 115 patients with colonization or IFI, 61 patients had growth of a yeast such as <em>Candida</em> species (spp.). Fifty-six patients were colonized prior to LTx. Being colonized with fungus before or within the first 12 months post-LTx did not significantly affect survival or CLAD development.</div></div><div><h3>Conclusions</h3><div>The results of the current study indicate that fungal colonization either pre-transplantation or within the first 12 months after does not correlate with increased risks of mortality or CLAD development. These findings show that while fungal colonization is a common occurrence in LTx recipients, it does not predispose the patients of the cohort to adverse outcomes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454585","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":"Sleeve gastrectomy as a bridge to cardiac recovery - A retrospective comparative cohort study","authors":"Thomas Goubar MD ,&nbsp;Samuel Kim MD ,&nbsp;David Cistulli MD ,&nbsp;Douglas Fenton-Lee MBBS ,&nbsp;R. Louise Rushworth PhD ,&nbsp;Peter S. Macdonald MD, PHD ,&nbsp;Anne M. Keogh MBBS","doi":"10.1016/j.jhlto.2025.100224","DOIUrl":"10.1016/j.jhlto.2025.100224","url":null,"abstract":"<div><h3>Background</h3><div>Obesity in patients with heart failure with reduced ejection fraction (HFrEF) increases morbidity and may preclude them from accessing advanced heart failure therapies. Bariatric surgery, specifically sleeve gastrectomy (SG), may improve eligibility for cardiac transplant; however, its impact on heart failure outcomes is not well defined.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with obesity (body mass index [BMI] ≥35 kg/m²) and (left ventricular ejection fraction [LVEF] ≤40%) who underwent SG at a tertiary heart transplant center. Outcomes were compared with controls matched for age, sex, LVEF, and BMI receiving standard care. We evaluated BMI, New York Heart Association (NYHA) functional class, medications, echocardiographic parameters, time to advanced heart failure therapies, and survival.</div></div><div><h3>Results</h3><div>Twenty patients (median BMI 42.8 kg/m², LVEF 25%) underwent SG compared to 40 matched patients. Both groups demonstrated reductions in BMI; however, weight loss was significantly greater in the treatment group (−9.9 [95% CI −12.2, −7.6] vs. −2.7 [−4.3, −1.1] kg/m², p &lt; 0.05). Despite this, improvements in LVEF (+16.6% [10.2, 23.0] vs. +0.1% [−4.4, 4.7], p &lt; 0.05) along with NYHA class (−0.8 [95% CI: −1.3, −0.3] vs. +0.4 [0.1, 0.7], p &lt; 0.05) were only observed in those receiving SG. Overall survival was significantly higher in the treatment group [HR: 0.2 (0.07, 0.62), p &lt; 0.01], which had no deaths compared to 35% in the comparison group.</div></div><div><h3>Conclusion</h3><div>In patients with HFrEF and obesity, SG is associated with significant improvements in cardiac function and survival compared to standard care, supporting its role as a safe and effective bridge to recovery or candidacy.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"8 ","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454744","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":"Lung transplantation for pulmonary chronic graft-versus-host disease: a missed opportunity?","authors":"Andrea Zajacova MD ,&nbsp;Hélène Schoemans MD, PhD ,&nbsp;Mark Greer MD, MRCP ,&nbsp;Hildegard Greinix MD ,&nbsp;Peter Jaksch MD ,&nbsp;Osnat Shtraichman MD ,&nbsp;Rayid Abdulqawi MD, PhD ,&nbsp;Are M. Holm MD, PhD ,&nbsp;Robin Vos MD, PhD ,&nbsp;Saskia Bos MD, PhD","doi":"10.1016/j.jhlto.2025.100209","DOIUrl":"10.1016/j.jhlto.2025.100209","url":null,"abstract":"<div><div>Chronic graft-versus-host disease is a common complication after allogeneic hematopoietic stem cell transplantation, with pulmonary chronic graft-versus-host disease (PcGvHD) particularly associated with a dismal prognosis. Lung transplantation (LuTx) is a final therapeutic option for well-selected patients affected by this condition. Nevertheless, only a small group of PcGvHD patients are referred for LuTx. This review addresses common concerns regarding referral and listing of PcGvHD patients for LuTx (such as risk of relapse of hematological malignancy, infectious complications and rejection) and survival outcomes of this specific cohort of patients. Importantly, LuTx for PcGvHD has comparable outcomes to other indications. The establishment of specific LuTx indication criteria for PcGvHD patients may improve referral rates and timing of both referral and listing of suitable candidates.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377576","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":"Pulmonary hypertension in Finland 2008-2020: A descriptive real-world cohort study (FINPAH)","authors":"Markku Pentikäinen ,&nbsp;Piia Simonen ,&nbsp;Helena Tuunanen ,&nbsp;Pauliina Leskelä ,&nbsp;Terttu Harju ,&nbsp;Pertti Jääskeläinen ,&nbsp;Christian Asseburg ,&nbsp;Minna Oksanen ,&nbsp;Erkki Soini ,&nbsp;Christina Wennerström ,&nbsp;Airi Puhakka","doi":"10.1016/j.jhlto.2024.100191","DOIUrl":"10.1016/j.jhlto.2024.100191","url":null,"abstract":"<div><h3>Background</h3><div>To assess characteristics, risk group distribution, and prognosis of patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) in Finland.</div></div><div><h3>Methods</h3><div>Clinical chart review of patients with PAH or CTEPH recorded between 2008 and 2019 and linkage to official mortality data.</div></div><div><h3>Results</h3><div>We identified 627 patients, with 502 (80%) diagnosed after 2008, yielding an incidence of PAH and CTEPH of 4.0 and 2.9/million/year, respectively. The median time from symptoms to diagnosis was 1 year. Mean age at diagnosis of PAH patients (<em>n</em> = 268) was 57 years, 73% were women, 40% had idiopathic PAH, 28% associated with connective tissue diseases, and 15% with congenital heart disease, 9% had ≥3 cardiovascular comorbidities. At 1 year, 34%/34%/24%/8% were at the low/intermediate-low/intermediate-high/high Compera 2.0 risk classification groups. Survival was 91.3%, 74.8%, and 62.6% at 1, 3, and 5 years, respectively, with an improving trend over calendar time. Ten PAH patients had a lung transplant. PAH subtype, cardiac output, and the presence of ischemic heart disease or type 2 diabetes predicted survival.</div><div>CTEPH patients (<em>n</em> = 189) were 63 years (mean) at diagnosis and 49% were women. Of the CTEPH patients, 29% underwent pulmonary endarterectomy (PEA) and 22% were treated with balloon pulmonary angioplasty. Survival was 94.6%, 87.2%, and 79.4% at 1, 3, and 5 years, respectively. PEA patients were younger, had fewer comorbidities, and had longer survival than non-PEA patients.</div></div><div><h3>Conclusions</h3><div>Incidence and survival of PAH and CTEPH patients in Finland were similar to previously presented data for other countries.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173254","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}