JHLT Open最新文献

{"title":"Lung transplantation from donation after circulatory death donors over 55 years old: A national analysis of outcomes and utilization","authors":"Isaac S. Alderete MD MHS ,&nbsp;Samantha E. Halpern MD MHS ,&nbsp;Oliver K. Jawitz MD MHS ,&nbsp;Ahmed Gurses MD ,&nbsp;Haoran Jiang ,&nbsp;Hiroshi Date MD ,&nbsp;Jacob Klapper MD MHS ,&nbsp;Matthew G. Hartwig MD MHS ,&nbsp;Kunal J. Patel MD PhD","doi":"10.1016/j.jhlto.2025.100423","DOIUrl":"10.1016/j.jhlto.2025.100423","url":null,"abstract":"<div><h3>Background</h3><div>Lungs from older donation after circulatory death (DCD) donors are underutilized; however, these organs may represent an opportunity to expand the donor pool. Herein, we evaluated utilization and outcomes of lung transplants using lungs from older DCD donors.</div></div><div><h3>Methods</h3><div>Using national data from 2016 to 2024, we identified all adult DCD donors and corresponding isolated lung transplant recipients. Multivariable logistic regression was used to identify predictors of lung utilization. Kaplan-Meier and Cox proportional hazards methods were used to compare graft survival between recipients of lungs from DCD donors &lt;55 and ≥55 years.</div></div><div><h3>Results</h3><div>Among 10,769 older (age ≥ 55) DCD donors identified, lungs were transplanted from only 302 (2.8%) with significant organ procurement organization- and center-level variation in use. Just one center exceeded 50 transplants using older DCD donors over the study period. Utilization increased over time (7 cases in 2016 vs 111 in 2024; <em>p</em> &lt; 0.001). Ex-vivo lung perfusion (odds ratio 5.93) and higher PaO₂/FiO₂ ratio (odds ratio 1.33 per 50-point increase) were independently associated with transplantation of older DCD donor lungs. One- and three-year graft survival were similar between age groups; older donor age was not associated with increased risk of graft failure in adjusted models.</div></div><div><h3>Conclusions</h3><div>Lungs from older DCD donors remain underutilized despite comparable outcomes. Their use is highly concentrated among a small number of centers and organ procurement organizations, suggesting that local behaviors and infrastructure strongly influence disposition. Broader adoption of ex-vivo lung perfusion and strategic recipient matching may support safe expansion of this untapped donor pool.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571803","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":"Impact of initial hematocrit levels during direct procurement and perfusion on the likelihood of primary graft dysfunction in donation after circulatory death heart transplantation","authors":"Emmanuel Odekunle BS ,&nbsp;Adham Makarem MD, MPH ,&nbsp;George Olverson BS ,&nbsp;Kamila Drezek BS ,&nbsp;Eriberto Michel MD ,&nbsp;David D’Alessandro MD ,&nbsp;Ioannis Mastoris MD ,&nbsp;Shannon N. Tessier PhD ,&nbsp;Asishana Osho MD, MPH ,&nbsp;S. Alireza. Rabi MD, PhD","doi":"10.1016/j.jhlto.2025.100442","DOIUrl":"10.1016/j.jhlto.2025.100442","url":null,"abstract":"<div><h3>Background</h3><div>Optimizing perfusion parameters when using ex vivo heart perfusion systems is critical for maximizing organ quality and extending perfusion duration. Hematocrit (HCT) of the perfusate may influence oxygen delivery and perfusion dynamics, yet its clinical significance remains uncertain.</div></div><div><h3>Methods</h3><div>In this retrospective single-center study, we utilize regression models to explore the relationship between hematocrit (HCT) of the device perfusate during normothermic machine perfusion (using the Transmedics Organ System [OCS]) and recipient outcomes following transplantation. Cohorts with HCT &lt;15% packed cell volume [PCV] were compared with those with HCT ≥15% PCV.</div></div><div><h3>Results</h3><div>Among 74 recipients, moderate and severe primary graft dysfunction (defined as needing extracorporeal machine oxygenation post-transplant) did not differ significantly between cohorts. Mean inotrope scores 48 hours post admission were significantly higher in recipients with higher perfusate HCT. The ICU length of stay in the higher HCT group was numerically high but did not achieve statistical significance.</div></div><div><h3>Conclusion</h3><div>Higher perfusate HCT was not associated with reduced PGD and may be linked to increased postoperative support requirements. These findings raise important questions about optimal HCT levels for ex vivo perfusion and warrant further prospective investigation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100442"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789608","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":"Lung transplantation for chronic thromboembolic pulmonary hypertension","authors":"Laurent Godinas ,&nbsp;Michaela Orlitová ,&nbsp;Emanuele Muscogiuri ,&nbsp;Laurens J. Ceulemans ,&nbsp;Elie Fadel ,&nbsp;Marion Delcroix ,&nbsp;Tom Verbelen","doi":"10.1016/j.jhlto.2025.100461","DOIUrl":"10.1016/j.jhlto.2025.100461","url":null,"abstract":"<div><div>Therapeutic advances in chronic thromboembolic pulmonary hypertension (CTEPH) over the last 10 years have improved patient prognosis. As a result, the role of lung transplantation (LTx) for this indication has been greatly reduced. In this review article, we describe the evolution of treatments for CTEPH, the place that remains for lung transplantation, and the particularities of lung transplantation for this indication.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839581","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":"Bronchial stenosis after lung transplant: Risk factors and clinical outcomes","authors":"Antonio Coppolino ,&nbsp;Rie Maurer ,&nbsp;Ella Woehl ,&nbsp;Erin M. Connolly ,&nbsp;Elene Chamberlin ,&nbsp;Hilary J. Goldberg ,&nbsp;Selvin S. Jacob ,&nbsp;Stefi F. Lee ,&nbsp;John C. Kennedy ,&nbsp;Adil Sheikh ,&nbsp;Audra J. O’Neill ,&nbsp;Simran Gupta ,&nbsp;Ruben A. Hernandez Acosta ,&nbsp;Victor Kovac ,&nbsp;Mohamed Keshk ,&nbsp;Amy Hackmann ,&nbsp;John Dunning ,&nbsp;Nirmal S. Sharma ,&nbsp;Lindsey R. Baden ,&nbsp;Ann E. Woolley","doi":"10.1016/j.jhlto.2025.100392","DOIUrl":"10.1016/j.jhlto.2025.100392","url":null,"abstract":"<div><h3>Background</h3><div>Bronchial stenosis is a known complication after lung transplantation, but risk factors remain incompletely understood. We identified predictors of bronchial stenosis requiring bronchoscopic intervention, with a focus on post-transplant bacterial infections, and its impact on clinical outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 342 adult lung transplant recipients at a single center between 2017 and 2023. Bronchial stenosis was defined as localized airway narrowing requiring intervention. Clinical, perioperative, and infectious variables—censored to precede the onset of stenosis—were analyzed using univariate and multivariable logistic regression. Outcomes included survival, acute cellular and antibody-mediated rejection, and chronic lung allograft dysfunction (CLAD).</div></div><div><h3>Results</h3><div>Thirty-four patients (9.9%) developed bronchial stenosis requiring intervention. Multivariable analysis identified male sex (OR: 2.77, 95% CI: 1.13–6.79, <em>p</em> = 0.0261), pulmonary graft dysfunction (PGD) (OR: 3.45, 95% CI: 1.23–9.69, <em>p</em> = 0.0190), length of index hospitalization (OR: 1.01, 95% CI: 1.00–1.02, <em>p</em> = 0.0479), and any positive post-transplant bacterial respiratory culture—prior to onset of stenosis—(OR: 3.97, 95% CI: 1.67–9.48, <em>p</em> = 0.0019) as independent risk factors. Pneumonia and colonization with <em>Pseudomonas aeruginosa</em> or other gram-negatives were strongly associated with stenosis, while <em>Staphylococcus aureus</em> infections and colonization were not. Bronchial stenosis did not significantly impact survival, rejection, or CLAD incidence.</div></div><div><h3>Conclusions</h3><div>Bronchial stenosis following lung transplantation is associated with PGD and bacterial airway infections, particularly <em>Pseudomonas</em> species or other gram negatives. These findings support an association between early gram-negative bacterial airway infections and bronchial stenosis and highlight the need for infection prevention and further prospective studies to clarify causal mechanisms and guide targeted interventions.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026122","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":"The unsung heroes: A scoping review of the experiences of lung transplant informal caregivers","authors":"Jane Simanovski PhD, NP ,&nbsp;Jody Ralph PhD, RN ,&nbsp;Jamie Crawley PhD, RN ,&nbsp;Kelly Bryce PhD ,&nbsp;Dana Sleiman BScN, RN ,&nbsp;Edward Cruz PhD, RN","doi":"10.1016/j.jhlto.2025.100472","DOIUrl":"10.1016/j.jhlto.2025.100472","url":null,"abstract":"<div><div>Informal caregivers support patients after lung transplantation (LTx). With growing recognition of the multiple demands placed on caregivers, this scoping review aimed to systematically map the literature surrounding informal caregiving experiences after LTx using JBI guidelines. Multiple databases were searched from January 2010 to May 2025 based on a combination of synonyms and controlled vocabulary related to “caregiver” and “lung transplant recipients”. A total of 404 records were screened after the removal of duplicates. Among these, 16 sources met the inclusion criteria with 12 (75%) classified as full publications, 3 (19%) peer-reviewed conference abstracts, and 1 poster presentation. Most studies were based in North America (11/16 [69%]) with the remainder from Europe or Australia. Only 19% (3/16) of the sources were published within the past 5 years. There were 7 qualitative studies (44%), 6 quantitative (38%), 2 mixed methods (12%), and 1 literature review. Informal caregivers described a wide variety of challenges ranging from high levels of caregiver burden, psychological and emotional impacts, handling multiple daily practicalities, knowledge deficits, and the need for more support. Positive experiences of the informal caregiver role include positive adjustment, presence of support networks and relationships, improved quality of life, and benefiting from educational support and preparation. Informal caregivers remain an integral resource in supporting patients after LTx. However, most available evidence predates recent advances in transplantation practice—with 80% published before 2020—limiting its current relevance and highlighting the need for further research and targeted interventions to support this population.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100472"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975964","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":"Right ventricular function assessment by transesophageal echocardiography in lung transplantation: Preoperative, intraoperative, and postoperative considerations","authors":"Etienne Revelly ,&nbsp;André Denault ,&nbsp;Alex Moore","doi":"10.1016/j.jhlto.2025.100412","DOIUrl":"10.1016/j.jhlto.2025.100412","url":null,"abstract":"<div><h3>Background</h3><div>Right ventricular (RV) function is a key determinant of outcomes in lung transplantation, particularly in patients with pre-existing pulmonary hypertension. The RV is uniquely sensitive to perioperative hemodynamic stressors, including ischemia-reperfusion injury, abrupt afterload changes, and allograft implantation.</div></div><div><h3>Purpose</h3><div>This review aims to summarize the perioperative echocardiographic assessment of RV function in lung transplantation, emphasizing the role of transesophageal echocardiography (TEE) in evaluating RV performance and guiding intraoperative management.</div></div><div><h3>Methods</h3><div>A comprehensive synthesis of recent literature was performed, focusing on echocardiographic parameters relevant to RV evaluation during the preoperative, intraoperative, and postoperative phases of lung transplantation. Both conventional and advanced imaging modalities were reviewed.</div></div><div><h3>Discussion</h3><div>TEE provides real-time insights into RV adaptation and dysfunction. Key parameters include fractional area change, tricuspid annular plane systolic excursion (TAPSE), tricuspid annular velocity (S’), and speckle-tracking–derived strain. Three-dimensional echocardiography enhances volumetric and geometric assessment, while venous congestion indices such as the Venous Excess Ultrasound (VExUS) score offer indirect hemodynamic evaluation. Intraoperatively, dynamic monitoring supports optimization of preload, afterload, and inotrope therapy. Postoperative complications—such as RV outflow tract obstruction and pulmonary vascular anastomotic dysfunction—require prompt recognition. Persistent RV dysfunction despite afterload reduction may reflect intrinsic myocardial disease.</div></div><div><h3>Conclusion</h3><div>Comprehensive echocardiographic evaluation throughout all perioperative phases is essential for optimizing RV performance and improving outcomes in lung transplantation. Future studies should aim to standardize RV assessment protocols and validate multimodal imaging approaches for perioperative clinical decision-making.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469028","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":"Optimizing recovery of marginal donor hearts with low ejection fraction: A national retrospective study from Switzerland","authors":"Raphaël Giraud ,&nbsp;Selina Adam ,&nbsp;Benjamin Assouline ,&nbsp;Franziska Beyeler ,&nbsp;Roger Hullin ,&nbsp;Karim Bendjelid ,&nbsp;Franz Immer","doi":"10.1016/j.jhlto.2025.100411","DOIUrl":"10.1016/j.jhlto.2025.100411","url":null,"abstract":"<div><h3>Background</h3><div>In Switzerland, heart transplantation is limited by donor availability. Marginal donor hearts—characterized by older age, comorbidities, or reduced left ventricular ejection fraction (LVEF)—are often declined despite being structurally normal. Since impaired LVEF may be reversible, optimized donor management could improve cardiac function and transplant eligibility.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 415 brain-dead donors (2017–2021) from the Swiss Organ Allocation System. Donors were categorized as optimal (LVEF ≥50%) or marginal (LVEF 15–49%), irrespective of structural abnormalities, to focus on a modifiable functional parameter. Predictors of heart transplantation were assessed using univariate and multivariable logistic regression. Additional analyses evaluated hemodynamic monitoring, diagnostic strategies, management duration, and functional recovery based on serial echocardiography.</div></div><div><h3>Results</h3><div>Among 415 donors, 287 were optimal and 62 marginal. Transplantation rates were higher in optimal hearts (62.7% vs. 23.6%, p &lt; 0.001). LVEF ≥50% independently predicted transplantation (adjusted OR = 4.56; 95% CI: 2.34–8.89; p &lt; 0.001), together with younger age, lower norepinephrine dose, central monitoring, and repeated echocardiography. Marginal hearts demonstrated significant improvement in LVEF after optimized management (p &lt; 0.0001), suggesting that reversible dysfunction can be mitigated through tailored hemodynamic and pharmacologic strategies.</div></div><div><h3>Conclusions</h3><div>Optimized donor management can restore left ventricular function in marginal hearts and enhance transplant eligibility. Standardized national guidelines may help expand the donor pool and improve transplantation outcomes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469086","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":"Left ventricular assist device implantation in advanced kidney disease","authors":"Benjamin N. French MD ,&nbsp;Anudeep S. Nakirikanti MD ,&nbsp;Ian Kusher BS ,&nbsp;Kris Wittersheim RN, MSN, APRN-BC ,&nbsp;J. David Vega MD ,&nbsp;Mani Daneshmand MD ,&nbsp;Divya Gupta MD","doi":"10.1016/j.jhlto.2025.100422","DOIUrl":"10.1016/j.jhlto.2025.100422","url":null,"abstract":"<div><h3>Background</h3><div>Advanced chronic kidney disease (CKD) is often considered a contraindication to left ventricular assist device (LVAD) implantation, yet limited data exist on outcomes in the era of the HeartMate 3 device.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 193 patients who underwent HeartMate 3 LVAD implantation at a tertiary care academic medical center between July 2016 and July 2023. Patients were stratified by preoperative estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m² (control, <em>n</em> = 154) vs &lt;30 (advanced kidney disease, <em>n</em> = 39). Outcomes included survival and the need for renal replacement therapy (RRT).</div></div><div><h3>Results</h3><div>At 30 days post-implantation, survival was lower in advanced kidney disease patients compared with controls (84.6% vs 94.2%, <em>p</em> = 0.04). However, survival at 1 year (79.5% vs 79.9%, <em>p</em> = 0.87) and 2 years (73.9% vs 68.7%, <em>p</em> = 0.60) did not differ significantly. Post-implantation RRT was required in 30.3% of advanced kidney disease patients and 18.2% of controls (<em>p</em> = 0.18).</div></div><div><h3>Conclusions</h3><div>Although early postoperative mortality is higher, patients with advanced CKD undergoing HeartMate 3 LVAD implantation achieve comparable 1- and 2-year survival to controls. These findings suggest LVAD implantation may be a reasonable option in carefully selected patients with advanced kidney disease.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100422"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521156","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":"Histidine-rich glycoprotein ameliorated lung ischemia-reperfusion injury in a mouse model","authors":"Yujiro Kubo MD, PhD ,&nbsp;Seiichiro Sugimoto MD, PhD ,&nbsp;Daiki Ousaka PhD ,&nbsp;Dengli Wang PhD ,&nbsp;Toshiaki Ohara MD, PhD ,&nbsp;Toshio Shiotani MD, PhD ,&nbsp;Shin Tanaka MD, PhD ,&nbsp;Ken Suzawa MD, PhD ,&nbsp;Kazuhiko Shien MD, PhD ,&nbsp;Kentaroh Miyoshi MD, PhD ,&nbsp;Mikio Okazaki MD, PhD ,&nbsp;Yasuyuki Hosono MD, PhD ,&nbsp;Akihiro Matsukawa MD, PhD ,&nbsp;Shinichi Toyooka MD, PhD","doi":"10.1016/j.jhlto.2025.100453","DOIUrl":"10.1016/j.jhlto.2025.100453","url":null,"abstract":"<div><h3>Background</h3><div>Histidine-rich glycoprotein (HRG) is a multifunctional plasma glycoprotein involved in the regulation of various biological processes. Decreased plasma levels of HRG at 72 h after lung transplantation have been shown to be associated with severe primary graft dysfunction and poor transplant outcomes. In this study, we examined the effect of HRG supplementation on lung ischemia-reperfusion injury (IRI) in mice.</div></div><div><h3>Methods</h3><div>The experimental mice were divided into a Sham group and three IRI groups (n=5 each) that received phosphate-buffered saline, human serum albumin, or HRG (HRG/IRI group), respectively. The lung function, lung injury, neutrophil infiltration, cellular apoptosis, inflammatory mediators, neutrophil extracellular traps (NETs), translocation status of high-mobility group box 1 (HMGB1), and hemolytic products in the injured tissue/plasma were compared among the groups.</div></div><div><h3>Results</h3><div>The HRG/IRI group showed significantly improved oxygenation capacity and a reduced severity of lung injury as compared with the other IRI groups. The HRG/IRI group also showed significantly less severe tissue inflammation in the reperfused lung, including a lower level of neutrophil infiltration, apoptotic cells, and neutrophil-associated inflammatory mediators than the other IRI groups. Moreover, formation of NETs and HMGB1 translocation were significantly suppressed in the HRG/IRI group as compared with the other IRI groups. A significantly greater degree of scavenging of hemolytic products was observed in the HRG/IRI group than the other IRI groups.</div></div><div><h3>Conclusion</h3><div>HRG supplementation ameliorated lung IRI in mice by suppressing inflammatory responses triggered by neutrophil-associated factors, including formation of NETs, HMGB1 translocation, and accumulation of hemolytic products.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100453"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736370","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":"Parasitic diseases in heart transplantation: challenges of Toxoplasmosis and Chagas Disease","authors":"Alexandre Mestre Tejo MD ,&nbsp;Silvia Vidal Campos PhD","doi":"10.1016/j.jhlto.2025.100450","DOIUrl":"10.1016/j.jhlto.2025.100450","url":null,"abstract":"<div><div>Parasitic diseases have always caused a significant burden in endemic countries. However, due to globalization and immigration, more cases are emerging in non-endemic regions, leading to a growing incidence in solid organ transplantation. These immunocompromised patients, such diseases, have the potential to reactivate and cause severe disease and graft damage, often leading to death. Two specific parasites play a special role in the heart transplant scenario: <em>Trypanosoma cruzi</em>, responsible for Chagas disease, and T<em>oxoplasma gondii</em>, for Toxoplasmosis. In endemic countries, Chagas disease is not only one of the main indications for a heart transplant, but also responsible for several episodes of reactivation after transplantation, requiring careful surveillance for preemptive treatment. <em>T. gondii</em> has the potential to reactivate in immunocompromised hosts, leading to myocarditis and/or disseminated disease, often fatal. Prophylaxis is safe and effective to prevent reactivation. This review aims to summarize the most important aspects of Chagas disease and Toxoplasmosis in the heart transplant setting, with emphasis on pre-transplant screening, prophylaxis, and monitoring.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100450"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839590","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}