JHLT Open最新文献

{"title":"BTT-ECMO Trends and Outcomes Under Revised Heart Allocation System","authors":"Aniket S. Rali MD, FACC, FCCP ,&nbsp;Het Patel ,&nbsp;Matthew M. Lander ,&nbsp;Kaitlyn Brennan ,&nbsp;John Trahanas ,&nbsp;Kelly Schlendorf ,&nbsp;JoAnn Lindenfeld ,&nbsp;Manreet Kanwar","doi":"10.1016/j.jhlto.2024.100180","DOIUrl":"10.1016/j.jhlto.2024.100180","url":null,"abstract":"<div><div>Under the revised UNOS heart allocation system, waitlist and post-transplant outcomes among patients bridged to transplant with VA-ECMO (BTT-ECMO) have improved. However, it remains largely unknown if these early trends have persisted over time. We queried the UNOS database for all adult heart-only BTT-ECMO recipients between January 2019 and December 2022. Our analysis shows that under the revised system, waitlist mortality and 1-year post-transplant outcomes have remained favorable, despite increased utilization of BTT-ECMO. This finding supports the original intent of the revised allocation system in ensuring more rapid transplantation of the sickest patients while avoiding a higher post-HT mortality.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173012","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":"Myocardial functional recovery following durable ventricular assist device in children","authors":"Bhavikkumar Langanecha ,&nbsp;Osami Honjo ,&nbsp;Alyssa Power ,&nbsp;Oshri Zaulan ,&nbsp;Christoph Haller ,&nbsp;Kristen George ,&nbsp;Linda Fazari ,&nbsp;Andrea Maurich ,&nbsp;David Chiasson ,&nbsp;Aamir Jeewa","doi":"10.1016/j.jhlto.2024.100181","DOIUrl":"10.1016/j.jhlto.2024.100181","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular assist device (VAD) explantation following myocardial functional recovery (MFR) for heart failure (HF) is uncommon in children and is associated with a risk of HF recurrence.</div></div><div><h3>Material and Methods</h3><div>Retrospective, single-center study of pediatric patients who were supported with durable VADs, both intracorporeal continuous flow devices (CFD) and paracorporeal pulsatile flow devices (PFD), between 2004 and 2022.</div></div><div><h3>Results</h3><div>A total of 74 children, of which 43 were female, underwent VAD implantation (PFD = 61 and CFD = 14) at a median (interquartile range) age of 5.6 (0.8, 13.5) years and with a weight of 16.2 (7.5, 40.7) kg. From this cohort, we identified 9 of 75 (12%) children who underwent VAD explantation for MFR. Of those, 7 of 9 (77%) were under 2 years of age and 6 of 9 (67%) were supported for &gt;90 days. Five patients had dilated cardiomyopathy, 3 with anomalous left coronary artery from pulmonary artery and 1 with tachycardia-induced cardiomyopathy. Six were listed for transplantation as a part of their HF management strategy following VAD implantation. After explant, 8 of 9 patients remained in HF remission with no symptoms and stable left ventricular function. One patient had a recurrence of HF following explantation after demonstrating MFR while on VAD support.</div></div><div><h3>Conclusions</h3><div>MFR resulting in VAD explantation is feasible in children with chronic HF especially for those &lt;2 years of age. Further work is needed to better identify the features that promote MFR and maintain it after explant.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173786","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 transplant outcomes for recipients with alpha-1 antitrypsin deficiency, by use of alpha-1 antitrypsin augmentation therapy","authors":"Atharv V. Oak MEng ,&nbsp;Jessica M. Ruck MD, PhD ,&nbsp;Alfred J. Casillan MD, PhD ,&nbsp;Armaan F. Akbar BS ,&nbsp;Ramon A. Riojas MD, PhD ,&nbsp;Pali D. Shah MD ,&nbsp;Jinny S. Ha MD, MHS ,&nbsp;Sara Strout PharmD ,&nbsp;Allan B. Massie PhD ,&nbsp;Dorry L. Segev MD, PhD ,&nbsp;Christian A. Merlo MD, MPH ,&nbsp;Errol L. Bush MD","doi":"10.1016/j.jhlto.2024.100201","DOIUrl":"10.1016/j.jhlto.2024.100201","url":null,"abstract":"<div><h3>Background</h3><div>For patients with alpha-1 antitrypsin (AAT) deficiency, AAT augmentation therapy can be an important part of care. However, for those who require a lung transplant (LT), there is currently only limited information to guide the use of AAT augmentation therapy post-LT.</div></div><div><h3>Methods</h3><div>We identified all LT recipients from 2011-2021 in the Scientific Registry of Transplant Recipients with an AAT deficiency diagnosis. We categorized recipients by use of AAT augmentation therapy post-LT and compared their baseline characteristics using Fisher’s exact test and Wilcoxon rank-sum tests. We used Kaplan-Meier analyses and estimated the average treatment effect (ATE) of post-LT AAT augmentation therapy on mortality and all-cause graft failure (ACGF). The ATE measures the observed effect we would see if everyone in the population received the intervention as opposed to just a subset.</div></div><div><h3>Results</h3><div>Among the 447 recipients with AAT deficiency, 109 used AAT augmentation therapy pre-LT, of which 32 (29.4%) continued post-LT. Recipients who used augmentation therapy post-LT were younger (56.5 [53-59.75] vs 57 [53.75-63], <em>p</em> = 0.04) and had shorter ischemia time (mean 311 vs 363 minutes, <em>p</em> = 0.03) than those who did not. The age-adjusted ATE estimate of post-LT augmentation therapy use on time to death and ACGF was +1.69 and +1.48 years, respectively. Post-LT augmentation therapy use was associated with a mortality reduction in the top quartile bilirubin subgroup (<em>p</em> = 0.02, log-rank test).</div></div><div><h3>Conclusions</h3><div>In our study, the use of augmentation therapy post-LT was associated with improved survival. Confirmatory prospective studies should be considered to inform post-LT AAT therapy guidelines.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172817","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":"Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons.","authors":"Awab Ahmad MD ,&nbsp;Timothy R. Harris MD ,&nbsp;Aaron Williams MD ,&nbsp;Alexandra DeBose-Scarlett MD ,&nbsp;Rubayet Kamal BS ,&nbsp;Enock Atta Adjei MD ,&nbsp;Hasan K. Siddiqi MD ,&nbsp;Chen Chia Wang ,&nbsp;Mark Petrovic ,&nbsp;Clifton D. Keck ,&nbsp;Shelley R. Scholl RN ,&nbsp;Ashish S. Shah MD ,&nbsp;Swaroop Bommareddi MD ,&nbsp;Brian Lima MD MBA ,&nbsp;John M. Trahanas MD","doi":"10.1016/j.jhlto.2025.100217","DOIUrl":"10.1016/j.jhlto.2025.100217","url":null,"abstract":"<div><h3>Background</h3><div>Local surgeon recovery of donor livers and kidneys is common and well-studied. This practice is rare and poorly studied in cardiac transplantation. We examined clinical outcomes of cardiac allografts recovered by local surgeons vs. recipient institution surgeons.</div></div><div><h3>Methods</h3><div>A retrospective review of all recoveries of adult cardiac allografts from brain dead donors for a single academic transplant center between 1/2020 and 12/2021 was performed. Donor and recipient baseline characteristics, distance traveled and ischemic time, and recipient outcomes were collected. Primary graft dysfunction (PGD) was determined based on 2014 ISHLT guidelines.</div></div><div><h3>Results</h3><div>218 recovery attempts were included, 25 conducted by local surgeons. Donor demographics between the two groups were similar, with a mean age of 31.5±10 years. There was a non-significant trend towards higher acceptance rates by local surgeons compared to recipient center surgeons (96% vs 82.9%, p=0.139). Ischemic times (208±28 vs 176±61 min p=0.003) and travel distances (788 vs 615 miles, p=0.011) were longer in the local recovery group. There was no difference in severe PGD (4.2% vs 7.5%, p=1.0), moderate/severe PGD (12.5% vs 14.4%, p=0.22) or 30-day survival (95.8% vs 95%, p=0.218) between the local surgeon and recipient center recovered allografts.</div></div><div><h3>Conclusion</h3><div>Cardiac allografts recovered by a local surgeon team are high quality with similar rates of organ acceptance, PGD, and 30-day survival. This provides evidence that leveraging the expertise of the local surgical team is a safe and effective method for decreasing travel risks, financial expenditure, and opportunity cost associated with cardiac allograft recovery.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173010","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":"Contemporary treatment of right ventricular failure","authors":"Bibhuti B. Das MD ,&nbsp;Shashi Raj MD, FAAP, FACC","doi":"10.1016/j.jhlto.2024.100203","DOIUrl":"10.1016/j.jhlto.2024.100203","url":null,"abstract":"<div><div>Right ventricular failure (RVF) is a clinical syndrome resulting from structural and functional changes in the right ventricle (RV), leading to inadequate blood flow to the pulmonary circulation and elevated systemic venous pressures. Factors modulating RV function include afterload, preload, contractility, and interventricular dependency. The pathophysiology of RVF involves complex interactions, such as maladaptive hypertrophy, metabolic reprogramming, inflammation, fibrosis, apoptosis, and endothelial dysfunction. Therapeutic strategies are limited for RVF, as basic and clinical research has historically focused mainly on the left ventricle. Novel pharmacological interventions targeting metabolism, calcium homeostasis, oxidative stress, extracellular matrix remodeling, endothelial function, and inflammation are needed to address RVF effectively. This review explores the etiology, mechanisms, and pathophysiology of RVF, drugs directly targeting the RV myocardium, the intricate biological processes between RV and pulmonary vascular remodeling, surgical and device therapies, and future perspectives on managing RVF.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173783","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":"Patient–specific hemodynamic modeling to optimize LVAD speed and right heart health","authors":"Mustafa M. Ahmed ,&nbsp;Holly Grant ,&nbsp;Jasmine Martinez ,&nbsp;Joshua Thomas ,&nbsp;Mohammad Al-Ani ,&nbsp;Alex Parker ,&nbsp;Juan Vilaro ,&nbsp;Juan Aranda ,&nbsp;Venkat Keshav Chivukula","doi":"10.1016/j.jhlto.2024.100190","DOIUrl":"10.1016/j.jhlto.2024.100190","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular assist device (LVAD) speed optimization and right heart failure post device implantation are major clinical challenges. Right heart catheterization (RHC)–guided speed titration studies are often performed to optimize LVAD settings, which are unknown and must be optimized for each patient. A virtual hemodynamic model (VHM) that can be tailored to each patient may provide useful guidance and reduce repeated studies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis on 16 patients implanted with HeartMate 3 (HM3) who underwent RHC speed titration study as an outpatient. A custom-designed VHM was built and customized for each patient based on RHC measurements. VHM predictions were obtained for multiple scenarios: (1) population–based pulmonary system parameters, (2) patient-specific systemic and pulmonary resistance and capacitance parameters, (3) clinical optimization–based patient-specific mean arterial pressure (MAP), and (4) several MAP targets ranging from 70 to 90 mm Hg.</div></div><div><h3>Results</h3><div>All patients who underwent RHC speed titration had a clinician–guided speed increase, with a median increase of 300 revolutions per minute (rpm). Using each patient’s customized VHM, virtual speed optimization demonstrated congruence with clinician-guided optimization, with a median predicted speed increase of 321 rpm. After virtual optimization, there was a decrease in the pulmonary artery pressure for 13 patients (81.25%), indicating a predicted improvement in pulmonary parameters.</div></div><div><h3>Conclusions</h3><div>For our cohort of 16 patients, there was an overall congruence between clinician–guided and patient–specific VHM-predicted optimal LVAD speeds. The magnitude of speed change varied depending on individual patient targets. This may provide individualized speed titration goals and lessen the need for repeat invasive studies.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173870","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":"Corrigendum to “Donor-derived cell-free DNA is a valuable monitoring tool after single lung transplantation: Multicenter analysis” [JHLT Open, 6 (2024) 100155]","authors":"Ambalavanan Arunachalam ,&nbsp;Fatima Anjum ,&nbsp;Justin P. Rosenheck ,&nbsp;Reinaldo Rampolla ,&nbsp;Reda Girgis ,&nbsp;Howard J. Huang ,&nbsp;Kathryn Crabtree ,&nbsp;Sarah McCormick ,&nbsp;Zhiji Zhang ,&nbsp;Sangeeta Bhorade ,&nbsp;David J. Ross","doi":"10.1016/j.jhlto.2024.100196","DOIUrl":"10.1016/j.jhlto.2024.100196","url":null,"abstract":"","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171929","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":"Brain atrophy in heart failure patients following left ventricular assist device implantation or heart transplantation","authors":"D.Alan Herbst MD ,&nbsp;Banafsheh Shakibajahromi MD ,&nbsp;Michael V. Genuardi MD ,&nbsp;Amit Iyengar MD ,&nbsp;Dawn Mechanic-Hamilton PhD ,&nbsp;H. Branch Coslett MD ,&nbsp;Pavan Atluri MD ,&nbsp;Christopher G. Favilla MD","doi":"10.1016/j.jhlto.2025.100211","DOIUrl":"10.1016/j.jhlto.2025.100211","url":null,"abstract":"<div><div>Advanced heart failure is associated with accelerated brain atrophy, largely related to chronic cerebral malperfusion. Both heart transplantation (HT) and left ventricular assist device (LVAD) implantation improve vital organ perfusion, but the comparative effect on brain atrophy remains unclear. Given the MR incompatibility of LVADs, we leveraged serial CT imaging in patients who underwent either HT or LVAD implantation. 58 patients were included in this single-center retrospective cohort (23 LVAD; 35 HT). LVAD patients experienced greater brain atrophy (median: 7.1 mL/year; IQR: 0.9–15.7) than transplant patients (median: 0.4 mL/year; IQR: −6.7–13.9), but this difference was non-significant (<em>p</em>=0.09). Temporal atrophy (expansion of the Sylvian fissure) was greater in LVAD patients (median: 0.91 mm/year; IQR: 0.14–2.27) than HT patients (median: 0.10 mm/year; IQR: 0.02–0.55), <em>p</em>=0.005. These observations reveal a need for future work to prospectively quantify brain atrophy after LVAD implantation and HT, while comparing with that of advanced heart failure.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143171930","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":"Computational pathology assessments of cardiac stromal remodeling: Clinical correlates and prognostic implications in heart transplantation","authors":"Eliot G. Peyster MD, MSc ,&nbsp;Cai Yuan PhD ,&nbsp;Sara Arabyarmohammadi PhD ,&nbsp;Priti Lal MD ,&nbsp;Michael D. Feldman MD, PhD ,&nbsp;Pingfu Fu PhD ,&nbsp;Kenneth B. Margulies MD, MS ,&nbsp;Anant Madabhushi PhD, FAIMBE, FIEEE, FNAI","doi":"10.1016/j.jhlto.2024.100202","DOIUrl":"10.1016/j.jhlto.2024.100202","url":null,"abstract":"<div><h3>Background</h3><div>The hostile immune environment created by allotransplantation can accelerate pathologic tissue remodeling. Both overt and indolent inflammatory insults propel this remodeling, but there is a paucity of tools for monitoring the speed and severity of remodeling over time.</div></div><div><h3>Methods</h3><div>This retrospective cohort consisted of <em>n</em> = 2,167 digitized heart transplant biopsy slides along with records of prior inflammatory events and future allograft outcomes (cardiac death or allograft vasculopathy). Utilizing computational pathology analysis, biopsy images were analyzed to identify the pathologic stromal changes associated with future allograft loss or vasculopathy. Biopsy images were then analyzed to assess which historical inflammatory events drive progression of these pathologic stromal changes.</div></div><div><h3>Results</h3><div>The top 5 features of pathologic stromal remodeling most associated with adverse allograft outcomes were also strongly associated with histories of both overt and indolent inflammatory events. Compared to controls, a history of high-grade or treated rejection was significantly associated with progressive pathologic remodeling and future adverse outcomes (32.9% vs 5.1%, <em>p</em> &lt; 0.001). A history of recurrent low-grade rejection and Quilty lesions was also significantly associated with pathologic remodeling and adverse outcomes vs controls (12.7% vs 5.1%, <em>p</em> = 0.047). A history of high-grade or treated rejection in the absence of recurrent low-grade rejection history was not associated with pathologic remodeling or adverse outcomes (7.1% vs 5.1%, <em>p</em> = 0.67).</div></div><div><h3>Conclusions</h3><div>A history of both traditionally treated and traditionally ignored alloimmune responses can predispose patients to pathologic allograft remodeling and adverse outcomes. Computational pathology analysis of allograft stroma yields translationally relevant biomarkers, identifying accelerated remodeling before adverse outcomes occur.</div></div><div><h3>Data Availability</h3><div>The data that support the findings of this study are presented in the manuscript and extended data sections. Unprocessed raw data are available from the corresponding author upon reasonable request. Source code for the stromal feature analysis pipeline is hosted on GitHub and freely available: <span><span>https://github.service.emory.edu/CYUAN31/Pathomics_StromalBioMarker_in_Myocardium.git</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172816","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 combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study","authors":"Renita Wilson BS ,&nbsp;J. Asher Jenkins MD ,&nbsp;Juan Maria Farina MD ,&nbsp;Blake Langlais MS ,&nbsp;Bashar Aqel MD ,&nbsp;Ashraf Omar MD ,&nbsp;Jonathan D’Cunha MD PhD ,&nbsp;Pedro Reck dos Santos MD PhD","doi":"10.1016/j.jhlto.2025.100212","DOIUrl":"10.1016/j.jhlto.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>Concomitant liver and lung transplant (ConLi-LTx) may be indicated for select pediatric patients with cystic fibrosis (CF). This study aims to analyze pre-transplant predictors and post-transplant outcomes of ConLi-LTx and lung transplant (LTx) only in pediatric patients with cystic fibrosis.</div></div><div><h3>Methods</h3><div>The ISHLT International Thoracic Organ Transplant Registry was queried for patients &lt;18 years old with CF who underwent ConLi-LTx and LTx-only from 1994-June 2018. Data were propensity matched to LTx-only controls and analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate.</div></div><div><h3>Results</h3><div>We identified 18 ConLi-LTx who were compared to 72 LTx-only cases. No significant differences were identified in patient demographics, resting oxygen requirement prior to transplant, or six-minute walking distance at time of listing. Interestingly, ConLi-LTx patients demonstrated significantly improved overall (p=0.0220) and BOS-free survival (p=0.0167).</div></div><div><h3>Conclusions</h3><div>There were no differences in pre-transplant predictors of simultaneous liver and lung transplantation in pediatric patients with cystic fibrosis compared to those who received LTx-only. The noted survival benefits of ConLi-LTx remains uncertain, as patients who underwent simultaneous transplant are likely well-selected as candidates for such an extensive procedure, and we hypothesize that the liver may play a role in immunologic benefit. Further research is warranted regarding pre-transplant characteristics of pediatric cystic fibrosis patients who may be considered for concomitant liver with lung transplant.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"7 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173011","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}