JHLT Open最新文献

{"title":"Venous thromboembolism in lung transplant recipients: timing and clinical impact, a 10-year cohort analysis","authors":"Dieuwertje Ruigrok MD, PhD ,&nbsp;Lucie E. Boersma MD ,&nbsp;Jon Admiraal MD ,&nbsp;Ares M. Rasoul MD ,&nbsp;Nuray Kusadasi MD, PhD ,&nbsp;Sue A. Braithwaite MD ,&nbsp;Linda M. de Heer MD, PhD ,&nbsp;Bart Luijk MD, PhD ,&nbsp;Rob Schönwetter MD ,&nbsp;Marco C. Post MD, PhD","doi":"10.1016/j.jhlto.2025.100458","DOIUrl":"10.1016/j.jhlto.2025.100458","url":null,"abstract":"<div><h3>Introduction</h3><div>The burden of venous thromboembolism (VTE) in lung transplant (LTx) recipients is not fully elucidated despite its frequent occurrence. We report the incidence of VTE and characteristics of VTE in a large LTx cohort, assess severity using risk stratification algorithms, and explore associations with graft survival and chronic lung allograft dysfunction (CLAD).</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was performed on LTx recipients transplanted between July 2012 and August 2022 in our center. Primary outcome was incidence of VTE. Three groups were compared as follows: patients with early VTE (i.e<em>.,</em> within the first 6 months after LTx), late VTE (i.e<em>.,</em> beyond the first 6 months after LTx), and no VTE.</div></div><div><h3>Results</h3><div>About 94/286 patients (33%) were diagnosed with VTE (median follow-up of 4.3 years): 67/94 (71%) early VTE and 27/94 (29%) late VTE. 66/94 (70%) of VTE events were pulmonary embolism (PE). In the early VTE group, none of the PE cases were classified as intermediate-high risk PE and 1 patient had high-risk (fatal) PE. Graft survival was not different between groups; median CLAD-free survival was shorter in patients with late VTE (6.2 years) compared to patients without VTE during follow-up (9.8 years) (<em>p</em> = 0.044).</div></div><div><h3>Conclusions</h3><div>Thirty-three percent of LTx recipients developed VTE, 71% within the first 6 months after LTx. Seventy percent of cases were acute PE, but fatal or severe nonfatal PE were rare. No effect of VTE on graft survival was seen; CLAD-free survival was shorter in patients with late VTE compared to patients without VTE.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100458"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790211","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 severe obesity on heart transplantation outcomes: A meta-analysis of survival and complications","authors":"Ana Maria Bicudo Diniz MD ,&nbsp;Adriana Loricchio Veiga MD ,&nbsp;Sofia Wagemaker Viana ,&nbsp;Anaís Concepcion Marinho Andrade de Moura MD ,&nbsp;Beatriz Laus P. Lima ,&nbsp;Niti Dalal MBBS MD ,&nbsp;Aabha Divya MBBS, MCh","doi":"10.1016/j.jhlto.2025.100404","DOIUrl":"10.1016/j.jhlto.2025.100404","url":null,"abstract":"<div><h3>Background</h3><div>Heart transplantation (HT) is the standard treatment for end-stage heart failure, but severe obesity (Body Mass Index [BMI] ≥ 35 kg/m²) is linked to worse outcomes and is considered a relative contraindication. Obese patients face increased perioperative risks, longer wait times, and reduced survival, though improved clinical care may mitigate some effects. As obesity rates rise, the suitability of the current BMI is increasingly debated. Evidence remains limited and inconsistent, highlighting a need for clearer guidance. This systematic review and meta-analysis assess the impact of severe obesity on survival and post-transplant complications in HT recipients.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and was registered in PROSPERO (CRD420251036442). We included cohort studies and randomized controlled trials (RCTs) (2000–2025) comparing outcomes in adult heart transplant recipients with a BMI ≥ 35 kg/m² vs lower BMI. Primary outcomes were mortality and post-transplant complications. Searches were conducted in PubMed, Scopus, Embase, and Cochrane CENTRAL. Multiple reviewers did data extraction and bias assessment (ROBINS-I) independently. Random-effects models were used for statistical analysis, with heterogeneity assessed via I², and sensitivity analyses performed. Publication bias was evaluated using funnel plots.</div></div><div><h3>Results</h3><div>The search strategy retrieved 1,697 articles or abstracts, 595 were excluded for being duplicates, and 59 full-text articles were selected for full-text analysis. Of these, 9 cohorts were included, 7 from the United States and 2 from Canada, with 218,272 patients, of whom 206,459 had a BMI &lt; 35 and 11,813 had a BMI ≥ 35kg/m².</div></div><div><h3>Conclusion</h3><div>This meta-analysis shows that severe obesity (BMI ≥ 35 kg/m²) remains associated with higher rates of infection, graft failure, and post-transplant mortality, despite advances in care. These outcomes likely reflect underlying immune and metabolic dysfunctions in obese patients, emphasizing the need for tailored strategies to improve long-term survival after heart transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521152","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":"Pathologists’ experience and routine practice in high-volume lung transplant centers: An international survey","authors":"Fiorella Calabrese MD ,&nbsp;David M. Hwang MD ,&nbsp;Francesca Lunardi MD, ScD, PhD ,&nbsp;Riccardo Iannaco MPharm ,&nbsp;Julien Adam MD ,&nbsp;Levent M. Akyürek MD ,&nbsp;Benjamin Adam MD ,&nbsp;Balko Jan MD, PhD ,&nbsp;Gerald Berry MD ,&nbsp;Lauren D’Sa MD ,&nbsp;Aurelie Fabre MD ,&nbsp;Antonin Fattori MD ,&nbsp;Gregory A. Fishbein MD ,&nbsp;Kristianna M. Fredenburg MD, PhD ,&nbsp;Teresa Hermida Romero MD ,&nbsp;Aliya N. Husain MD ,&nbsp;Kirk Jones MD ,&nbsp;Izidor Kern MD ,&nbsp;Chieh-Yu Lin MD ,&nbsp;Rita Louis MD ,&nbsp;Deborah J. Levine MD","doi":"10.1016/j.jhlto.2025.100415","DOIUrl":"10.1016/j.jhlto.2025.100415","url":null,"abstract":"<div><div>Lung allograft pathology encompasses a wide spectrum of disorders, with new entities and emerging diagnostic technologies. The main goal of this study was to document pathologists’ current global practices and highlight areas of consensus and divergence worldwide. A 24-item survey was distributed to transplant centers and responses were received from 35 specialists (51% European, 49% non-European). Most centers used both surveillance and symptom-driven assessments (77%), mainly with transbronchial biopsies (86%) and bronchoalveolar lavage (83%). Non-European centers were more likely to adopt digital pathology (OR 3.03), to use donor-derived cell-free DNA (dd-cfDNA) (OR 2.94), and supported large airway sampling (OR 2.27). Larger centers used dd-cfDNA (OR 2.75) more frequently and consider large airway sampling (OR 2.18). Responders largely supported standardized reporting (86%), reintroducing grade AX (94%), and independent bronchial lesion scoring (82%). Most endorsed an “indeterminate” category for acute and chronic rejection. These findings reflect evolving practices in the field and will inform the ongoing revision of the Lung Allograft Pathology Working Classification.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521151","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":"Prognostic impact of restrictive ventilatory defects in chronic lung allograft dysfunction without restrictive allograft syndrome-like opacities: Stratification of emerging undefined and unclassified phenotypes","authors":"Taiki Fukuda MD, PhD ,&nbsp;Yusei Nakamura MD ,&nbsp;Yuki Ko MD, PhD ,&nbsp;Shu-Chi Tseng MD ,&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, FACR","doi":"10.1016/j.jhlto.2025.100445","DOIUrl":"10.1016/j.jhlto.2025.100445","url":null,"abstract":"<div><h3>Background</h3><div>Chronic lung allograft dysfunction (CLAD) remains a critical factor affecting post-lung transplant prognosis. While RAS-like opacities (RLO) are established as poor prognostic indicators, prognostic stratification of non-RLO CLAD cases, including undefined and unclassified phenotypes per the 2019 International Society for Heart and Lung Transplantation (ISHLT) criteria, remains unexplored.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 241 bilateral lung transplant recipients between 2005 and 2021. CLAD was diagnosed and classified per the 2019 ISHLT criteria. Non-RLO patients were stratified by restrictive ventilatory defects for survival analysis. Diaphragmatic elevation and pleural effusion were also evaluated as potential causes of restrictive physiology and their prognostic significance.</div></div><div><h3>Results</h3><div>Of 83 CLAD patients, 61 (73.5%) had no RLO. In multivariable Cox analysis of non-RLO patients, restrictive ventilatory defects showed a trend toward worse outcomes (Hazard ratio [HR]: 2.56, 95% CI: 0.98–6.71; <em>p</em> = 0.055), while obstructive defects showed no association (HR: 0.88, <em>p</em> = 0.785). When accounting for retransplantation as a competing event using Fine-Gray regression, restrictive ventilatory defects were significantly associated with increased cumulative incidence of death (subdistribution HR: 2.96, 95% CI: 1.17–7.51; <em>p</em> = 0.022). Pleural effusion showed a trend toward association with restrictive defects (<em>p</em> = 0.063) and emerged as an independent prognostic factor (HR: 5.06, 95% CI: 1.57–16.27; <em>p</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>Non-RLO CLAD patients with restrictive ventilatory defects demonstrated significantly increased cumulative incidence of death (retransplantation as a competing risk), challenging the assumption that all non-RLO cases follow a favorable BOS-like prognosis. Pleural effusion was identified as a significant independent prognostic marker.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100445"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736373","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":"Acute impact of lung transplantation on respiratory-swallow coordination, swallowing impairment, and airway invasion: A prospective cohort study","authors":"Kahla Graham PhD ,&nbsp;Jungwha Julia Lee PhD ,&nbsp;Rade Tomic MD ,&nbsp;Ambalavanan Arunachalam MD ,&nbsp;Bonnie Martin-Harris PhD","doi":"10.1016/j.jhlto.2025.100402","DOIUrl":"10.1016/j.jhlto.2025.100402","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplant recipients possess premorbid risk factors for swallowing impairment and airway invasion, including potential alterations in respiratory-swallow coordination. Although aspiration is highly prevalent after lung transplantation, the impact of lung transplantation, its procedures, and postoperative pain management on respiration and swallowing are not understood.</div></div><div><h3>Methods</h3><div>A prospective cohort study of adult lung transplant recipients referred for pre- and postoperative modified barium swallow studies. Respiratory signals were synchronously captured with videofluoroscopic images and analyzed to determine the respiratory phase preceding swallowing events. Swallowing impairment and airway invasion were analyzed using the Modified Barium Swallow Impairment Profile and Penetration-Aspiration Scale (PAS). Wilcoxon signed-rank tests, paired <em>t</em>-tests, and mixed effects models were conducted.</div></div><div><h3>Results</h3><div>Twenty-eight patients were included. Sixty-nine percent of swallows were initiated during expiration before (173/252) and after (166/239) lung transplantation; however, individual variability was noted. Swallowing impairment significantly worsened after lung transplantation, and post-transplant status was associated with greater impairment in 10 physiologic swallowing components and laryngeal penetration/aspiration (<em>p</em> &lt; 0.05). After lung transplantation, atypical respiratory-swallow patterning was significantly associated with impaired laryngeal elevation (OR [95% CI] = 2.13 [1.20, 3.76] <em>p</em> = 0.009), laryngeal vestibular closure (OR [95% CI] = 1.62 [1.12, 2.35] <em>p</em> = 0.010), and airway invasion (OR [95% CI] = 1.95 [1.18, 3.23] <em>p</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>Swallowing impairment and airway invasion worsened after lung transplantation and were associated with atypical respiratory-swallow patterning. These findings suggest acute swallowing complications that warrant early assessment and targeted interventions to mitigate aspiration risk and support short- and long-term postoperative outcomes after lung transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736375","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":"Limitations of ventricular assist devices in pediatrics: When one size does not fit all","authors":"Áine Lynch ,&nbsp;Aamir Jeewa","doi":"10.1016/j.jhlto.2025.100428","DOIUrl":"10.1016/j.jhlto.2025.100428","url":null,"abstract":"<div><div>Ventricular assist device (VAD) use in pediatric heart failure is an evolving field with increasing volume and case complexity of patients supported. Despite this, limited VADs used are developed for infants and children, with significant numbers supported using adult devices. While outcomes on support are influenced by a variety of factors, including illness severity at VAD implant, need for additional right heart support, and presence of congenital heart disease, body size remains an independent predictor of mortality and adverse events on VAD support. Those patients able to accommodate adult-designed implantable continuous-flow VADs experience markedly improved survival outcomes and lower complication rates with improved rehabilitation potential. For the remaining cohort, device choices are limited to extracorporeal VAD support with inferior outcomes and care limited to hospital settings. The deficit in pediatric-specific VAD devices is a well-recognized need to optimize care for this complex cohort.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026142","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":"Contemporary approach to desensitization: Targeted therapies for HLA sensitized pediatric heart transplant candidates – Study design and rationale","authors":"Lakshmi R. Gokanapudy Hahn MD, MSCI ,&nbsp;Marlena Habal ,&nbsp;Adriana Zeevi ,&nbsp;Kathleen E. Simpson ,&nbsp;Warren Zuckermann ,&nbsp;Kevin Daly ,&nbsp;Chad Mao ,&nbsp;Joseph Rossano ,&nbsp;James K. Kirkin ,&nbsp;Charles E. Canter","doi":"10.1016/j.jhlto.2025.100429","DOIUrl":"10.1016/j.jhlto.2025.100429","url":null,"abstract":"<div><h3>Purpose</h3><div>HLA sensitization significantly limits donor availability and increases waitlist mortality in pediatric heart transplantation (HT). Current desensitization strategies are largely ineffective or equivocal. Recent adult studies show that a dual approach with Carfilzomib (CFZ), a proteasome inhibitor, and Belatacept (BELA), a costimulation blocker, reduces class I and II HLA antibodies (Abs). This study will evaluate the clinical utility of CFZ and BELA in reducing HLA antibody type and strength in pediatric and young adult patients.</div></div><div><h3>Methods</h3><div>This prospective, observational study will include about 30 patients from 6 pediatric clinical sites, an HLA core and a mechanistic core lab. Patients aged 10–24 years, highly sensitized with class I and/or class II cPRA ≥ 50% (MFI &gt; 4000), will be included. Exclusion criteria: EBV seronegative, HIV+, and a history of hematologic malignancy. Secondary endpoints include mechanistic studies on how desensitization affects cellular subsets producing HLA Abs, whether reductions in antibody strength persist until transplant, and post-transplant outcomes such as antibody mediated rejection and graft survival.</div></div><div><h3>Results</h3><div>The study’s unique design harmonizes the use of a novel protocol across sites using a central IRB and is the first prospective, registry-based investigation in pediatric HT using the Pediatric Heart Transplant Society (PHTS) registry. The HLA core will measure antibody response through MFIs, titers, and cPRA, while the mechanistic core will use advanced investigations to support the trial's clinical endpoints.</div></div><div><h3>Conclusion</h3><div>This multicenter study aims to establish a transformative, standardized approach to desensitization and antibody evaluation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100429"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839583","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 infections: From epidemiology to treatment","authors":"Marta Hernández-Meneses ,&nbsp;Elena Sandoval ,&nbsp;Marta Farrero","doi":"10.1016/j.jhlto.2025.100451","DOIUrl":"10.1016/j.jhlto.2025.100451","url":null,"abstract":"<div><h3>Background</h3><div>Infections are among the most frequent and severe complications in patients supported with left ventricular assist devices (LVADs), significantly affecting morbidity, mortality, and transplant candidacy. Driveline infections are the most common, but involvement of the pump or pocket is associated with more complex management and worse outcomes.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive narrative review of current literature on LVAD infections, including epidemiology, updated definitions, microbiology, diagnostic tools, and treatment strategies in both bridge-to-transplant and destination therapy patients.</div></div><div><h3>Results</h3><div>Infection rates range from 19% to 39%, with <em>Staphylococcus aureus</em> and coagulase-negative staphylococci as the most frequent pathogens. PET/CT improves diagnostic accuracy in cases of suspected deep-seated or ambiguous infection. Antimicrobial therapy is the mainstay of treatment. Suppressive antibiotic therapy may be considered as LVAD cannot be removed easily, though data supporting its use are limited. Surgical strategies, such as debridement, VAC therapy, driveline relocation, and pump exchange, should be adapted to the clinical context. Adjunctive options like bacteriophages and cold atmospheric plasma are under investigation. Prevention through optimized surgical technique and driveline management remains essential.</div></div><div><h3>Conclusions</h3><div>Management of LVAD infections requires individualized, multidisciplinary strategies. Despite technological advances, prevention and early diagnosis remain critical. Further studies are needed to define best practices and reduce infection-related morbidity.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100451"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789610","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":"Dioxygen consumption after deep hypothermic circulatory arrest pulmonary endarterectomy","authors":"Sylvain Diop ,&nbsp;Elie Fadel ,&nbsp;Thibaut Genty ,&nbsp;Maria-Cristina Kassab ,&nbsp;Iolanda Ion ,&nbsp;Jacques Thes ,&nbsp;François Stephan","doi":"10.1016/j.jhlto.2025.100448","DOIUrl":"10.1016/j.jhlto.2025.100448","url":null,"abstract":"<div><h3>Objectives</h3><div>Cardiac surgery is associated with an increased dioxygen (O₂) consumption (VO₂) following cardiopulmonary bypass (CPB). But data on intraoperative VO₂ variation during pulmonary endarterectomy (PEA) are scarce. We aimed to assess the variation of VO₂ and O₂ delivery (DO₂) between the induction of general anesthesia and the weaning off CPB in patients undergoing PEA.</div></div><div><h3>Methods</h3><div>A prospective single center observational study was conducted from May to November 2023 in patients that underwent PEA. Hemodynamic and biological data were collected from arterial and venous blood gas after the induction of general anesthesia and after CPB weaning.</div></div><div><h3>Results</h3><div>Forty-nine patients were included in the final analysis. The mean age was 57 (<span><math><mo>±</mo></math></span>14.3) years, and 30 (61%) patients were male. There was no significant change in VO₂ and DO₂ (O₂ delivery) after CPB weaning (VO₂=104.5 (<span><math><mo>±</mo></math></span>45.9) vs 110.5 (<span><math><mo>±</mo></math></span>30.4) ml of O₂/min/m²; p=0.33; DO₂=426.1 (<span><math><mo>±</mo></math></span>166.3) vs 398.1 (<span><math><mo>±</mo></math></span>109.4) ml of O₂/min/m²; p=0.18 respectively). There was a weak correlation between CPB duration and VO₂ following CPB weaning (R=0.41; p=0.008). No correlation between the duration of aortic cross clamp time, the duration of circulatory arrest, and post CPB VO₂ were found (R=0.22; p=0.14 and R=0.22; p=0.10, respectively).</div></div><div><h3>Conclusion</h3><div>There was no significant increase in VO₂ and DO₂ after deep hypothermic circulatory arrest PEA surgery.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100448"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790217","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":"Design and rationale of the MIGHTEE study: Motivational interviewing and group heart transplant exercise and education","authors":"Jonathan B. Edelson ,&nbsp;Lauren Schneider ,&nbsp;Shannon O’Malley ,&nbsp;Jessica Somogie ,&nbsp;Jing Huang ,&nbsp;Zeyu Nancy Li ,&nbsp;Carley Boyle ,&nbsp;Matthew J. O’Connor ,&nbsp;Stephen Paridon ,&nbsp;Kimberly Y. Lin ,&nbsp;Joseph W. Rossano ,&nbsp;Meghan Lane-Fall ,&nbsp;Melissa K. Cousino","doi":"10.1016/j.jhlto.2025.100421","DOIUrl":"10.1016/j.jhlto.2025.100421","url":null,"abstract":"<div><h3>Background</h3><div>Many pediatric heart transplant (HT) recipients have decreased physical activity, which worsens their cardiovascular risk profile, contributes to long-term morbidity and mortality, and is associated with lower quality of life (QOL). While participation in a regular exercise program improves the cardiovascular health of pediatric HT recipients, there are limited data on how to best implement exercise-based interventions that are accessible, effective, and sustainable.</div></div><div><h3>Methods</h3><div>This manuscript describes the design, rationale, and baseline cohort characteristics of the Motivational Interviewing and Group Heart Transplant Exercise and Education (MIGHTEE) intervention, a structured virtual group exercise program developed with input from pediatric HT recipients and their families.</div></div><div><h3>Results</h3><div>Over 24 months, 65 HT recipients were screened, and 44 recipients were determined to be eligible. Of the 23 subjects enrolled in MIGHTEE (52% enrollment rate), the majority were male (52%), and 26% self-identified as Black. The mean subject age was 16.1 years (standard deviation [SD] = 2.2), and the mean time from HT was 4.9 years (range = 1-18 years) with 43% having a history of congenital heart disease. All participants completed baseline testing, and wearable device adherence exceeded 80% of monitored days.</div></div><div><h3>Conclusions</h3><div>This manuscript describes the rationale and study design of the MIGHTEE study, which will provide important data regarding the optimal methods for delivering physical activity-related interventions to pediatric HT survivors. This design and rationale paper highlights the feasibility of enrollment and program delivery, with outcomes analyses forthcoming in subsequent reports.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100421"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571805","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}