JHLT Open最新文献

{"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}

{"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":"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":"Percutaneous management and outcomes of outflow graft obstruction in patients with left ventricular assist device: A single-center experience","authors":"Yu Wu ,&nbsp;Sylvie Baudart ,&nbsp;Richard Cheng ,&nbsp;Kimberly Kallianos ,&nbsp;Ryan Ruaysungnoen ,&nbsp;Jackie DesJardin ,&nbsp;Mandar Aras ,&nbsp;Krishan Soni ,&nbsp;Amy Fiedler ,&nbsp;Jason Smith ,&nbsp;Liviu Klein","doi":"10.1016/j.jhlto.2025.100464","DOIUrl":"10.1016/j.jhlto.2025.100464","url":null,"abstract":"<div><h3>Background</h3><div>Outflow graft obstruction (OGO) is a rare but potentially fatal complication of left ventricular assist device (LVAD) therapy. Timely diagnosis and intervention are critical to prevent hemodynamic compromise and death.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 191 LVAD patients treated between January 2016 and April 2025. Seven (3.66%) had imaging-confirmed OGO. One died before intervention; 6 underwent intravascular ultrasound (IVUS)-guided stenting. LVAD flows, pressure gradient, and 12-month survival were analyzed.</div></div><div><h3>Results</h3><div>Patients had a mean age of 59.0 ± 13.8 years with a mean LVAD support duration of 63.6 ± 25.3 months. After stenting, mean LVAD flow improved from 1.98 to 4.70 L/min (<em>p</em> = 0.006), while gradients decreased from 74.67 to 31.67 mmHg (<em>p</em> = 0.027). No major complications occurred; all were discharged on warfarin and clopidogrel. The 12-month survival was 83.3% with 2 hemorrhagic strokes.</div></div><div><h3>Conclusion</h3><div>Intravascular ultrasound-guided stenting of OGO is safe and effective. Timely intervention may improve survival. Further research is needed for optimal antiplatelet strategies in LVAD patients undergoing stenting for OGO.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100464"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839591","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":"Medium-term comprehensive outcomes of heart transplantation using donors with hepatitis C viremia to aviremic recipients","authors":"Ritika Mazumder DO ,&nbsp;Sarah Khan MD ,&nbsp;Sakthi Surya Prakash MD ,&nbsp;Qijun Yang MS ,&nbsp;Omar T. Sims PhD ,&nbsp;Randall C. Starling MD, MPH ,&nbsp;William Carey MD","doi":"10.1016/j.jhlto.2025.100467","DOIUrl":"10.1016/j.jhlto.2025.100467","url":null,"abstract":"<div><h3>Background</h3><div>Although direct-acting antiviral (DAA) therapy has enabled successful use of organs from donors with hepatitis C (HCV) with favorable initial results, medium-term outcome data remains insufficient. This study aimed to compare 4-year mortality, primary graft dysfunction, and major adverse cardiac events (MACE) between heart transplants from donors with hepatitis C viremia (D+) and donors without hepatitis C viremia (D−) in aviremic recipients. Medium-term complications, including incidence of rejection, coronary artery vasculopathy (CAV), fibrosing cholestatic hepatitis (FCH), and extrahepatic manifestations of HCV, were also investigated.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 256 (23 D+ and 233 D−) heart transplant recipients at a single institution between 2018 and 2022.</div></div><div><h3>Results</h3><div>Over a 4-year follow-up period, survival was similar between D+ and D− recipients (91.3% [21/23] vs 89.3% [208/233], <em>p</em> = 0.61). The likelihood of death from primary graft dysfunction was similar between D+ and D− groups within a 90-day follow-up period (4.3% vs 2.1%, <em>p</em> = 0.52). The rate of composite MACE was similar in both groups (<em>p</em> = 1.00). Both D+ and D− groups had similar rates of acute cellular rejection (8.7% vs 12.9%, <em>p</em> = 0.94), antibody-mediated rejection (4.3% vs 8.2%, <em>p</em> = 1.00), and CAV (17.4% vs 11.6%, <em>p</em> = 0.27). None of the patients developed fibrosing cholestatic hepatitis. No definitive extra-hepatic manifestations of HCV were noted in D+ recipients.</div></div><div><h3>Conclusion</h3><div>Patient and graft survival rates do not differ between D+ and D− heart transplant recipients. There is no difference in post-transplant complications, including MACE, rejection, CAV, FCH, and extrahepatic manifestations of HCV. These findings suggest medium-term safety in utilizing D+ hearts for enlarging the pool of limited organs.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100467"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924311","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":"Tuberculosis in lung and heart transplant recipients","authors":"María Asunción Pérez-Jacoiste Asín PhD ,&nbsp;Francisco López-Medrano PhD ,&nbsp;José María Aguado PhD","doi":"10.1016/j.jhlto.2025.100398","DOIUrl":"10.1016/j.jhlto.2025.100398","url":null,"abstract":"<div><div><em>Mycobacterium tuberculosis</em> is a significant opportunistic pathogen in solid organ transplant recipients, primarily due to the chronic immunosuppression required to prevent graft rejection. Lung and heart transplant recipients are particularly susceptible to tuberculosis (TB) reactivation, as they often undergo more intensive and prolonged immunosuppressive regimens compared to recipients of other organ transplants with lower immunogenicity. Additionally, the risk of donor-derived TB is notably higher in lung transplantation, underscoring the critical importance of thorough TB screening for both donors and recipients. Implementing appropriate treatment protocols based on screening results is essential to prevent the development of TB disease, which can adversely affect the recipient's prognosis. Diagnosing TB in solid organ transplant recipients presents unique challenges. Immunosuppression can attenuate typical inflammatory responses, leading to atypical or absent symptoms. Moreover, there is a higher incidence of extrapulmonary and disseminated TB in this population, which can result in diagnostic delays. Treatment complexities arise from significant drug interactions, particularly between rifampicin and immunosuppressive agents. Furthermore, there is a lack of high-quality studies evaluating the efficacy of rifampin-free regimens and newer drugs for treating multidrug-resistant TB in transplant recipients. This review focuses on TB in the context of lung and heart transplantation, emphasizing the necessity of pretransplant TB infection screening for both donors and recipients, as well as the management strategies for TB disease following transplantation.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521155","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 anastomotic infection after lung transplantation – An interdisciplinary review","authors":"Etienne Abdelnour-Berchtold MD ,&nbsp;Pieter-Jan Gijs MD ,&nbsp;Angela Koutsokera MD ,&nbsp;Laura N. Walti MD","doi":"10.1016/j.jhlto.2025.100417","DOIUrl":"10.1016/j.jhlto.2025.100417","url":null,"abstract":"<div><div>Airway complications (AC) are an important cause of morbidity and mortality post-lung transplantation (LTx). Bronchial anastomotic infection (BAI) is a complication as well as a risk factor for progressive AC post-lung transplantation. The two are closely related and difficult to untangle. AC affects approximately one in ten LTx-recipients, while BAI is reported in around one in thirty LTx-recipients. Associated bacterial pathogens frequently include <em>Pseudomonas aeruginosa</em> and other gram-negative pathogens, while the most frequent reported fungal pathogen is <em>Aspergillus spp.</em>. Associated complication rates are reported to be high. Although the epidemiology and outcome of AC have been investigated, there is an important lack of BAI-specific literature. The incidence, risk factors, treatment and prevention of BAI are not well known. To close this knowledge gap and to ultimately improve prevention, management and outcome; interdisciplinary investigations and prospective studies are warranted.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521150","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":"Experience with isavuconazole in lung transplant recipients with Aspergillus isolation in respiratory tract specimens: A multicenter, observational study","authors":"Jose Tiago Silva ,&nbsp;Francisco López-Medrano ,&nbsp;Alicia de Pablo ,&nbsp;Andrea Gutiérrez-Villanueva ,&nbsp;Ana Fernández-Cruz ,&nbsp;Ángela Cano ,&nbsp;Elisa Ruiz-Arabi ,&nbsp;Julián Torre-Cisneros ,&nbsp;Arnau Monforte ,&nbsp;Cristina Berastegui ,&nbsp;Oscar Len ,&nbsp;David Brandariz-Núñez ,&nbsp;Dolores Sousa-Regueiro ,&nbsp;Myrian Aguilar-Pérez ,&nbsp;Mario Fernández-Ruiz ,&nbsp;José Maria Aguado","doi":"10.1016/j.jhlto.2025.100419","DOIUrl":"10.1016/j.jhlto.2025.100419","url":null,"abstract":"<div><h3>Background</h3><div><em>Aspergillus</em> is a life-threatening opportunistic pathogen in lung transplant recipients (LuTRs). Isavuconazole (ISA) is a broad-spectrum triazole with favorable pharmacokinetics and safety profile. The clinical experience with ISA in LuTRs, however, is still limited.</div></div><div><h3>Methods</h3><div>We performed an ambispective observational study from June 2019 to June 2024 in 5 Spanish centers. Adult LuTRs with isolation of <em>Aspergillus</em> spp. in respiratory tract specimens and indication of ISA therapy (either for the treatment of invasive pulmonary aspergillosis [IPA] or tracheobronchial aspergillosis [TBA] or for preemptive therapy) were eligible. The safety outcome comprised the occurrence of treatment-emergent adverse events (trAEs) and the need for modification of tacrolimus dose. Effectiveness outcomes included clinical, mycological, and radiological response at the end of treatment (EoT).</div></div><div><h3>Results</h3><div>Overall, 50 LuTRs were included. ISA was administered for a median duration of 101 days (interquartile range: 27-161) for the treatment of IPA (18 [36.0%]) or TBA (27 [54.0%]) and as preemptive therapy (5 [10.0%]). The incidence rates of any trAE and trAE requiring premature ISA discontinuation were 24.0% and 10.0%, respectively. Most patients (35 [70.0%]) completed the planned course of therapy. Tacrolimus daily dose was reduced by a median of one-third in half of the patients (26/48 [54.2%]). Clinical, mycological, and radiological responses at EoT among were achieved in 66.7%, 84.2%, and 64.3% of evaluable patients, respectively. Aspergillosis-attributable mortality at the end of follow-up was 12.0%.</div></div><div><h3>Conclusions</h3><div>ISA was well tolerated in LuTRs and proved to be effective for the treatment of invasive <em>Aspergillus</em> syndromes.</div></div>","PeriodicalId":100741,"journal":{"name":"JHLT Open","volume":"11 ","pages":"Article 100419"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571804","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}