Haruchika Yamamoto, Gavin W Wilson, Adam Sundby, Siyi Zhu, Jonathan Allen, Bonnie T Chao, Akhi Akhter, Shaf Keshavjee, Andrew Sage, Jonathan C Yeung
{"title":"dTBCell-free DNA in Ex-Vivo Lung Perfusate is Associated with Low-Quality Lungs and Lung Transplant Outcome.","authors":"Haruchika Yamamoto, Gavin W Wilson, Adam Sundby, Siyi Zhu, Jonathan Allen, Bonnie T Chao, Akhi Akhter, Shaf Keshavjee, Andrew Sage, Jonathan C Yeung","doi":"10.1016/j.healun.2025.02.1693","DOIUrl":"https://doi.org/10.1016/j.healun.2025.02.1693","url":null,"abstract":"<p><strong>Background: </strong>Cell-free DNA (cfDNA) in ex vivo lung perfusion (EVLP) perfusate has been shown to potentially reflect lung injury; however, the relationship between cfDNA concentration with clinical EVLP lung outcomes has not been elucidated.</p><p><strong>Methods: </strong>A discovery cohort of n=100 clinical EVLP cases and a validation cohort (n=50) were used in this single-center, retrospective cohort study. cfDNA was extracted and quantified from perfusate samples. The concentration of cfDNA at 1h and the change in cfDNA concentration per hour of EVLP in the transplanted and declined groups were compared by univariable and multivariable logistic regression. cfDNA was introduced as an additional factor in a machine learning algorithm to predict lung utilization and post-operative outcome and the performance evaluated.</p><p><strong>Results: </strong>Significantly higher cfDNA concentrations were observed in the declined group than in the transplanted group (1h: p < 0.001; delta/h: p = 0.031). Multivariable analysis among the 1h factors showed that [cfDNA 1h] (OR 4.27, p = 0.010) was an independent prognostic factor. Increases in [cfDNA 1h], [cfDNA delta/h], and both showed that both initial [cfDNA] and increases in [cfDNA] over time were independently correlated with the probability of a lung being declined. The validation analysis also confirmed higher [cfDNA 1h] in the declined group than in the transplanted group (p = 0.010). Addition of [cfDNA] features improved the performance of a machine learning algorithm used to predict donor lung utilization.</p><p><strong>Conclusion: </strong>The cfDNA concentration in EVLP perfusate correlates with the rate of decline of lungs for transplant from EVLP.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Invited Commentary Harnessing Multi-Omics for Lung IRI Drug Discovery.","authors":"Norihisa Shigemura","doi":"10.1016/j.healun.2025.02.1683","DOIUrl":"https://doi.org/10.1016/j.healun.2025.02.1683","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felicia Y Ho, Xingmei Wang, Douglas E Schaubel, Mauer Biscotti, Marisa Cevasco, Aditya G Parikh, Meeta P Kerlin, Jason D Christie, Peter P Reese, Emily A Vail
{"title":"Heart donation and transplant recipient survival outcomes from deceased organ donors managed in hospital-based versus independent donor care units.","authors":"Felicia Y Ho, Xingmei Wang, Douglas E Schaubel, Mauer Biscotti, Marisa Cevasco, Aditya G Parikh, Meeta P Kerlin, Jason D Christie, Peter P Reese, Emily A Vail","doi":"10.1016/j.healun.2025.02.1694","DOIUrl":"10.1016/j.healun.2025.02.1694","url":null,"abstract":"<p><strong>Background: </strong>Despite growing prevalence, the impact of centralized deceased organ donor care on heart donation and transplant recipient outcomes remains unknown.</p><p><strong>Methods: </strong>We conducted a retrospective study using Organ Procurement and Transplantation Network deceased donor and transplant recipient data. We included adult deceased organ donors after brain death managed in 21 U.S. regions with donor care units (DCUs) January 2019 - December 2022 and their heart recipients. The primary exposure was organ recovery in independent versus hospital-based DCUs. Outcomes included heart graft survival duration (primary) and incidence of heart donation.</p><p><strong>Results: </strong>The cohort captured 9830 donors after brain death, 3302 in 10 independent DCUs (33.6%) and 1366 (13.9%) in 11 hospital-based DCUs (the remainder in hospitals). Unadjusted heart donation did not differ between independent and hospital-based DCUs (40.9% vs. 40.4%, p=0.75). In a logistic regression model including donor factors, odds of heart donation did not differ by DCU type (aOR 1.02, 95% CI 0.86-1.22). Among 3108 heart transplant recipients from cohort heart donors, restricted mean survival time 4 years after transplant was not different between hearts recovered in independent versus hospital-based DCUs (1292 days vs. 1276). In a Cox model including donor and recipient factors, adjusted hazards of graft failure were not different by DCU type (aHR 0.79, 95% CI 0.50-1.24).</p><p><strong>Conclusions: </strong>Among deceased organ donors after brain death, heart donation and heart transplant survival did not vary between hospital-based and independent DCUs. Further work is needed to determine if DCU utilization increases the number of hearts available for transplant.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feras H Khaliel, Muhammad I Haq, Ahmed K Alsulbud, Yasmin A Altwaijri, Ali B Alenazy, Ahmed R Almustafa, Adel A Aly, Mandeep R Mehra
{"title":"\"First-In-Human\" Totally Robotic Orthotopic Heart Transplant.","authors":"Feras H Khaliel, Muhammad I Haq, Ahmed K Alsulbud, Yasmin A Altwaijri, Ali B Alenazy, Ahmed R Almustafa, Adel A Aly, Mandeep R Mehra","doi":"10.1016/j.healun.2025.02.1685","DOIUrl":"https://doi.org/10.1016/j.healun.2025.02.1685","url":null,"abstract":"<p><strong>Importance: </strong>Traditionally, heart transplantation surgery requires a median sternotomy due to the perceived complexity of a large organ replacement. Whether an alternative minimally invasive approach to perform a successful heart transplant can be accomplished remains uncertain.</p><p><strong>Objective: </strong>To develop a safe and effective technique for totally robotic heart transplantation DESIGN: Using a multidisciplinary team, technical timed training using the robot-assisted approach was accomplished on multiple cadavers. Importantly, practice to limit the donor organ ischemic time to ensure patient safety was deemed essential and once readiness was achieved, an in-vivo operation was undertaken.</p><p><strong>Setting: </strong>Academic cardiac surgical unit of King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia).</p><p><strong>Participant: </strong>A 16-year-old boy with refractory biventricular heart failure caused by a non-ischemic dilated cardiomyopathy MAIN OUTCOME: A successful totally robotic heart transplant, with a short ischemic time, mechanical ventilation <24 hours, rapid patient mobilization and reduced post operative pain and hospital duration of stay.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Information for Readers","authors":"","doi":"10.1016/S1053-2498(25)00053-1","DOIUrl":"10.1016/S1053-2498(25)00053-1","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 3","pages":"Page A4"},"PeriodicalIF":6.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Su Yeon Lee, Han Na Lee, Hyun Jung Koo, Hwa Jung Kim, Ho Cheol Kim, Jee Hwan Ahn, Sang-Bum Hong, Kyung-Hyun Do
{"title":"Prognostic Value of Cardiac CT-Derived RV Dysfunction in Lung Transplantation Candidates: A Single-Center Retrospective Study.","authors":"Su Yeon Lee, Han Na Lee, Hyun Jung Koo, Hwa Jung Kim, Ho Cheol Kim, Jee Hwan Ahn, Sang-Bum Hong, Kyung-Hyun Do","doi":"10.1016/j.healun.2025.02.1576","DOIUrl":"https://doi.org/10.1016/j.healun.2025.02.1576","url":null,"abstract":"<p><strong>Background: </strong>There are no specific criteria for listing and prioritizing lung transplantation (LTx) candidates based on the severity of right ventricular (RV) dysfunction. We evaluated the prognostic value of cardiac CT-derived RV ejection fraction (RVEF) in LTx candidates.</p><p><strong>Methods: </strong>This retrospective study included patients who were listed for LTx and underwent cardiac computed tomography (CT) between September 2019 and December 2023. Patients were categorized into three groups based on CT-derived RVEF and survival analyses were performed among these groups: normal RVEF (≥ 45%), mild-to-moderate RV dysfunction (25%-45%), and severe RV dysfunction (< 25%).</p><p><strong>Results: </strong>In the 203 patients (median age, 61 years [interquartile range [IQR], 54-64]), the most common indication for LTx was interstitial lung disease (79.3%). Patients were followed for a median duration of 297 days (IQR, 140-632), and the one-year survival rates were 85.2% for those with normal RV, 69.3% for those with mild-to-moderate RV dysfunction, and 55.6% for those with severe RV dysfunction (p < 0.001). Severe RV dysfunction (hazard ratio [HR] 6.72, p = 0.020), age (HR 1.1, p = 0.010), and 6-minute walking distance (HR 0.62, p = 0.010) were associated with an increased risk of one-year mortality.</p><p><strong>Conclusions: </strong>Severe RV dysfunction identified on cardiac CT was a significant prognostic factor for one-year mortality in LTx candidates. Patients with severe RV dysfunction should be prioritized for LTx and classified as urgent due to their elevated short-term mortality risk. Cardiac CT may provide valuable prognostic information during the pre-transplant evaluation process.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Vosoughi, Ambily Ulahannan, Qixuan Li, Ella Huszti, Andrzej Chruscinski, Daniella Birriel, Goodness Madu, Grace Teskey, Meghan Aversa, Tereza Martinu, Stephen Juvet
{"title":"Humoral immunity to lung antigens early post-transplant confers risk for chronic lung allograft dysfunction.","authors":"Daniel Vosoughi, Ambily Ulahannan, Qixuan Li, Ella Huszti, Andrzej Chruscinski, Daniella Birriel, Goodness Madu, Grace Teskey, Meghan Aversa, Tereza Martinu, Stephen Juvet","doi":"10.1016/j.healun.2025.02.1577","DOIUrl":"10.1016/j.healun.2025.02.1577","url":null,"abstract":"<p><strong>Background: </strong>Autoantibodies and de novo donor HLA-specific antibodies (dnDSA) may contribute to chronic lung allograft dysfunction (CLAD). However, the breadth of reactivities against self-antigens and their association with CLAD has been underexamined. In a single-center study, we screened lung transplant (LTx) recipients for novel autoantibodies at transplant and 6 months post-LTx, assessed dnDSA exposure, and CLAD-free survival.</p><p><strong>Methods: </strong>Serum samples were collected from 89 crossmatch-negative bilateral LTx recipients at the time of LTx and 6 months post-LTx, before a CLAD diagnosis, for autoantibody screening using a custom antigen microarray.</p><p><strong>Results: </strong>Patients who developed CLAD by 5 years post-LTx demonstrated a decrease in average IgG reactivity, but no decrease in IgM reactivity when measured at 6 months post-LTx. IgG anti-tropoelastin, SP-D, and thyroglobulin autoantibodies were significantly elevated 6 months post-LTx in patients who developed CLAD by 5 years, compared to those who remained CLAD-free at 5 years. In contrast, patients who remained CLAD-free at 5 years had elevated levels of IgG anti-CENP-B at both timepoints and PM/SCL100 at 6 months post-LTx, suggesting these may confer protection. Exposure to autoantibodies against lung-enriched targets and dnDSA conferred increased CLAD risk.</p><p><strong>Conclusions: </strong>We identified novel autoantibodies associated with CLAD-free survival, bolstering the independent relationship between autoantibodies and CLAD. We also identified autoantibody signatures that are associated with a marked increase in CLAD risk. Exposure to lung-enriched targets and dnDSA may have a reciprocal amplifying effect that lies on a tissue-specific mechanistic pathway leading to CLAD.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Will the real high-risk heart transplant recipients please stand up?","authors":"Rashmi Jain, Evan P Kransdorf","doi":"10.1016/j.healun.2025.02.1578","DOIUrl":"10.1016/j.healun.2025.02.1578","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dong Tian, Xiang-Yun Zheng, Sen-Lin Hou, Zeng-Wei Yu, Ye Wu, Pei-Zhi Liu, Lin-Xi Liu, Yu-Xuan Chen, Yang Zhao, Yang Li, Hong-Tao Tang, Wei-Yang Chen, Ya-Ling Liu, Chuan-Fen Zhang, Yun Wang, Hong-Ying Wen, Qiang Pu, Masaaki Sato, Lun-Xu Liu
{"title":"Baicalein relieves lung graft ischemia-reperfusion injury by reducing advanced glycation endproducts: From screens to mechanisms.","authors":"Dong Tian, Xiang-Yun Zheng, Sen-Lin Hou, Zeng-Wei Yu, Ye Wu, Pei-Zhi Liu, Lin-Xi Liu, Yu-Xuan Chen, Yang Zhao, Yang Li, Hong-Tao Tang, Wei-Yang Chen, Ya-Ling Liu, Chuan-Fen Zhang, Yun Wang, Hong-Ying Wen, Qiang Pu, Masaaki Sato, Lun-Xu Liu","doi":"10.1016/j.healun.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.healun.2025.01.023","url":null,"abstract":"<p><strong>Background: </strong>The lack of effective drugs for treating ischemia-reperfusion injury (IRI) in lung transplants (LTx) remains an issue. Traditional Chinese medicine (TCM) ingredients are promising but poorly studied in LTx. This study aimed to identify potential ingredients and elucidate their mechanisms.</p><p><strong>Methods: </strong>Ten TCM ingredients, including (-)-epigallocatechin-3-gallate, quercetin, wogonin, triptolide, berberine, fisetin, coumestrol, luteolin, nobiletin, and baicalein, were identified as promising candidates using a network pharmacology approach. All the candidates were tested for their ability to improve clamp-induced IRI. Multiple-dose validation was conducted in LTx models, with a focus on baicalein. The pharmacological efficacy of baicalin was verified in an ex-vivo rat lung perfusion model.</p><p><strong>Results: </strong>All ten TCM ingredients improved clamp-induced IRI. Multiple-dose validation confirmed that baicalein mitigated IRI-induced graft damage and dysfunction. Baicalein reduced the elevated levels of advanced glycation endproducts (AGEs) and their downstream pathogenic effects induced by IRI. Exogenous AGEs counteracted the therapeutic effect of baicalein.</p><p><strong>Conclusions: </strong>Baicalein inhibited AGE formation by modulating glucose oxidation rather than polyol metabolism. This study provides a laboratory foundation for the use of TCM ingredients in the treatment of IRI in LTx.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In Memoriam - Professor Allan R Glanville, Past President ISHLT.","authors":"Peter Mark Anthony Hopkins","doi":"10.1016/j.healun.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.healun.2025.02.004","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}