Journal of Heart and Lung Transplantation最新文献

{"title":"Therapeutic decisions in chronic thromboembolic pulmonary hypertension pre- and post-intervention should be informed by multimodal risk stratification.","authors":"Paula Appenzeller, Hakim Ghani, Joanna Pepke-Zaba","doi":"10.1016/j.healun.2026.04.026","DOIUrl":"https://doi.org/10.1016/j.healun.2026.04.026","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816303","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":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: 2026 Annual Report of Heart and Lung Transplantation.","authors":"Göran Dellgren, Wida S Cherikh, Tajinder P Singh, Kyung-Hee Kim, Alexandra Lewis, Brian C Keller, Rossa Brugha, Estela Azeka, Eileen Hsich, Michael Perch, Don Hayes, Rebecca Cogswell","doi":"10.1016/j.healun.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.healun.2026.04.001","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773605","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":"Genome-wide association study reveals two novel genetic loci associated with chronic lung allograft dysfunction.","authors":"Simon Brocard, Vincent Mauduit, Martin Morin, Léo Boussamet, Nayane Dos Santos Brito Silva, Axelle Durand, Pierre Halitim, Benjamin Renaud-Picard, Benjamin Coiffard, Xavier Demant, Loïc Falque, Jérome Le Pavec, Antoine Roux, Thomas Villeneuve, Christiane Knoop, Claire Merveilleux, Mathilde Salpin, Nicolas Carlier, Pierre Antoine Gourraud, Antoine Magnan, David Lair, Laureline Berthelot, Mario Südholt, Nicolas Vince, Adrien Tissot, Sophie Limou","doi":"10.1016/j.healun.2026.03.011","DOIUrl":"10.1016/j.healun.2026.03.011","url":null,"abstract":"<p><strong>Background: </strong>Chronic lung allograft dysfunction (CLAD) leads to declining respiratory function and high mortality, representing the main barrier to long-term survival in lung transplantation (LT). We performed the first genome-wide association study (GWAS) investigating donor's and recipient's genetic factors associated with CLAD.</p><p><strong>Method: </strong>We genotyped 392 donor-recipient pairs from the multicentric Cohort in Lung Transplantation. We tested 4.5 million SNPs for association with CLAD using multivariable logistic regression models corrected for age, sex, initial disease and genetic ancestry. Three levels of explanatory variables were separately considered to conduct GWAS: donors-only, recipients-only, and donor-recipient mismatches. We also ran HLA-centric analyses using the same models.</p><p><strong>Results: </strong>Our analysis confirmed the deleterious impact of HLA allelic and epitopic mismatches on CLAD risk, mostly driven by class I HLA (p=0.004). No significant associations with CLAD were found for donors' genotypes or donor-recipient non-HLA mismatches. We highlighted two independent recipient's loci associated with CLAD, including one protective signal (0.39 in CLAD vs 0.66 in non-CLAD recipients, p-value=5.05×10^-7, q-value=0.017, OR=0.35) encompassing the PLXDC2 gene, and one risk signal (0.66 in CLAD vs 0.38 in non-CLAD recipients, p-value=9.86×10^-7, q-value=0.017, OR=2.83) encompassing the ZNF518A/BLNK genes. These non-coding SNPs are putative regulatory variants of gene expression. Importantly, our single-cell RNA-sequencing showed a down-regulation of PLXDC2 in fibroblasts and lung epithelium in CLAD vs healthy controls.</p><p><strong>Conclusion: </strong>This first LT GWAS revealed two candidate loci from the recipient's genome, both biologically relevant for CLAD pathogenesis. Our study calls for larger LT genomic initiatives to increase power for signal discovery.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493903","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":"Single-beat right ventricular-pulmonary artery coupling and residual heart failure in patients with a HeartMate 3 left ventricular assist device.","authors":"Francesco Castagna, Andrea Faini, Gianfranco Parati, Garrick Stewart, John Cockcroft, Ulrich Jorde, Mandeep R Mehra","doi":"10.1016/j.healun.2026.02.1661","DOIUrl":"https://doi.org/10.1016/j.healun.2026.02.1661","url":null,"abstract":"<p><strong>Background: </strong>Contemporary left ventricular assist devices (LVADs) improve survival, yet residual heart failure (HF) remains despite optimized device support. The extent to which right ventricular (RV)-pulmonary artery (PA) interaction, measured by single-beat elastance-based indices, identifies residual risk is unknown.</p><p><strong>Methods: </strong>We studied 70 adults implanted with HeartMate3 LVADs (2018-2022) who underwent pre-discharge right heart catheterization after echocardiographic and invasive LVAD optimization. Using a single-beat method, RV end-systolic elastance (E_es), PA effective arterial elastance (E_a), and the E_es:E_a ratio (RV-PA coupling) were derived from high-fidelity pressure waveforms. Associations between these indices and surrogates of residual HF (cardiac output [CO] at discharge, need for high-dose outpatient diuretics, and 3-month 6-minute walking distance [6MWD]) were evaluated using multivariable regressions.</p><p><strong>Results: </strong>Despite optimized LVAD support, patients demonstrated preserved RV E_es (0.40 ± 0.19mmHg/ml), elevated PA E_a (0.54 ± 0.21 mmHg/ml) and reduced E_es:E_a ratio (0.78 ± 0.36), consistent with RV-PA uncoupling. Higher PA E_a independently associated with lower CO and greater likelihood of high-dose diuretic use, while impaired RV-PA coupling (lower E_es:E_a) was the only hemodynamic parameter associated with reduced 6MWD. Traditional RV indices, including PAPi and CVP-to-wedge ratio, were not associated with outcomes.</p><p><strong>Conclusion: </strong>Single-beat RV-PA elastance metrics identify residual HF phenotypes in clinically optimized HM3 recipients not captured by standard right-sided indices. If prospectively validated, incorporating RV E_es, PA E_a (\"flow obstruction\") and E_es:E_a (\"energy inefficiency\") into pre-discharge assessment may be used to refine risk stratification and inform device-directed and pulmonary vascular interventions during LVAD.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633744","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":"Management of obesity in the contemporary LVAD era.","authors":"Vanessa S Faria, Milica Vukićević, Ameesh Isath, Mandeep R Mehra","doi":"10.1016/j.healun.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.healun.2026.02.005","url":null,"abstract":"<p><p>Obesity is a defining comorbidity in durable left ventricular assist device (LVAD) supported patients, driven in part by transplant listing policies that consider body mass index (BMI) ≥35 kg/m2 a relative contraindication to heart transplantation. In the contemporary LVAD era, obesity is no longer associated with excess early or intermediate-term mortality. Instead, it functions as a morbidity amplifier and a barrier to definitive therapy, contributing to higher rates of device-related complications, healthcare utilization, and reduced access to transplantation. Importantly, clinically meaningful weight loss during LVAD support is uncommon, with fewer than 20% patients achieving 10% weight loss, typically insufficient to restore transplant eligibility. Lifestyle and exercise interventions in LVAD supported patients improve quality of life but rarely produce transplant-enabling weight loss. Pharmacological therapies, particularly incretin-based agents, have demonstrated promising weight-loss efficacy in observational LVAD cohorts, with acceptable short-term tolerability. However, LVAD-specific prospective safety and effectiveness data are lacking, and experience in heart failure with reduced ejection fraction has raised cautionary signals. Bariatric surgery, most commonly laparoscopic sleeve gastrectomy, reliably induces weight loss and may increase transplant listing and transplantation rates in selected patients, but is accompanied by high perioperative morbidity and is supported exclusively by observational data from selected cohorts. This perspective reviews contemporary evidence for obesity management during LVAD support, emphasizing therapeutic trade-offs, limitations of existing data, and unresolved clinical and policy questions. Development of structured, stepwise treatment pathways and generation of LVAD-era data are essential to improve transplant access and outcomes in this growing patient population.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592558","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":"Fifty-year pediatric heart transplant outcomes: A pediatric-adult center linked analysis","authors":"Seth A. Hollander MD ,&nbsp;Stephanie Hsiao ,&nbsp;Anubodh S. Varshney ,&nbsp;Helen Luikart ,&nbsp;Alireza Raissadati ,&nbsp;Daniel Bernstein ,&nbsp;Michael Ma ,&nbsp;Kari Wujcik ,&nbsp;Lynsey Barkoff ,&nbsp;John Dykes ,&nbsp;Donna Lee ,&nbsp;David N. Rosenthal","doi":"10.1016/j.healun.2025.10.022","DOIUrl":"10.1016/j.healun.2025.10.022","url":null,"abstract":"<div><h3>Purpose</h3><div>Long-term outcomes after pediatric heart transplant (pHT) are rarely reported owing to young programs and loss of follow-up after transition to adult care. We leveraged our program age, center volume, and linked electronic medical record to analyze 50-year outcomes after pHT, including events after adult care transfer.</div></div><div><h3>Methods</h3><div>Retrospective review of all pHT over 50 years at Stanford (August 19, 1974 to August 19, 2024). Patient characteristics and posttransplant outcomes, including death, retransplant, and subsequent kidney transplantation, were ascertained from the pediatric and adult electronic medical records, public records, and personal communication with other centers.</div></div><div><h3>Results</h3><div>There were 567 pHTs in 540 patients. Status as of August 19, 2024 was confirmed for 526 (97%),11 (2%) had partial follow-up, and 3 were missing. Over 1,888,341 follow-up days, 50 (9%) received a second heart transplant (27 pediatric, 23 adult) after a median of 9 (5, 14) years; 3 (1%) received a third heart transplant; 6 (1%) received a subsequent kidney transplant, and 212 (39%) died (172 pediatric, 40 adult). Median survival was 16.7 years; survival improved in successive eras (<em>p</em>&lt;0.001).</div></div><div><h3>Conclusion</h3><div>This linked analysis of pediatric and adult programs shows excellent long-term pHT outcomes with median survival exceeding 15 years and improving. Nearly half of retransplants occur after transfer; subsequent kidney transplant occurs infrequently.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 485-491"},"PeriodicalIF":6.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592837","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":"Pediatric heart transplantation: We’ve come a long way but there is still a long way to go","authors":"Mary E. Teresczuk MD,&nbsp;Joseph W. Rossano MD","doi":"10.1016/j.healun.2025.11.009","DOIUrl":"10.1016/j.healun.2025.11.009","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 492-493"},"PeriodicalIF":6.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575439","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":"Beyond mechanics: Searching for biology in baseline lung allograft dysfunction","authors":"Jamie L. Todd MD, MHS","doi":"10.1016/j.healun.2025.11.020","DOIUrl":"10.1016/j.healun.2025.11.020","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 415-416"},"PeriodicalIF":6.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145567307","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":"Association between listing hemodynamics and heart transplantation waitlist outcomes: An analysis of the Scientific Registry of Transplant Recipients","authors":"Mark N. Belkin MD ,&nbsp;Molly White MS ,&nbsp;Alejandro Plana MD MS ,&nbsp;Seyed Ehsan Saffari ,&nbsp;Anthony J. Kanelidis MD ,&nbsp;Valluvan Jeevanandam MD ,&nbsp;Christopher Salerno MD ,&nbsp;Ann B. Nguyen MD ,&nbsp;Bow B. Chung MD ,&nbsp;Sara Kalantari MD ,&nbsp;Nitasha Sarswat MD ,&nbsp;Gene Kim MD ,&nbsp;Manreet Kanwar MD ,&nbsp;Sean P. Pinney MD ,&nbsp;William Parker ,&nbsp;Jonathan Grinstein MD","doi":"10.1016/j.healun.2025.10.017","DOIUrl":"10.1016/j.healun.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>The association between invasive hemodynamics measurements at time of listing for heart transplantation and the outcome of removal from the waitlist for death or deterioration was evaluated.</div></div><div><h3>Methods</h3><div>Retrospective analysis of the Scientific Registry of Transplant Candidates, including all adults listed for heart transplant from October 2018 through December 2023 was completed. All patients with listing hemodynamics for statuses 1-4, and 6, were included, unless obtained while on mechanical circulatory support. Survival analyses was performed using competing risks regressions to assess the association between baseline hemodynamic parameters and 30-day and one-year outcomes. Results reported as sub-hazard ratios (HR) and 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 22,396 patients were listed for heart transplant, of which 14,079 patients met inclusion criteria. Aortic pulsatility index (API) &lt; 1.45 (subHR 2.14 95%CI 1.64,2.79 <em>p</em>&lt;0.001), left ventricular stroke work index (LVSWI) &lt; 20 (subHR 2.37 95%CI 1.77,3.19 <em>p</em> &lt;0.001), myocardial performance score (MPS) &lt; 0.5 (subHR 2.15 95%CI 1.64,2.81 <em>p</em>&lt;0.001), pulmonary capillary wedge pressure (PCWP) &gt; 15 mmHg (subHR 2.15 95%CI 1.67,2.85 <em>p</em>&lt;0.001), and systolic blood pressure (SBP) &lt; 90 mmHg (subHR 2.19 95%CI 1.67,2.85 <em>p</em>&lt;0.001) had the strongest association with the primary outcome. As continuous metrics, API and MPS were most strongly associated with the primary outcome.</div></div><div><h3>Conclusions</h3><div>API, LVSWI, MPS, PCWP, and SBP were the strongest predictors of transplant waitlist removal for death or deterioration of patients. The current heart transplant allocation system could be improved by incorporating more prognostic hemodynamic criteria for waitlist risk stratification.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 350-362"},"PeriodicalIF":6.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145567308","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":"Commentary: Pregnancy after lung transplantation − a complex interplay of risk and hope","authors":"Katherine A. Young MD","doi":"10.1016/j.healun.2025.11.015","DOIUrl":"10.1016/j.healun.2025.11.015","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 428-429"},"PeriodicalIF":6.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145567313","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}