Journal of Heart and Lung Transplantation最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S1053-2498(25)01888-1","DOIUrl":"10.1016/S1053-2498(25)01888-1","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 5","pages":"Page A2"},"PeriodicalIF":6.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817134","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":"Longitudinal assessment of bone mineral density changes after heart transplant: Implications for DXA screening frequency","authors":"Ronnie Sebro MD, PhD ,&nbsp;Mahmoud Elmahdy MBBS ,&nbsp;Ayanna Braxton","doi":"10.1016/j.healun.2025.01.020","DOIUrl":"10.1016/j.healun.2025.01.020","url":null,"abstract":"<div><div>We evaluated the rate of bone mineral density (BMD) loss after heart transplant using dual-energy X-ray absorptiometry (DXA) to determine the optimal DXA surveillance frequency. This retrospective study involved 153 heart transplant recipients aged 50 years or greater, followed for up to 5,614 (median 1,111) days after transplant. Mixed-effects models with random intercepts were used to evaluate BMD changes over time. We found that males had higher BMD at each site before transplant (<em>p</em> &lt; 0.05 for all). Patients with normal BMD pretransplant had a greater rate of BMD loss compared to patients who had low BMD pretransplant at the femoral neck. The rate of BMD loss was fastest at the femoral neck in patients with normal BMD pretransplant, with an estimated annual femoral neck BMD decrease of 0.00905 g/cm². The expected time for a patient to have a significant change in BMD is 1,332 days (95% confidence interval [909, 2,493] days).</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 5","pages":"Pages 823-829"},"PeriodicalIF":6.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817044","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":"Time-series tacrolimus trough level prediction using multivariate long short-term memory networks: Methodology and prospective validation","authors":"Haruki Choshi MD ,&nbsp;Kentaroh Miyoshi MD, PhD ,&nbsp;Maki Tanioka MD, PhD ,&nbsp;Shinichi Toyooka MD, PhD","doi":"10.1016/j.healun.2025.01.013","DOIUrl":"10.1016/j.healun.2025.01.013","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 5","pages":"Pages 845-847"},"PeriodicalIF":6.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817046","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":"Machine learning model for tacrolimus dosing: Can we validate and compare to existing options?","authors":"Michael G.S. Shashaty MD, MSCE ,&nbsp;Gary E. Weissman MD, MSHP ,&nbsp;Marc H. Scheetz PharmD, MSC ,&nbsp;Todd A. Miano PharmD, PhD","doi":"10.1016/j.healun.2024.12.021","DOIUrl":"10.1016/j.healun.2024.12.021","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 5","pages":"Pages 843-844"},"PeriodicalIF":6.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817045","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":"ISHLT consensus statement on the perioperative use of ECLS in lung transplantation: Part III: Postoperative considerations.","authors":"Archer Kilbourne Martin, Olaf Mercier, Brandi Bottiger, Marcelo Cypel, Julien Fessler, David Gomez-De-Antonio, Bronwyn Levvey, Haifa Lyster, Basil Nasir, Melissa Sanchez, Keith Wille, Ashley Virginia Fritz, Theresa Gelzinis, Konrad Hoetzenecker, Kavita Dave, Sandra Lindstedt, Nandor Marczin, Barbara Wilkey, Marc Schecter, James Walsh, Orla Morrissey, Caroline Landry, Siavosh Saatee, Sakhee Kotecha, Juergen Behr, Jasleen Kukreja, Göran Dellgren, Anna K Reed","doi":"10.1016/j.healun.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.healun.2025.03.004","url":null,"abstract":"<p><p>The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no multidisciplinary consensus document has examined the perioperative considerations of how to best manage these patients. To address this challenge, this perioperative utilization of ECLS in lung transplantation consensus statement was approved for development by the International Society for Heart and Lung Transplantation Standards and Guidelines Committee. International experts across multiple disciplines, including cardiothoracic surgery, anesthesiology, critical care, pediatric pulmonology, adult pulmonology, pharmacy, psychology, physical therapy, nursing, and perfusion, were selected based on expertise and divided into subgroups examining the preoperative, intraoperative, and postoperative periods. Following a comprehensive literature review, each subgroup developed recommendations to examine via a structured Delphi methodology. Following 2 rounds of Delphi consensus, a total of 22 recommendations regarding postoperative considerations for ECLS in lung transplantation met consensus criteria. These recommendations focus on the criteria for postoperative ECLS as well as select multidisciplinary team management considerations throughout the entire postoperative spectrum.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199354","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":"Donor care units in heart transplantation: The heart of the matter.","authors":"Ioannis Mastoris, David D'Alessandro","doi":"10.1016/j.healun.2025.03.026","DOIUrl":"10.1016/j.healun.2025.03.026","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795513","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":"Rescue kidneys in lung transplantation: A retrospective analysis of recipients who might have benefitted from a kidney safety net.","authors":"Jiashu Xue, Reed Jenkins, Jessica Ruck, Christian Merlo, Errol Bush","doi":"10.1016/j.healun.2025.03.025","DOIUrl":"10.1016/j.healun.2025.03.025","url":null,"abstract":"<p><strong>Background: </strong>In 2023, a new United Network for Organ Sharing (UNOS) policy established criteria for a kidney allocation safety net for lung transplant recipients (LTRs) with chronic renal dysfunction. We sought to evaluate the demographics and outcomes of past lung transplant recipients who would have been eligible for a rescue kidney under the new criteria.</p><p><strong>Methods: </strong>Using the UNOS Organ Procurement and Transplantation Network (OPTN) registry, we identified lung transplant recipients from 2005 to 2023 who fit the eligibility for rescue kidneys. Rescue kidney eligibility was defined as recipients who had an eGFR≤20ml/min, CrCl≤20ml/min, or were receiving chronic dialysis at any point 60-365 days post-transplant. Baseline characteristics and survival out to 1 and 3 years were evaluated for the rescue kidney-eligible cohort compared to all other lung transplant recipients in the study period.</p><p><strong>Results: </strong>Five hundred and fifty four (2.1%) of all recipients would have been eligible for a rescue kidney under the new policy. Comparing to non-eligible group, they were older (median, 62 vs 61 years; p < 0.001), had higher body mass index (BMI) (27 vs 26; p < 0.001), and were more often Black (13% vs 9%; p < 0.001). They also had a significantly higher proportion of renal dysfunction (including chronic kidney disease [CKD] stage III, IV and V) at the time of transplant (17% vs 7%; p < 0.001) and higher likelihood of pre-transplant dialysis (7% vs 0%; p < 0.001). The rescue-eligible recipients had higher rates of life support (14% vs 11%; p = 0.031) and greater lung allocation score (LAS) at transplant (median 40 vs 39; p < 0.01). Compared to non-eligible recipients, rescue kidney-eligible recipients had lower survival at 1 year (42% vs. 88%, p < 0.001) and 3 years (28% vs. 71%, p < 0.001). These differences in mortality risk persisted after adjusting for donor and recipient characteristics (1-year mortality aHR 9.27; 95% CI 8.16-10.55; p < 0.001; 3-year aHR 5.55; 95% CI 4.97-6.20; p < 0.001).</p><p><strong>Conclusion: </strong>While relatively few recipients would have been eligible for a rescue kidney under the new policy, they had significantly worse survival than non-eligible recipients. This underscores the severe illness of these patients and the importance of assessing whether rescue kidneys can reduce these mortality differences.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788471","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":"A randomized trial of open lung protective ventilation compared to conventional mechanical ventilation in deceased organ donors.","authors":"Lorraine B Ware, Tatsuki Koyama, Ciara M Shaver, Sharon Swain, John Nguyen, Ahmad Salehi, Gundeep Dhillon, Nancy Wickersham, Julia Maheshwari, Jonathan P Singer, S Samuel Weigt, Jasleen Kukreja, Michael A Matthay","doi":"10.1016/j.healun.2025.03.027","DOIUrl":"10.1016/j.healun.2025.03.027","url":null,"abstract":"<p><strong>Background: </strong>We conducted a randomized trial of open lung protective ventilation (OLPV) compared to conventional ventilation (CV) in deceased donors. The primary outcome was lung utilization for transplantation.</p><p><strong>Methods: </strong>Eligible donors were ≥13 years with PaO₂/FiO₂ between 150 and 400 mmHg. Donors were randomized to volume control with OLPV [tidal volume (TV) 8 ml/kg, PEEP 10 cmH₂O, protocolized recruitment maneuvers (RM)] or CV [TV 10 ml/kg, PEEP 5 cm H₂O, RM only after vent disconnect] for duration of donor management. Lungs were evaluated for transplantation on standardized ventilator settings in both arms [TV 10 ml/kg, PEEP 5 cm H₂O, FiO₂ 1.0].</p><p><strong>Results: </strong>One hundred and fifty three donors were randomized (74 to OLPV, 79 to CV) and included in the final analysis. Median duration of treatment was 50 hours and did not differ by arm. Donor lung utilization was 23% in the OLPV arm and 22% in the CV arm, p = 0.85. Change in PaO₂/FiO₂ from randomization to procurement did not differ by treatment; median increase (quartiles) in OLPV versus CV was 68 mmHg (18, 127) vs 74 (-27, 170), p = 0.72. There was no difference in need for vasopressors or serious adverse events between arms. Among 28 lung recipients in whom detailed outcomes were available, duration of mechanical ventilation, ICU stay and hospital stay were not different by treatment arm.</p><p><strong>Conclusions: </strong>An open lung protective ventilator strategy was safe but did not improve donor lung utilization or oxygenation compared to a conventional ventilator strategy in a population of US organ donors. NCT03439995.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788409","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":"Right atrial size in PAH: Independent marker or just an echo of RV dysfunction?","authors":"Tor Skibsted Clemmensen, Mads Jønsson Andersen","doi":"10.1016/j.healun.2025.03.022","DOIUrl":"10.1016/j.healun.2025.03.022","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788510","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":"An immersive look into temperature-controlled hypothermic heart preservation.","authors":"Fuyi Liao, Andrew E Gelman","doi":"10.1016/j.healun.2025.03.023","DOIUrl":"10.1016/j.healun.2025.03.023","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788460","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}