Journal of Heart and Lung Transplantation最新文献

{"title":"Reducing driveline infection risk in durable mechanical circulatory support devices with ultra-flexible wires for energy transfer.","authors":"Andreas P Kourouklis, Xi Wu, Julius Kaemmel, Sanne Hertegonne, Srikanth Mairpady Shambat, Mihyun Lee, Christian Grossmann, Raphael Hagen, Daniel Fehr, Fabrizio Spano, Carolina Pietsch, Simone de Brot, Nikola Cesarovic, Qun Ren, Mathias Bonmarin, Miriam Weisskopf, Annelies S Zinkernagel, Evgenij Potapov, Volkmar Falk, Edoardo Mazza","doi":"10.1016/j.healun.2025.07.012","DOIUrl":"10.1016/j.healun.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>Driveline infections (DLIs) pose a burden to heart failure patients supported by durable mechanical circulatory support devices (dMCSs). A major factor to DLI comes from the low mechanical compliance of drivelines, affecting wound healing. New drivelines that mitigate mechanical stress on skin may reduce the risk of DLI. We investigate macroscopic and microscopic effects of wires with low flexural stiffness on the risk of DLI.</p><p><strong>Methods: </strong>Prototypes equipped with ultra-flexible wires, due to their stranded metallic core and small diameter, were percutaneously implanted in an adult ovine model of DLI and subjected to electric conditions typical of dMCS operation. In the control (no bacterial inoculation, n=2 animals, follow-up period around 2 months) and inoculation (with Staphylococcus epidermidis, n=2 animals, follow-up period 1.5 months) study groups, the commercial dMCS drivelines and the prototypes were implanted at equivalent surgical sites of each animal. In the inoculation group, the surgical sites were infected with Staphylococcus epidermidis 2 weeks post-implantation.</p><p><strong>Results: </strong>Ultra-flexible wires showed flawless electromechanical performance, enabled fast recovery of skin redness in the first 2 weeks (p<0.05), and reduced inflammation (p<0.0001) at the exit site compared to commercial dMCS drivelines. After S. epidermidis inoculation at the exit site, ultra-flexible wires displayed reduced bacterial number (34 times lower) compared to commercial dMCS drivelines, avoiding internal biofilm formation and macroscopic signs of infection.</p><p><strong>Conclusions: </strong>Using small, ultra-flexible wires reduced wound size and mechanical stress at the exit site, strengthening barrier function and lowering the risk of DLI. The use of ultra-flexible wires may improve the quality and duration of life of patients supported with dMCS.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718019","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 cold storage: Rise of the machines","authors":"Shivank Madan MD, MHA ,&nbsp;Daniel J. Goldstein MD","doi":"10.1016/j.healun.2025.07.019","DOIUrl":"10.1016/j.healun.2025.07.019","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1725-1727"},"PeriodicalIF":6.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718017","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":"Decoding pulmonary arterial hypertension-associated myopathy: Omics-based insights into myopathy and exercise intolerance","authors":"Yazhini Ravi MD ,&nbsp;Chittoor B. Sai-Sudhakar MD, FRCS, FACS","doi":"10.1016/j.healun.2025.07.014","DOIUrl":"10.1016/j.healun.2025.07.014","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1809-1810"},"PeriodicalIF":6.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701088","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":"From rescue to preemption: Rethinking the therapeutic paradigm in cardiogenic shock","authors":"Alessandro Verde MD, PhD,&nbsp;Andrea Garascia MD","doi":"10.1016/j.healun.2025.07.007","DOIUrl":"10.1016/j.healun.2025.07.007","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page 1829"},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693497","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 causality between right ventricular reserve function and aortic valve opening: Which came first, the chicken or the egg?","authors":"Masaru Hatano MD, PhD ,&nbsp;Minoru Ono MD, PhD","doi":"10.1016/j.healun.2025.07.011","DOIUrl":"10.1016/j.healun.2025.07.011","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page 1786"},"PeriodicalIF":6.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693460","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":"Consequences of patient denial at first exemption request for cardiac transplantation","authors":"A. Alam MD ,&nbsp;S. Golob MD ,&nbsp;S. Patel MPH ,&nbsp;N. Fatma PhD ,&nbsp;D. Segev ,&nbsp;A. Massie PhD ,&nbsp;M. Moussa MD ,&nbsp;E. Flattery MD ,&nbsp;K. Phillips MD ,&nbsp;B. Wayda MD ,&nbsp;J.N. Katz ,&nbsp;D. Stewart MS ,&nbsp;S. Gentry PhD ,&nbsp;R.I. Goldberg MD ,&nbsp;S. Rao MD ,&nbsp;A. Reyentovich MD ,&nbsp;N. Moazami MD","doi":"10.1016/j.healun.2025.06.025","DOIUrl":"10.1016/j.healun.2025.06.025","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1838-1840"},"PeriodicalIF":6.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678039","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":"Combined heart-lung transplantation: Options for increasing the donor pool","authors":"Don Hayes Jr MD, MS, MEd, MBA ,&nbsp;Marie M. Budev DO, MPH ,&nbsp;David C. McGiffin MB, BS, FRACS, DMedHS","doi":"10.1016/j.healun.2025.07.003","DOIUrl":"10.1016/j.healun.2025.07.003","url":null,"abstract":"<div><div>Combined heart-lung transplant (HLT) peaked globally in 1989–1990 with a subsequent fall in case numbers; however, there has been a steady increase in the number of HLTs performed in the United States since 2014. Due to rising interests in HLT, there was a timely session on HLT at the International Society for Heart and Lung Transplantation 45th Annual Meeting and Scientific Sessions. The session highlighted a novel approach to reduce geographical limitations for donor organs using ex vivo normothermic perfusion, but it re-introduced historical complications associated with en bloc double lung transplantation and the tracheal anastomosis. To continue advancing care to patients with combined heart and lung disease, the cardiothoracic transplant community needs to address challenges for access to donor organs for HLT candidates through resolving logistical and distance issues and developing best practice using machine perfusion and temperature-controlled preservation strategies.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1831-1832"},"PeriodicalIF":6.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678096","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":"“No Hearts Left Behind”: A global proposal to rescue discarded donor hearts","authors":"Arezu Aliabadi-Zuckermann MD ,&nbsp;Andreas Zuckermann MD ,&nbsp;Mandeep R. Mehra MD, MSc","doi":"10.1016/j.healun.2025.07.009","DOIUrl":"10.1016/j.healun.2025.07.009","url":null,"abstract":"<div><div>Despite technological and logistical progress in heart transplantation, thousands of viable donor hearts are still discarded annually—particularly in the United States—while patients elsewhere continue to die waiting. This viewpoint proposes a global paradigm shift: enabling transatlantic exchange of unused donor hearts through advanced preservation technologies and reciprocal allocation frameworks. Using registry data from Eurotransplant and the United States, we highlight striking disparities in donor acceptance criteria, especially regarding older or donors previously considered less suitable. We argue that many of these organs, declined locally for non-biological reasons, could safely be transplanted in regions where differing practices and technologies allow their use. Advances in preservation—including temperature-controlled static storage, hypothermic oxygenated perfusion, and normothermic ex vivo systems—now permit safe transport over thousands of kilometers, challenging traditional constraints of time and geography. We outline the ethical, financial, and regulatory prerequisites for a transatlantic donor heart exchange system and propose early feasibility trials to initiate proof-of-concept sharing. Such a model would require transparency, international oversight, and an equitable “payback” mechanism to maintain trust and balance. Ultimately, we argue that a globally integrated approach to organ sharing—similar to international marrow registries—could transform access to transplantation, reduce waitlist mortality, and better honor the gift of donation. “No Hearts Left Behind” is more than a slogan: it is an ethical imperative supported by technological feasibility. The time has come to build the bridges—legal, logistical, and moral—that make global heart exchange a reality.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1833-1835"},"PeriodicalIF":6.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669330","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":"Natural history of lung function after lung transplantation; from ALAD to BLAD to CLAD or otherwise","authors":"Rodrigo Vazquez-Guillamet MD,&nbsp;Roger D. Yusen MD, MPH","doi":"10.1016/j.healun.2025.06.030","DOIUrl":"10.1016/j.healun.2025.06.030","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1763-1765"},"PeriodicalIF":6.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144630352","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":"Proteomic and metabolomic profiling nominates druggable targets and biomarkers for pulmonary arterial hypertension–associated myopathy and exercise intolerance in male monocrotaline rats","authors":"Phablo Abreu PhD ,&nbsp;Ryan Moon BA ,&nbsp;Jenna B. Mendelson BS ,&nbsp;Todd Markowski MS ,&nbsp;LeeAnn Higgins PhD ,&nbsp;Kevin Murray PhD ,&nbsp;Candace Guerrero PhD ,&nbsp;Jeffrey Blake ,&nbsp;Sasha Z. Prisco MD, PhD ,&nbsp;Kurt W. Prins MD, PhD","doi":"10.1016/j.healun.2025.06.034","DOIUrl":"10.1016/j.healun.2025.06.034","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary arterial hypertension (PAH) is a rare but debilitating condition that causes exercise intolerance and ultimately death. Skeletal muscle derangements contribute to depressed exercise capacity in PAH, but the mechanisms underlying muscle dysfunction, including the changes in muscle biology based on fiber type, are understudied.</div></div><div><h3>Methods</h3><div>We evaluated exercise capacity, muscle histopathology, mitochondrial density, mitochondrial proteomics, and metabolomics/lipidomics of <em>quadriceps (</em>predominately fast fibers<em>)</em> and <em>soleus (</em>predominately slow fibers) muscles in the monocrotaline (MCT) rat model of PAH.</div></div><div><h3>Results</h3><div>MCT rats exhibited impaired exercise capacity. Surprisingly, there were divergent atrophic and metabolic remodeling in the <em>quadriceps</em> and <em>soleus</em> muscles of MCT rats. In the <em>quadriceps</em>, there was a mild atrophic response only in type II fibers. In contrast, both type I and II fibers atrophied in the <em>soleus</em>. Both muscles exhibited fibrotic infiltration, but mitochondrial density was reduced in the <em>quadriceps</em> only. Mitochondrial proteomics and tissue metabolomics/lipidomics profiling demonstrated that the 2 muscles exhibited distinct responses, as the <em>quadriceps</em> had impairments in oxidative phosphorylation/fat metabolism and storage of triacylglycerides. However, the <em>soleus</em> showed signs of proteasome deficiencies and alterations in phosphatidylcholine/phosphatidylethanolamine homeostasis. Finally, profiling of metabolites/lipids in the serum identified potential novel biomarkers of exercise intolerance in PAH, including the dimethylarginine pathway, cysteine, and triacylglycerides.</div></div><div><h3>Conclusions</h3><div>Our data suggest differential cachectic and metabolic responses occur in PAH-induced myopathy. We nominate mitochondrial biogenesis and proteasome activation as potential druggable targets for PAH myopathy.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1798-1808"},"PeriodicalIF":6.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618581","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}