Journal of Heart and Lung Transplantation最新文献

{"title":"Beyond incision choices: Enhancing recovery in lung transplantation.","authors":"Don Hayes, Hiroshi Date","doi":"10.1016/j.healun.2026.08.010","DOIUrl":"10.1016/j.healun.2026.08.010","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794054","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 the mean arterial pressure: Tissue perfusion pressure and end-organ dysfunction after heart transplantation.","authors":"Anthony Kanelidis, Jonathan Grinstein","doi":"10.1016/j.healun.2026.08.004","DOIUrl":"10.1016/j.healun.2026.08.004","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697702","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":"It's in the genes, but not alone: exome sequencing and dilated cardiomyopathy.","authors":"Simon Urschel","doi":"10.1016/j.healun.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.healun.2026.08.006","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765170","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":"Primary graft dysfunction after heart transplantation: Impaired metabolic recovery as an emerging mechanism.","authors":"Chengliang Yang, Mustafa Toma, Scott J Tebbutt","doi":"10.1016/j.healun.2026.08.001","DOIUrl":"10.1016/j.healun.2026.08.001","url":null,"abstract":"<p><p>Primary graft dysfunction (PGD), the most extensively studied phenotype within the evolving spectrum of early graft dysfunction (EGD), remains the leading cause of early mortality after heart transplantation and continues to limit broader utilization of marginal donor organs. Despite advances in donor preservation strategies and perioperative management, the mechanisms underlying PGD remain incompletely understood. Traditionally, PGD has been conceptualized as a manifestation of ischemia-reperfusion injury (IRI) leading to early graft contractile failure. Accumulating evidence suggests that impaired metabolic recovery may represent one important mechanistic layer of multifactorial PGD, characterized by incomplete restoration of mitochondrial energetics and substrate utilization after IRI. Advances in metabolomics have enabled comprehensive profiling of circulating and perfusate metabolites, providing new insights into myocardial energy metabolism during transplantation and identifying candidate biomarkers of PGD. Notably, recent studies suggest that plasma metabolomic signatures may help identify recipients at increased risk of severe PGD, while metabolomic profiling during ex situ organ perfusion reveals the dynamic changes in myocardial fuel utilization that correlate with markers of graft injury. In parallel, machine perfusion technologies provide a unique platform for dynamic metabolic assessment of donor organs before implantation. Metabolic characterization of PGD may improve donor assessment, preservation strategies, and post-transplant monitoring, although clinical implementation will require prospective validation, standardized workflows, and clinically actionable thresholds. In this review, we summarize emerging evidence linking mitochondrial dysfunction and impaired metabolic recovery to PGD and propose a conceptual framework, informed by transplant metabolomic studies, to support graft assessment, preservation, perfusion, and transplantation.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697657","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":"It's a cold, cold, world: Interpreting kidney cold ischemia in simultaneous heart-kidney transplantation.","authors":"Matteo Fabbri, Johanna Contreras","doi":"10.1016/j.healun.2026.08.003","DOIUrl":"10.1016/j.healun.2026.08.003","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697739","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":"Prognostic significance of myocardial blood flow reserve and stress myocardial blood flow in the assessment of cardiac allograft vasculopathy in heart transplant recipients.","authors":"Liam J Stanton, Nikil Prasad, Andrew J Einstein, Kevin J O'Gorman, Srikar Dudipala, Ersilia M DeFilippis, Melana Yuzefpolskaya, Margarita Chernovolenko, Elaine Lam, Michelle Castillo, Justin Fried, Jayant Raikhelkar, Koji Takeda, Gabriel T Sayer, Nir Uriel, Kevin J Clerkin","doi":"10.1016/j.healun.2026.07.038","DOIUrl":"10.1016/j.healun.2026.07.038","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac allograft vasculopathy limits longevity following heart transplantation (HT). Non-invasive physiologic assessment with cardiac PET provides prognostic significance. We sought to assess the relative prognostic relevance of stress myocardial blood flow (sMBF) and myocardial blood flow reserve (MBFR) on post-transplant outcomes.</p><p><strong>Methods: </strong>All adult single-organ HT recipients who underwent ¹³N-ammonia PET myocardial perfusion imaging between 2016 and 2019 were included with a median follow-up of 7.2 years. Patients were categorized by MBFR (normal MBFR >2.0, low MBFR ≤2.0) and sMBF (normal sMBF >1.7 mL/min/g, low sMBF ≤1.7 mL/min/g) values into three groups: concordant normal, discordant, or concordant low.</p><p><strong>Results: </strong>Among 454 patients (25.8% female, median age 59 years, median time since HT 7.2 years), 287 (63.2%) had concordant normal MBFR and sMBF, 72 (15.9%) had discordant values (37 MBFR low, 35 sMBF low), and 95 (20.9%) were concordant low. Reductions in both MBFR and sMBF had an over 3-fold increased risk of death or retransplantation compared to those with both normal values (HR 3.3, 95% CI 2.2-4.8, p<0.0001). The risk remained elevated for those with discordant values, though magnitude of risk was lower (HR 2.5, 95% CI 1.6-3.9, p=0.0001). Only an isolated reduction in MBFR (HR 3.3, 95% CI 1.9-5.6, p<0.0001), not in sMBF (HR 1.7, 95% CI 0.8-3.3, p=0.14), conferred significant risk. Rate pressure product correction did not impact results.</p><p><strong>Conclusion: </strong>In this cohort, reduction in both sMBF and MBFR was associated with the highest risk of death or retransplant during a median follow-up of 7 years.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daratumumab for non-acute antibody-mediated rejection after pediatric heart transplantation: Treatment response in the presence and absence of circulating HLA donor-specific antibody.","authors":"Yuen Lo Yau, Qingyong Xu, Matthew D Zinn, Kirsten Rose-Felker, Shawn C West, Susan A Miller, Adriana Zeevi, Brian Feingold","doi":"10.1016/j.healun.2026.07.036","DOIUrl":"10.1016/j.healun.2026.07.036","url":null,"abstract":"<p><strong>Background: </strong>Late graft survival after pediatric heart transplantation (HT) remains inadequate, with chronic rejection being a major contributor. Daratumumab has shown promise treating antibody-mediated rejection (ABMR) with limited published experience in HT.</p><p><strong>Methods: </strong>We retrospectively analyzed all HT recipients at our center treated with daratumumab (16 mg/kg × 4 doses) for ABMR identified by elevated donor-derived cell-free DNA (dd-cfDNA) without graft dysfunction or hemodynamic compromise and confirmed by endomyocardial biopsy gene expression profiling (EMB-GEP). HLA-DSA and non-HLA antibodies, including angiotensin II type 1 receptor (AT1R) antibody, were assessed pre- and post-treatment.</p><p><strong>Results: </strong>Ten recipients were identified and treated with daratumumab, including 4 without HLA-DSA at diagnosis. dd-cfDNA decreased (1.6% to 0.04%; p=0.002) post-treatment. Among 8 with post-treatment EMB, ABMR resolved (n=6) or showed only possible ABMR (n=2) after treatment. HLA-DSA total MFI (p=0.031), non-HLA antibody burden (p=0.004), and AT1R Ab concentration (p=0.004) declined post-treatment. Six patients experienced subsequent elevations of dd-cfDNA at a median of 246 days (IQR, 239-283) with ABMR recurrence on EMB and responded to retreatment. No T-cell mediated rejection occurred after treatment.</p><p><strong>Conclusions: </strong>Daratumumab was associated with significant improvements in dd-cfDNA, EMB-GEP, and antibody burden in pediatric and young adult HT recipients with ABMR. Response among patients without circulating HLA-DSA or with reduced but persistent HLA-DSA after treatment implies effects beyond plasma cell depletion. Rebound ABMR was common but responded to retreatment, suggesting periodic maintenance dosing may be required. Prospective studies are needed to define optimal treatment strategies and long-term outcomes.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689241","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 the incision: Rethinking surgical access in lung transplantation.","authors":"Alberto Benazzo, Konrad Hoetzenecker","doi":"10.1016/j.healun.2026.07.034","DOIUrl":"10.1016/j.healun.2026.07.034","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684703","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":"Improved sensitivity for respiratory pathogen detection in bronchoalveolar lavage from lung transplant recipients using targeted next-generation sequencing.","authors":"Aldo Iacono, Craig D Tipton, Jason C Sniffen, Jose Alexander, Nick Tallman, Caleb D Phillips, Michael Terrin, Esther Benamu, Marnik Wijesinha, Si Pham","doi":"10.1016/j.healun.2026.07.035","DOIUrl":"10.1016/j.healun.2026.07.035","url":null,"abstract":"<p><p>Next-generation sequencing (NGS) can improve pathogen detection in pulmonary infections among lung transplant recipients (LTRs). Here, NGS was retrospectively compared to conventional cultures (CC) in parallel bronchoalveolar lavage (BAL) specimens from LTRs. Positivity rates were compared using sensitivity and specificity relative to a composite reference for infection. NGS species-level diagnostic accuracy was assessed against culture as reference. In total, 122 bronchoscopies from 31 LTRs were included. Compared to infection, broad-range sensitivity of CC was 50.5% (95% confidence interval [CI], 35.6% to 65.4%), which was lower than NGS at 74.2% (95%CI, 64.0% to 2.3%, p=0.0016) and NGS+CC at 77.4% (95%CI, 66.0% to 85.8%). However, NGS specificity was lower at 86.2% (95%CI, 66.6% to 95.1%) compared to CC at 100% (95%CI, 100% to 100%, p=0.049). For pathogens detected by CC, NGS had a pooled sensitivity, specificity, and accuracy of 82.1%, 98.7%, and 98.6%, respectively. In conclusion, adding NGS improves microbiologic workups for pulmonary infection in immunocompromised patients after lung transplantation.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701567","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 beginning of the end for static cold storage of the donor heart.","authors":"John Dark","doi":"10.1016/j.healun.2026.07.024","DOIUrl":"10.1016/j.healun.2026.07.024","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630712","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}