Journal of Heart and Lung Transplantation最新文献

{"title":"DCD heart transplantation with NRP: Excellent results and a continued uphill battle.","authors":"Alex Reyentovich, Marzia Leacche, Nader Moazami","doi":"10.1016/j.healun.2025.06.014","DOIUrl":"10.1016/j.healun.2025.06.014","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511972","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":"Refining lung donor specific antibody-associated risk using donor-derived cell free DNA.","authors":"Kieran Halloran","doi":"10.1016/j.healun.2025.06.023","DOIUrl":"10.1016/j.healun.2025.06.023","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511977","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":"Letter to the editor.","authors":"Anton Sabashnikov, Sanjay Agrawal, Bartlomiej Zych, Vicky Gerovasili","doi":"10.1016/j.healun.2025.06.013","DOIUrl":"10.1016/j.healun.2025.06.013","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511975","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":"Clinical Management of the Impella 5.5 Pump.","authors":"Alexander M Bernhardt, Vanessa Blumer, Christophe Vandenbriele, Benedikt Schrage, Kanika Mody, Federico Pappalardo, Scott Silvestry, Mark Anderson, Jacob Abraham, Ann Gage, Daniel Goldstein, Michael Grant, Ilija Klipa, Thomas Schlöglhofer, Sern Lim, Jacob Moller, Bernd Pannholzer, Ezequiel Molina, Julia Riebandt, Nir Uriel, Anthony Carnicelli, Evgenij Potapov, Manreet Kanwar","doi":"10.1016/j.healun.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.healun.2025.06.008","url":null,"abstract":"<p><p>The Impella 5.5 (Abiomed, USA) is a catheter-based micro-axial flow pump that has emerged as a vital tool in managing patients with cardiogenic shock (CS). Delivering up to 5.5 L/min of flow, it enables full left ventricular (LV) support with beneficial hemodynamic and metabolic effects. Its unique advantages include high-flow, antegrade circulatory support with the potential for prolonged usage, making it suitable for bridging to recovery or heart replacement therapies. This manuscript provides a comprehensive, structured guide for the clinical management of patients supported with the Impella 5.5. It outlines best practices for patient selection, surgical implantation techniques-most commonly via the axillary artery-perioperative management, anticoagulation strategies, and postoperative monitoring. Special emphasis is placed on complication management, including bleeding, hemolysis, right ventricular dysfunction, stroke, aortic valve injury, and vascular complications. Technologies like SmartAssist and Impella Connect are highlighted for their utility in real-time device monitoring and remote management. The manuscript also discusses a three-phase framework for recovery: hemodynamic stabilization, initiation of guideline-directed medical therapy (GDMT), and structured weaning protocols. Considerations for transitioning patients to heart transplantation or durable LVADs, as well as explant techniques, are detailed. The importance of multidisciplinary coordination-including a mechanical circulatory support (MCS) coordinator-is emphasized to ensure optimal patient outcomes. By synthesizing available evidence and institutional experience, this guide aims to standardize Impella 5.5 management, reduce complications, and improve outcomes in critically ill patients with advanced heart failure or CS.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505912","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":"Summary of the International Society for Heart and Lung Transplantation consensus conference on emerging understanding of antibodies and antibody-mediated rejection in heart transplantation.","authors":"Jon Kobashigawa, Andreas Zuckermann, Adriana Zeevi, Markus J Barten, Patricia P Chang, Monica Colvin, Guillaume Coutance, Anne Dipchand, Stephan Ensminger, Marta Farrero, Marlena Habal, Anne Halpin, Annette M Jackson, Yosef Manla, Kavitha Muthiah, Luciano Potena, Elaine F Reed, Kelly Schlendorf, Palak Shah, Anat Tambur, Simon Urschel, Steven Webber, Lori West, Jong-Chan Youn, Jignesh Patel","doi":"10.1016/j.healun.2025.02.1690","DOIUrl":"10.1016/j.healun.2025.02.1690","url":null,"abstract":"<p><p>The understanding of circulating antibodies and their relationship to antibody-mediated rejection (AMR) has yet to be fully elucidated in heart transplantation. Circulating antibodies are important in both pretransplant and post-transplant. In the pretransplant period, the more antibodies detected in a patient awaiting heart transplantation often significantly reduces the chance of obtaining a compatible donor heart. In the post-transplant period, de novo antibody development against the donor heart remains a challenge to manage. In both pre- and post-transplant scenarios, it is not known what approach is optimal for treating these patients with circulating antibodies. To address these unmet needs, a consensus conference was organized on April 18, 2023, endorsed by the International Society for Heart and Lung Transplantation. The conference represented a collaborative multidisciplinary effort by experts in cardiothoracic transplantation from across the world to understand and discuss the optimum approach and treatment of circulating antibodies and AMR in heart transplant candidates and recipients. The conference served as a forum to better understand antibodies and AMR and their impact on transplant patients. The nature of this consensus is to prepare a platform and pave the way for further detailed studies. The findings and consensus statements are hereby presented.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266416","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":"Multi-institutional outcomes of Impella use in pediatric patients: A brief communication from the ACTION Network.","authors":"Jonathan B Edelson, Shahnawaz Amdani, David N Rosenthal, Benjamin Kroslowitz, Brian Morray, Sabrina Law, Anna Joong, Sarah Wilkens, David M Peng, Michelle Ploutz, Jenna Murray, Jodie Lantz, Jesse J Esch, Mehreen Iqbal, Timothy Lancaster, Christina VanderPluym, Aamir Jeewa, Svetlana Shugh, Mohammad Absi, Muhammad Shezad, Matthew J O'Connor, Angela Lorts, Sebastian Tume","doi":"10.1016/j.healun.2025.06.007","DOIUrl":"10.1016/j.healun.2025.06.007","url":null,"abstract":"<p><p>This retrospective cohort study includes 150 pediatric patients supported with the Impella between April 2018 and November 2024. Median weight was 62.9 kg (interquartile range [IQR] 51.0-79.7 kg) and the smallest weighed 19.0 kg. Axillary artery implants occurred in 40.1% of patients while the femoral artery was used in 29%. Most patients had dilated cardiomyopathy (57.3%); however, a significant portion had transplant graft dysfunction (14.7%) or congenital heart disease (13.3%). One quarter of the cohort (N = 38) were supported with extracorporeal membrane oxygenation (ECMO) before Impella; 76% (N = 29) used ECMO and Impella in tandem, while 24% (N = 9) transitioned from ECMO to Impella. Major bleeding, major infection, device malfunction, or stroke were reported in 28% of patients (N = 42). Positive clinical outcomes were achieved in 89.3% of patients; 32.7% explanted for recovery, 32% transplanted, and 23.3% changed to another device. These data demonstrate a potential role for this device in children with refractory advanced heart failure and a need for increased work to limit adverse events.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284962","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":"Plasma-supplemented red cell concentrates as alternatives to whole blood in porcine ex vivo heart perfusion.","authors":"Kiarra Durand, Celina Phan, Sanaz Hatami, Mitchell Wagner, Larissa Lautner, Mackenzie Brandon-Coatham, Carly Olafson, Darren H Freed, Jason P Acker","doi":"10.1016/j.healun.2025.06.002","DOIUrl":"10.1016/j.healun.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Normothermic ex vivo organ perfusion holds promise for increasing the organ donor pool; however, standard use of autologous whole blood (WB) presents logistical and functional challenges. This study compared red cell concentrate (RCC)-, rejuvenated RCC-, and WB-based perfusates over a 4-hour ex vivo heart perfusion (EVHP) to assess blood quality and its impact on myocardial function.</p><p><strong>Methods: </strong>Porcine WB was leukodepleted and hypothermically stored until perfusion. RCCs were divided into five perfusate groups (n = 3, unless otherwise indicated): (A) WB with 14-day-stored RCCs (n = 2), (B) 14-day-stored RCCs alone, (C) 14-day-stored RCCs with plasma, (D) day-14 rejuvenated RCCs, perfused on day 14 of storage with plasma, (E) day-14 rejuvenated RCCs, perfused on day 21 of storage with plasma. All groups were compared to WB (n = 5). At the start and after four hours of perfusion, measurements of coronary flow, cardiac index, oxygen extraction, oxygen consumption, metabolites, red blood cell (RBC) indices, hemolysis, extracellular potassium, methemoglobin, p50, morphology, osmotic fragility, and deformability were collected.</p><p><strong>Results: </strong>Plasma-containing perfusates showed increased coronary flow, cardiac index, and initial oxygen consumption. After four hours, glucose concentrations in RCC-based solutions decreased, while hemolysis increased in most groups. Both rejuvenated RCC groups had lower extracellular potassium concentrations and improved oxygen affinity. WB-based perfusates demonstrated better RBC deformability and reduced fragility.</p><p><strong>Conclusions: </strong>Plasma is crucial for maintaining perfusate and myocardial quality in porcine EVHP models. RCC-based perfusates alongside plasma offer comparable quality to WB, potentially addressing some of the logistical challenges faced by EVHP, though this remains to be translated to humans.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258147","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 to rethink the prioritization of IABP patients in heart allocation systems worldwide?","authors":"C Delmas, C Vandenbriele, G Baudry","doi":"10.1016/j.healun.2025.06.001","DOIUrl":"10.1016/j.healun.2025.06.001","url":null,"abstract":"<p><p>The intra-aortic balloon pump (IABP) remains widely used in clinical practice despite increasing evidence questioning its efficacy and safety. Designed as a simple temporary mechanical circulatory support device, IABP might offer benefits such as afterload reduction, cardiac output enhancement, and coronary perfusion improvement. However, large randomized controlled trials such as IABP-SHOCK II and CRISP MI have failed to demonstrate a survival benefit in acute myocardial infarction related cardiogenic shock. The ALTSHOCK2 study recently failed to show a clinical advantage of IABP-therapy in patients with heart failure-related cardiogenic shock. The use of IABP as a bridge to transplantation is particularly common in countries where national allocation systems prioritize patients on IABP support. The results of the recent ALTSHOCK2-trial question the justification for its continued inclusion in prioritization models. Hence, we examine the physiological effects of IABP, its application in shock states and low cardiac-output syndrome, and its role in transplantation allocation policies worldwide. In line with the present data, we call for a reevaluation of its role in clinical practice and transplant allocation to align with strong clinical evidence.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248178","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 within the Scandiatransplant region-a multinational observational study spanning 38 years.","authors":"Oscar van der Have, Karin Tran-Lundmark, Håkan Wåhlander, Anu K Kaskinen, Thomas Möller, Klaus Juul, Timo Jahnukainen, Ilse Duus Weinreich, Taisto Sarkola, Johan Nilsson, Michal Odermarsky","doi":"10.1016/j.healun.2025.05.020","DOIUrl":"10.1016/j.healun.2025.05.020","url":null,"abstract":"<p><strong>Background: </strong>Thirty-eight years of pediatric heart transplantation (pHTx) within the Scandiatransplant organization were analyzed to describe volume trends, regional prevalence, underlying etiologies, and outcomes following listing and pHTx.</p><p><strong>Methods: </strong>Children <18 years listed for pHTx from January 1st 1986 to December 31st 2023 were identified in the Scandiatransplant registry. The cohort was split into groups based on the era of listing (ERA I; 1986-1998, ERA II; 1999-2011, and ERA III; 2012-2023).</p><p><strong>Results: </strong>A total of 597 children were listed and 461 (77.2%) reached pHTx. The regional incidence of pHTx was 4.0 per 100,000 live births. All centers performed a median of <4 pHTx per year. 6.5% were transplanted at <1 year of age. Waiting list duration increased over time, withdrawal frequency remained stable, and listing mortality decreased from 22.8% in ERA I to 6.8% in ERA III. The distribution of listing and transplant diagnoses were not different between eras. ABO-incompatible transplants increased over time, from 1.0% in ERA I to 8.8% in ERA III, as did transplant from ventricular assist devices (6.6% in ERA I, 19.9% in ERA III). Post-transplant survival was 78.0% at 10 years and 51.4% at 30 years. Survival was worse in patients with an etiology of congenital heart disease compared with cardiomyopathies. Era of listing was a determinant of listing mortality but not of post-transplant survival.</p><p><strong>Conclusions: </strong>Numbers of pHTx in the Scandiatransplant region are low but have increased with time. There has been a significant decrease in waiting list mortality over time, whereas improvements in post-pHTx outcomes have been less evident, most likely due to excellent short-term outcomes for the first graft recipients in the region.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248177","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)02009-1","DOIUrl":"10.1016/S1053-2498(25)02009-1","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 7","pages":"Page A2"},"PeriodicalIF":6.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205521","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}