Journal of Heart and Lung Transplantation最新文献

{"title":"Prognostic value of repeated peak oxygen uptake measurements in patients with a left ventricular assist device","authors":"William Herrik Nielsen MD ,&nbsp;Mariusz K. Szymanski MD, PhD ,&nbsp;Kiran K. Mirza MD, PhD ,&nbsp;Linda W. Van Laake MD, PhD ,&nbsp;Thomas Schmidt MA, PhD ,&nbsp;Darshan H. Brahmbhatt MB, BChir, MD (Res) ,&nbsp;Filio Billia MD, PhD, FRCPC ,&nbsp;Steven Hsu MD, FACC ,&nbsp;Guy MacGowan MD, FRCPI, FACC ,&nbsp;Djordje G. Jakovljevic PhD ,&nbsp;Piergiuseppe Agostoni MD, PhD ,&nbsp;Filippo Trombara MD ,&nbsp;Ulrich P. Jorde MD, PhD ,&nbsp;Yogita Rochlani MD ,&nbsp;Katrien Vandersmissen MSN ,&nbsp;Nils Reiss MD, PhD ,&nbsp;Stuart D. Russell MD ,&nbsp;Bart Meyns MD, PhD ,&nbsp;Finn Gustafsson MD, PhD, DMSC","doi":"10.1016/j.healun.2024.10.003","DOIUrl":"10.1016/j.healun.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Peak oxygen uptake (pVO₂) predicts mortality in patients with heart failure on left ventricular assist device (LVAD) support. This follow-up of the PRO-VAD study examines the prognostic value of repeated pVO₂ measurements during long-term follow-up.</div></div><div><h3>Methods</h3><div>This multicenter follow-up study included patients from the original PRO-VAD cohort who performed a cardiopulmonary exercise test (CPET) twice. Patients were categorized into 4 groups based on pVO₂ levels at the 2 CPETs: low at both tests, low at the first and high at the second test, high at the first and low at the second test, and high at both tests. Low pVO₂ was defined as ≤14 ml/kg/min (or ≤12 ml/kg/min if beta-blocker tolerant), while values above these thresholds were considered high. Survival outcomes were analyzed using the Kaplan-Meier method and cause-specific Cox analysis.</div></div><div><h3>Results</h3><div>The study included 152 patients with repeated CPETs at approximately 6 and 12 months following LVAD implantation. The cohort showed slight but significant pVO₂ improvement (median change: 0.4 ml/kg/min, <em>p</em> = 0.04). Persistently high pVO₂ (76 patients) was associated with a 5-fold reduction in mortality hazard (hazard ratio [HR] 0.20, <em>p</em> = 0.002), compared with persistently low pVO₂ (46 patients). Improvement from low to high pVO₂ (21 patients) displayed similar benefits (HR 0.21, <em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>pVO₂ measurements remain predictive of mortality upon reiteration in patients with LVAD, with changes in pVO₂ providing additional prognostic value in identifying patients with an excellent outcome on ongoing LVAD support and in identifying patients requiring further interventions.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 2","pages":"Pages 236-245"},"PeriodicalIF":6.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451797","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":"iPhone or Blackberry? The unsure future of ex vivo lung perfusion: A commentary on ex vivo lung perfusion national trends and posttransplant outcomes","authors":"Gaurav Sharma PhD, MBA ,&nbsp;Michael E. Jessen MD ,&nbsp;Matthias Peltz MD","doi":"10.1016/j.healun.2024.10.012","DOIUrl":"10.1016/j.healun.2024.10.012","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 2","pages":"Pages 159-160"},"PeriodicalIF":6.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488287","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 cardiac allograft vasculopathy: Harnessing multimodal imaging to improve prognosis.","authors":"Maria Generosa Crespo-Leiro, Mandeep R Mehra","doi":"10.1016/j.healun.2025.01.015","DOIUrl":"10.1016/j.healun.2025.01.015","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073722","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":"Early Renal Failure After Primary Thoracic Organ Transplantation.","authors":"Eileen Hsich, Tajinder P Singh, Wida S Cherikh, Alexandra Lewis, Shaina Kian, Michael Perch, Don Hayes, Rebecca Cogswell","doi":"10.1016/j.healun.2024.11.042","DOIUrl":"10.1016/j.healun.2024.11.042","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046933","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":"Survival and functional outcomes after pediatric living-donor lobar lung transplantation and deceased-donor lung transplantation: A Japanese multicenter retrospective study.","authors":"Yuki Morimura, Kei Matsubara, Satona Tanaka, Haruki Choshi, Shin Tanaka, Takashi Kanou, Yojiro Yutaka, Akihiro Ohsumi, Daisuke Nakajima, Yasushi Shintani, Seiichiro Sugimoto, Shinichi Toyooka, Hiroshi Date","doi":"10.1016/j.healun.2025.01.012","DOIUrl":"10.1016/j.healun.2025.01.012","url":null,"abstract":"<p><strong>Background: </strong>In pediatric living-donor lobar lung transplantation, whether transplanting adult lobes could result in satisfactory long-term survival and respiratory functional outcomes during and after the growth period in pediatric patients remains unclear. This study aimed to evaluate the long-term survival and functional prognosis after pediatric living-donor lobar lung transplantation and deceased-donor lung transplantation.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data of pediatric patients (age: ≤17 years) who underwent lung transplantation between March 2001 and December 2022 at 3 institutions in Japan.</p><p><strong>Results: </strong>Seventy and 24 patients who underwent living-donor and deceased-donor transplantation, respectively, were included. The 5-year and 10-year overall survival rates were 84.6% and 75.0% after living-donor transplantation and 85.8% and 85.8% after deceased-donor transplantation (p = 0.75), respectively. With a median follow-up period of 89.2 months, 48 living-donor cases (100%) and 16 deceased-donor cases (84.2%) had performance status 0 to 2 among 48 living-donor cases and 19 deceased-donor cases who were alive without retransplantation. They showed height growth (median +9.7 cm, p < 0.01); however, the height standard deviation score decreased after transplantation (median -0.22, p = 0.03). The difference in height standard deviation score between the last follow-up and pretransplantation was negative (median -0.42) in living-donor cases and significantly smaller than that in deceased-donor cases (median +0.19, p = 0.02).</p><p><strong>Conclusions: </strong>Pediatric living-donor lobar lung transplantation provided satisfactory long-term survival and functional prognosis that were comparable to those of deceased-donor lung transplantation. The limited post-transplant height growth in living-donor cases might be attributed to this favorable functional prognosis.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039527","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":"Targeting long-term benefit by tailoring calcineurin inhibitor-free regimens early after adult heart transplant.","authors":"Maya Barghash, Sean P Pinney","doi":"10.1016/j.healun.2025.01.014","DOIUrl":"10.1016/j.healun.2025.01.014","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028924","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":"Lung transplantation and bone health: A narrative review.","authors":"Anna M Rzepka, Lianne Tile, Chung-Wai Chow, Heather McDonald-Blumer, Cecilia Chaparro, Rowena Ridout, Angela M Cheung","doi":"10.1016/j.healun.2025.01.010","DOIUrl":"10.1016/j.healun.2025.01.010","url":null,"abstract":"<p><p>Bone health after lung transplantation has not been comprehensively reviewed in over 2 decades. This narrative review summarizes the available literature on bone health in the context of lung transplantation, including epidemiology, presentation, and postoperative management. Osteoporosis is reported in approximately 30% to 50% of lung transplant candidates, largely due to disease-related impact on bone and lifestyle, and corticosteroid-related effects during end-stage lung disease (interstitial lung diseases, chronic obstructive pulmonary disease, and historically cystic fibrosis). After lung transplantation, many patients experience steroid-induced bone loss, followed by stabilization or recovery to baseline levels with pharmacologic management. Although evidence on fracture incidence is limited, fracture risk appears to increase in the year following transplantation, with common fracture sites including the vertebrae and the ribs. Vertebral and rib fractures restrict chest expansion and affect lung function, underscoring the importance of fracture prevention in lung transplant recipients. There is limited evidence on the pharmacologic management of osteoporosis after lung transplantation. Existing randomized controlled trials have focused on parenteral bisphosphonates and calcitriol but have been underpowered to evaluate their effect on fracture outcomes. Resistance training, particularly in conjunction with antiresorptive therapy, has also been shown to improve bone health when initiated 2 months after transplantation. No studies to date have documented the effectiveness of denosumab in lung transplant recipients; more studies on pharmacotherapy are warranted to elucidate optimal medical management. Considering the high osteoporosis prevalence and fracture risk in lung transplant populations, the development of formal guidance is warranted to promote improved management after transplantation.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006721","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 ACTION VAD registry: A collective five-year experience","authors":"Jonathan B. Edelson MD ,&nbsp;Alexander Raskin ,&nbsp;Mohammed Absi ,&nbsp;Iki Adachi ,&nbsp;Othman Aljohani ,&nbsp;Anaam Alzubi ,&nbsp;Shahnawaz Amdani ,&nbsp;Alfred Asante-Korang ,&nbsp;Scott Auerbach ,&nbsp;Neha Bansal ,&nbsp;David Bearl ,&nbsp;Katerina Boucek ,&nbsp;Arene Butto ,&nbsp;Ryan Butts ,&nbsp;Jonathan Byrnes ,&nbsp;Chesney Castleberry ,&nbsp;Jennifer Conway ,&nbsp;Nhue Do ,&nbsp;John Dykes ,&nbsp;Joshua Friedland-Little ,&nbsp;Robert Niebler MD","doi":"10.1016/j.healun.2025.01.007","DOIUrl":"10.1016/j.healun.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.</div></div><div><h3>Methods</h3><div>The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018 to June 2023. It includes 1,430 devices implanted in 1,220 pediatric patients (≤18) from 57 sites across North America.</div></div><div><h3>Results</h3><div>Males comprised 55% of the registry patients. The median age was 3.7 years with a median implant weight of 13.6 kg; 36% of the cohort was &lt;10 kg. Nearly 40% of patients had a primary diagnosis of congenital heart disease (CHD). Patients with CHD represented 26% of VAD implants in 2018 which increased to 42% in 2023 (<em>p</em> <!-->=<!--> <!-->0.03). At implant, 25% of patients were supported with extracorporeal membrane oxygenation (ECMO), 4.9% with dialysis, and 54% were mechanically ventilated. Paracorporeal pulsatile pumps comprised 40.2% of implants, followed in incidence by paracorporeal continuous flow (28.5%), and implantable continuous flow (24.1%). The number of patients in the VAD Registry patients increased from 102 in 2018 to 256 in 2022, partly reflecting increased center participation in ACTION. Overall survival on support at 1 year was 79.2%, and the incidence of stroke was 13.7%. Infants demonstrated the poorest outcomes, with a 1-year survival of 72.9% and a higher incidence of stroke (20.8%).</div></div><div><h3>Conclusion</h3><div>The 5-year ACTION VAD experience highlights the growing collaboration in the pediatric VAD community and changes in clinical practice. More work is needed to improve survival and limit adverse outcomes, especially in younger patients.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 4","pages":"Pages 530-540"},"PeriodicalIF":6.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991700","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":"Short and long-term outcomes of lung transplantation from brain death vs. circulatory death donors: A meta-analysis of comparative studies.","authors":"Cristiano Spadaccio, Antonio Salsano, Salah Altarabsheh, Alejandra Castro-Varela, Carlos Gallego Navarro, Fernando Juarez Casso, Ahmed Abdelrehim, Kartik Andi, Rafaela V P Ribeiro, Kukbin Choi, Gustavo Knop, Cassie C Kennedy, Kelly M Pennington, Philip J Spencer, Richard Daly, Mauricio Villavicencio, Marcelo Cypel, Sahar A Saddoughi","doi":"10.1016/j.healun.2024.12.010","DOIUrl":"10.1016/j.healun.2024.12.010","url":null,"abstract":"<p><strong>Background: </strong>To investigate through a meta-analysis of comparative studies the impact of donor type (brain death DBD vs circulatory death DCD) on the short- and long-term outcomes of lung transplantation(LTx).</p><p><strong>Methods: </strong>Literature search (terms \"lung transplantation\" AND \"donation after circulatory death\") was performed up to July 2022 and studies comparing outcomes of LTx from DCD versus DBD were selected. Primary endpoints were early and long-term mortality. Secondary outcomes included primary graft dysfunction (PGD),acute rejection and postoperative complications. The long-term survival was analyzed by retrieving data from each available Kaplan-Meier and restricted mean survival time difference between DBD and DCD for long-term survival was estimated.</p><p><strong>Results: </strong>21 studies were included comprising 60105 patients (DBD=58548 DCD=1557). Recipient and donor baseline characteristics were similar between the two groups. No significant publication bias was observed. The estimated pooled odds ratio of early mortality favored DBD (OR=0.75,CI=0.56-1.00, I²=0%). No statistically significant difference was observed in the risk of acute rejection (OR=1.33, CI=0.82-2.17), and PGD grade 2-3 (OR=0.88, CI=0.69-1.13). One- and 5-year survival were 82.1% and 51.2%, and 86.2% and 62.7% for DBD and DCD groups, respectively (Log-rank,p<0.0001). Unadjusted hazard ratio was 0.693, with DCD as reference. DCD lungs demonstrated improved survival by 4.82% over 5-years when compared to DBD lungs.</p><p><strong>Conclusions: </strong>This meta-analysis of comparative studies between DCD and DBD demonstrates significant long-term survival advantage of DCD LTx despite an initial small but statistically significant increased mortality risk in the short-term. Data supports the continued implementation of DCD to increase the lung donor pool.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971125","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":"Early Results of an Infant Model of Orthotopic Cardiac Xenotransplantation","authors":"Chace B. Mitchell MD ,&nbsp;Joe Simmons DVM, PhD ,&nbsp;Carolyn L. Hodo DVM, PhD ,&nbsp;Sarah J. Neal PhD ,&nbsp;Sriram Chitta PhD ,&nbsp;Clementine Vo DO ,&nbsp;Kanwarpal Bakshi MD ,&nbsp;Julie Juliani CCP, FPP ,&nbsp;Julie Fenske CCP ,&nbsp;David C. Cleveland MD ,&nbsp;John D. Cleveland MD","doi":"10.1016/j.healun.2024.12.011","DOIUrl":"10.1016/j.healun.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Genetically engineered porcine hearts may have an application for infants in need of a bridge to cardiac allotransplantation. The current animal model that resulted in 2 human applications has been validated in adult non-human primates only. We sought to create an infant animal model of life sustaining cardiac xenotransplantation to understand limitations specific to this age group.</div></div><div><h3>Methods</h3><div>We performed 11 orthotopic cardiac xenotransplants from genetically modified infantile pigs into size-matched baboons (<em>Papio</em> spp). Porcine grafts were preserved using a modified Del Nido solution. Protocolized post-operative care and outcomes were tracked with invasive monitoring, echocardiogram, and serial chemistries (including a 7-cytokine panel).</div></div><div><h3>Results</h3><div>Mean ischemic time was 52.1 +/- 13.9 min. All porcine hearts separated from bypass in normal sinus rhythm with normal systolic function documented by echocardiogram at chest closure and again at 24 h. In the first 48 post-operative hours, mean vasoactive inotropic score for the recipients was 9.6 +/- 3.5. Survival &gt;3months was achieved in 6 animals. Five animals succumbed early (&lt;7days) either due to errors in care (n=2) or pulmonary complications (n=3) confirmed on chest radiograph and necropsy. Cytokine levels objectively increased following xenograft implant but were not significantly different between survivors and non-survivors.</div></div><div><h3>Conclusions</h3><div>In a non-human primate model of infant orthotopic cardiac xenotransplantation, cardiac function does not hinder early peri-operative survival. Instead, pulmonary edema and pleural effusions in the setting of systemic inflammation preclude clinical progression. Targeted therapies are necessary to encourage prolonged survival.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 4","pages":"Pages 503-510"},"PeriodicalIF":6.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950040","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}