The Journal of Heart and Lung Transplantation最新文献

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Corrigendum to 'Evaluating the mechanism of action behind controlled hypothermic preservation of donor hearts: A randomized pilot study' [J Heart Lung Transplant, 44 (2025) 1137-1145]. 供体心脏控制低温保存的作用机制评价:一项随机试点研究[J].心肺移植,44(2025):1137-1145。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-13 DOI: 10.1016/j.healun.2025.10.001
Allen A Razavi,Jon Kobashigawa,Aleksandr Stotland,Qiudong Chen,Jignesh Patel,Dominic Emerson,James Mirocha,Michael E Bowdish,Pedro Catarino,Dominick Megna,Tyler Gunn,Matthew Rafiei,Deepika Rai,Yang Song,Olayiwola Babalola,Adam Daniels,Michelle Kittleson,Evan Kransdorf,Andriana Nikolova,Lawrence Czer,Joanna Chikwe,Roberta A Gottlieb,Fardad Esmailian
{"title":"Corrigendum to 'Evaluating the mechanism of action behind controlled hypothermic preservation of donor hearts: A randomized pilot study' [J Heart Lung Transplant, 44 (2025) 1137-1145].","authors":"Allen A Razavi,Jon Kobashigawa,Aleksandr Stotland,Qiudong Chen,Jignesh Patel,Dominic Emerson,James Mirocha,Michael E Bowdish,Pedro Catarino,Dominick Megna,Tyler Gunn,Matthew Rafiei,Deepika Rai,Yang Song,Olayiwola Babalola,Adam Daniels,Michelle Kittleson,Evan Kransdorf,Andriana Nikolova,Lawrence Czer,Joanna Chikwe,Roberta A Gottlieb,Fardad Esmailian","doi":"10.1016/j.healun.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.healun.2025.10.001","url":null,"abstract":"","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Central versus Peripheral Arterial Cannulation for Intraoperative Extracorporeal Membrane Oxygenation Support in Lung Transplantation. 中央动脉插管与外周动脉插管在肺移植术中体外膜氧合支持中的效果。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-08 DOI: 10.1016/j.healun.2025.09.025
Ramiro Fernandez,Fabio Ius,Jose Euberto Mendez Reyes,Nunzio Davide de Manna,Andres Leon-Pena,Matthew Hartwig,Kamrouz Ghadimi,Nathaniel B Langer,Asishana A Osho,Mohammed Kashem,Yoshida Toyoda,Amir Emtiazjoo,Mindaugas Rackauskas,Laurens J Ceulemans,Cedric Vanluyten,Stephen Huddleston,Subramaniam Kathirvel,Silvana Crowley Carrasco,Pablo G Sanchez,Uma Ramamurthy,Dirk Van Raemdonck,Gabriel Loor
{"title":"Outcomes of Central versus Peripheral Arterial Cannulation for Intraoperative Extracorporeal Membrane Oxygenation Support in Lung Transplantation.","authors":"Ramiro Fernandez,Fabio Ius,Jose Euberto Mendez Reyes,Nunzio Davide de Manna,Andres Leon-Pena,Matthew Hartwig,Kamrouz Ghadimi,Nathaniel B Langer,Asishana A Osho,Mohammed Kashem,Yoshida Toyoda,Amir Emtiazjoo,Mindaugas Rackauskas,Laurens J Ceulemans,Cedric Vanluyten,Stephen Huddleston,Subramaniam Kathirvel,Silvana Crowley Carrasco,Pablo G Sanchez,Uma Ramamurthy,Dirk Van Raemdonck,Gabriel Loor","doi":"10.1016/j.healun.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.025","url":null,"abstract":"BACKGROUNDIntraoperative venoarterial extracorporeal membrane oxygenation (VA ECMO) is becoming the most common mode of extracorporeal life support (ECLS) in lung transplantation (LTx). We compared rates of primary graft dysfunction (PGD) and other perioperative outcomes in patients who underwent LTx using VA ECMO with either central or peripheral arterial cannulation.METHODSWe analyzed bilateral lung transplants using intraoperative VA ECMO which were entered into the multicenter international ECLS in LTx registry between 1/2016 and 8/2024. Our primary outcome included Grade 3 Primary Graft Dysfunction (PGD3) at 48-72 hours. Secondary outcomes included postoperative complications and survival.RESULTSThere were 501 transplants that met inclusion criteria: 315 in the central group and 186 in the peripheral group. The incidence of PGD3 at 48-72 hours was 26.3% in the central group and 30.1% in the peripheral group (P=0.42). In the logistic regression analysis, central versus peripheral cannulation was not associated with increased risk of PGD3 (OR 1.64, 95% CI 0.657 - 4.209, P=0.294). We found no difference between groups in other graft-related outcomes nor cannulation-related complications including stroke. In the Cox regression analysis, central versus peripheral cannulation was not associated with overall survival (HR 1.5, 95% CI 0.70-3.20, P=0.298).CONCLUSIONSThe choice of arterial cannulation strategy for intraoperative VA ECMO support did not impact the risk of PGD3, graft- or cannulation-related complications, nor mid-term survival. The decision regarding arterial cannulation site strategy should be tailored to meet patient and procedural needs.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ISHLT Statement on Vaccines in Transplant Recipients. 国际移植学会关于移植受者疫苗的声明。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-08 DOI: 10.1016/j.healun.2025.09.006
Jennifer K Chow,Neha Bansal
{"title":"ISHLT Statement on Vaccines in Transplant Recipients.","authors":"Jennifer K Chow,Neha Bansal","doi":"10.1016/j.healun.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.006","url":null,"abstract":"","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
International Society for Heart and Lung Transplantation Consensus Statement on the Referral and Selection of Pediatric Lung Transplant Candidates. 国际心肺移植学会关于儿童肺移植候选人的转诊和选择的共识声明。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-08 DOI: 10.1016/j.healun.2025.08.005
Don Hayes,Nicholas Avdimiretz,Rossa Brugha,Mary P Mullen,Miranda A Paraskeva,Levent Midyat,Melinda Solomon,Stuart C Sweet,Ernestina Melicoff-Portillo,Lara A Danziger-Isakov,Katsuhide Maeda,David L S Morales,Carol K Conrad,Nicolaus Schwerk,Paul Aurora,Paul J Crister,Fabienne Dobbels,Melissa Sanchez,Brigitte W M Willemse,Stephen E Kirkby,Kimberley G Miles,Rolf M F Berger,Franck F Rahaghi,Nagarajan Muthialu,Christian Benden
{"title":"International Society for Heart and Lung Transplantation Consensus Statement on the Referral and Selection of Pediatric Lung Transplant Candidates.","authors":"Don Hayes,Nicholas Avdimiretz,Rossa Brugha,Mary P Mullen,Miranda A Paraskeva,Levent Midyat,Melinda Solomon,Stuart C Sweet,Ernestina Melicoff-Portillo,Lara A Danziger-Isakov,Katsuhide Maeda,David L S Morales,Carol K Conrad,Nicolaus Schwerk,Paul Aurora,Paul J Crister,Fabienne Dobbels,Melissa Sanchez,Brigitte W M Willemse,Stephen E Kirkby,Kimberley G Miles,Rolf M F Berger,Franck F Rahaghi,Nagarajan Muthialu,Christian Benden","doi":"10.1016/j.healun.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.healun.2025.08.005","url":null,"abstract":"Children with advanced lung diseases are eligible to be considered as potential candidates for lung transplantation around the world. The timing of referral, evaluation, determination of candidacy, and listing of candidates poses challenges and ethical dilemmas for pediatric care providers. To address these challenges, the International Society for Heart and Lung Transplantation appointed an international panel of expert members to review the literature, to consider recent advances in the management of advanced pediatric lung diseases, and to generate the first consensus guidelines on the referral criteria and selection of pediatric lung transplant (LTx) candidates. This consensus document is meant to assist pediatric care providers throughout the world caring for children with advanced lung diseases to identify potential candidates for LTx, to optimize the timing of the referral of these patients to LTx centers, and to provide transplant centers with a framework for the evaluation and selection of children as candidates.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pregnancy after lung transplantation: TRIGGER study on anti-human leucocyte antigen alloimmunization and antibody-mediated rejection risk. 肺移植后妊娠:抗人白细胞抗原同种免疫和抗体介导的排斥风险的TRIGGER研究。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-08 DOI: 10.1016/j.healun.2025.09.021
A Leclerc,I Danner-Boucher,A Walencik,B Guyomarch,C Bry,V Dochez,J Le Pavec,O Brugière,M Reynaud-Gaubert,B Coiffard,R Kessler,X Demant,J Macey,C Merveilleux du Vignaux,C Saint-Raymond,P-R Burgel,N Carlier,J Silleran-Chassany,B Bayeh,F-X Blanc,A Tissot
{"title":"Pregnancy after lung transplantation: TRIGGER study on anti-human leucocyte antigen alloimmunization and antibody-mediated rejection risk.","authors":"A Leclerc,I Danner-Boucher,A Walencik,B Guyomarch,C Bry,V Dochez,J Le Pavec,O Brugière,M Reynaud-Gaubert,B Coiffard,R Kessler,X Demant,J Macey,C Merveilleux du Vignaux,C Saint-Raymond,P-R Burgel,N Carlier,J Silleran-Chassany,B Bayeh,F-X Blanc,A Tissot","doi":"10.1016/j.healun.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.021","url":null,"abstract":"BACKGROUNDPregnancies in women with lung transplants are considered high-risk due to comorbidities. There is a risk of pregnancy-related anti-human leucocyte antigen alloimmunization, which can potentially lead to antibody-mediated rejection in transplant patients. A few such cases have been reported in women receiving kidney, liver or heart transplants, but this risk has never been studied in lung transplantation. The aim of our study was to investigate the risk of developing antibody-mediated rejection in the year following pregnancy.METHODSThis is a multicenter retrospective study carried out in 11 French lung transplant centres. We included lung transplant recipients who had a pregnancy between the 1st January 2012 and the 31th December 2021.RESULTSSeventy-six pregnancies were included in 52 patients. These were mainly women with double lung transplantation (n=43; 82.7%). Cystic fibrosis (n=40; 76.9%) and pulmonary hypertension (n=11; 21%) were the main underlying disease for transplantation. Of the 76 pregnancies, 43 (56.6%) resulted in the birth of live children, while the others resulted in abortion (n=8; 10.5%) or miscarriage (n=25; 32.9%). Five antibody-mediated rejections (6.6%) were identified in the year following pregnancy, with a mean time of 6.24±6.02 months between the end of pregnancy and rejection. All five rejections resulted in graft loss, of which 2 deaths and 3 retransplantations. Nineteen pregnancies (25%) resulted in alloimmunization. When anti-human leucocyte antigen antibodies were de novo donor-specific antibodies (n=5), antibody-mediated rejection occurred in all cases.CONCLUSIONSPregnancy in female lung transplant recipients appears to be at risk of humoral rejection in the year following pregnancy.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Simultaneous Heart-Kidney Transplantation Using Donation After Circulatory Death Donors: A Propensity-Matched Analysis from the UNOS Registry. 循环性死亡供者捐献后同时进行心脏肾移植的结果:来自UNOS登记处的倾向匹配分析
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-07 DOI: 10.1016/j.healun.2025.09.022
Naoki Tadokoro,Sho Takemoto,Mansoo Cho,Taylor Nordan,Michael M Givertz,Tanujit Dey,Mandeep R Mehra,Akinobu Itoh
{"title":"Outcomes of Simultaneous Heart-Kidney Transplantation Using Donation After Circulatory Death Donors: A Propensity-Matched Analysis from the UNOS Registry.","authors":"Naoki Tadokoro,Sho Takemoto,Mansoo Cho,Taylor Nordan,Michael M Givertz,Tanujit Dey,Mandeep R Mehra,Akinobu Itoh","doi":"10.1016/j.healun.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.022","url":null,"abstract":"INTRODUCTIONSimultaneous heart-kidney transplantation (SHKT) has become an effective option for patients with end-stage heart and kidney failure; however, the shortage of donors remains a significant challenge. Since 2019, hearts donated after circulatory death (DCD) have been approved and increasingly used, but their safety in the context of SHKT has not been thoroughly studied.METHODSWe conducted a retrospective cohort study using the UNOS database from January 2019 to December 2024, identifying 1,761 adults who were primary SHKT recipients. To adjust for baseline differences, we performed propensity score matching (2:1 nearest neighbor), resulting in 298 donation after brain death (DBD) and 149 DCD recipients. The endpoints assessed included 2-year overall survival, delayed graft function (DGF), and kidney graft survival.RESULTSAfter matching, both heart and kidney out-of-body times remained significantly longer in the DCD group compared to the DBD group (p < 0.001). DGF was more common in the DCD group (36% vs. 26%, p = 0.023). Two-year survival rates were 83.6% in the DCD group and 82.3% in the DBD group (p = 0.88). Robust Cox models showed no association between donor type and two-year mortality (Hazard Ratio: 0.78, 95% Confidence Interval: 0.43-1.44, p = 0.5) or kidney graft failure (HR: 0.61, 95% CI: 0.16-2.26, p = 0.5).CONCLUSIONSHKT using DCD donor organs shows similar two-year survival and graft outcomes compared to those using DBD donors, supporting the safe and effective use of DCD organs to expand the donor pool.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Timing of quality of life and lung function changes during the first year following lung transplantation: a multi-center prospective cohort study. 肺移植后第一年生活质量和肺功能改变的时间:一项多中心前瞻性队列研究
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-07 DOI: 10.1016/j.healun.2025.09.024
Wayne M Tsuang,Megan L Neely,Lianne G Singer,John A Belperio,Marie Budev,Courtney W Frankel,Jerry Kirchner,Scott M Palmer,John M Reynolds,Jamie L Todd,S Sam Weigt,Laurie D Snyder
{"title":"Timing of quality of life and lung function changes during the first year following lung transplantation: a multi-center prospective cohort study.","authors":"Wayne M Tsuang,Megan L Neely,Lianne G Singer,John A Belperio,Marie Budev,Courtney W Frankel,Jerry Kirchner,Scott M Palmer,John M Reynolds,Jamie L Todd,S Sam Weigt,Laurie D Snyder","doi":"10.1016/j.healun.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.024","url":null,"abstract":"BACKGROUNDLung transplantation (LT) has been shown to improve lung function and Quality of Life (QoL). We sought to clarify if QoL improvements coincide with improvements in spirometry assessments in the first post-transplant year.METHODSIn the multi-center observational Clinical Trials in Organ Transplantation-20 study, LT recipients had longitudinal Forced Expiratory Volume in 1 second (FEV1) and QoL measurements, specifically the St. George's Respiratory Questionnaire (SGRQ) and 36-Item Short Form Survey (SF-36), collected at 1, 3-, 6-, 9- and 12-months post-LT. We assessed whether best QoL scores occurred before, simultaneously, or after best FEV1.RESULTSOf 803 recipients, 702 met inclusion criteria. The best total SGRQ score occurred before best FEV1 in 16.0% of patients, simultaneously in 28.3%, and afterwards in 55.7%. Similarly, the best SF-36 physical score occurred before best FEV1 in 18.7% of patients, simultaneously in 32.7%, and afterwards in 48.6%. Single LTs, age >65 years, male sex and diagnosis other than cystic lung disease were associated with a higher likelihood of achieving best QoL after best FEV1.CONCLUSIONBoth spirometry and multiple physical and social QoL domains improved over the first post-LT year, but these improvements did not necessarily occur simultaneously. Nearly half of patients reached their best respiratory specific and physical QoL scores after best FEV1, however timing varied by recipient characteristics. As the pace of post-LT recovery is multifactorial, our findings provide insights to patients and providers regarding anticipated post-transplant changes and highlights the importance of considering both spirometry and QoL measures.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lung transplantation for chronic thromboembolic pulmonary hypertension - a case series. 肺移植治疗慢性血栓栓塞性肺动脉高压-一个病例系列。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-07 DOI: 10.1016/j.healun.2025.09.026
Andrei M Darie,Atsuo Doi,Bronwyn J Levvey,Helen Shingles,Shaun Yo,Trevor Williams,Gregory I Snell
{"title":"Lung transplantation for chronic thromboembolic pulmonary hypertension - a case series.","authors":"Andrei M Darie,Atsuo Doi,Bronwyn J Levvey,Helen Shingles,Shaun Yo,Trevor Williams,Gregory I Snell","doi":"10.1016/j.healun.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.026","url":null,"abstract":"INTRODUCTIONChronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary vascular disease amenable to multimodal therapy. Pulmonary endarterectomy (PEA) is the cornerstone of CTEPH treatment for operable patients. However, a significant proportion of patients present with inoperable disease or residual postoperative pulmonary hypertension. Lung transplantation (LTx) remains a lifesaving therapy for patients with end-stage right heart failure due to CTEPH.METHODSIn this case series we describe six cases of CTEPH undergoing LTx at the Alfred Hospital. Half of the patients included in this case series underwent PEA prior to LTx.RESULTSThe most frequent finding on explant histology was arterial muscular hypertrophy due to thrombotic arteriopathy. We present the pre-transplant hemodynamic features and discuss the long-term outcomes post-LTx and the surgical challenges that can arise in the context of prior cardiothoracic surgery.CONCLUSIONSLTx is a definitive, although rarely utilized therapy, underlining the growing expertise and advancements in specific multimodal therapy for CTEPH.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HOPE for children: successful pediatric DCD heart transplantation using hypothermic oxygenated perfusion. 儿童的希望:低温充氧灌注成功的儿童DCD心脏移植。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-06 DOI: 10.1016/j.healun.2025.09.020
Nicholas Js Chilvers,Katrien Vandendriessche,Niels Moeslund,Marius Berman,Janne Brouckaert,Tanveer Butt,Barbara Cardoso,Bjorn Cools,David Crossland,John Dark,Paul Henderson,Katherine Hulley,Mylvaganam Jeyakanthan,Jerome Jungschleger,Pradeep Kaul,Muhammad Khawaja,Klaes V Lenbroch,Alan McCheyne,Mohamed Nassar,Filip Rega,Zdenka Reinhardt,Emma Simpson,Maja Thomassen,Andreas Wallinder,James Warburton,Lu Wang,Louise Kenny
{"title":"HOPE for children: successful pediatric DCD heart transplantation using hypothermic oxygenated perfusion.","authors":"Nicholas Js Chilvers,Katrien Vandendriessche,Niels Moeslund,Marius Berman,Janne Brouckaert,Tanveer Butt,Barbara Cardoso,Bjorn Cools,David Crossland,John Dark,Paul Henderson,Katherine Hulley,Mylvaganam Jeyakanthan,Jerome Jungschleger,Pradeep Kaul,Muhammad Khawaja,Klaes V Lenbroch,Alan McCheyne,Mohamed Nassar,Filip Rega,Zdenka Reinhardt,Emma Simpson,Maja Thomassen,Andreas Wallinder,James Warburton,Lu Wang,Louise Kenny","doi":"10.1016/j.healun.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.020","url":null,"abstract":"BACKGROUNDThe number of children referred for advanced heart failure management is increasing and with it the demand for heart transplant. However, transplantation rates have declined and waiting list mortality is up to 25%. Whilst Donation after Circulatory Death (DCD) heart recovery has increased adult transplant activity significantly, barriers have prevented the same in pediatrics. In the UK and Belgium, we have adopted hypothermic oxygenated perfusion (HOPE) to address this inequity.METHODSPre-clinical: A porcine DCD-HOPE model was developed to simulate neonatal and infant heart recovery, preservation and transplantation, including functional assessment.CLINICALHearts were recovered from 6 pediatric donors (3 DCD and 3 Donation after Brainstem Death (DBD)), aged 16months - 13years), preserved with HOPE and transplanted. For small donors, this required a pediatric research cannula and surgical techniques such as arch augmentation.RESULTSIn the pre-clinical model, porcine infant hearts could be successfully recovered, perfused and transplanted with good cardiac output post-bypass. In the clinical series, hearts from donors as small as 9kg were successfully recovered, perfused and transplanted. For the DCD cohort, median functional warm ischemic time was 19 minutes and there was no severe primary graft dysfunction. Survival at follow-up (median 287.5 days) was 100% and echocardiograms showed normal systolic function.CONCLUSIONSThere is great need to facilitate DCD heart recovery for infants and neonates. We have reported our outcomes from the world's first and smallest pediatric DCD-HOPE heart transplants and demonstrated that HOPE provides the long-awaited solution for pediatric DCD donation down to even neonatal donors. We call upon clinicians and policymakers to support DCD-HOPE to provide equity for child donors and recipients.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Coronary Hypoperfusion During Agonal Phase on Outcomes Following Donation After Circulatory Death Heart Transplantation. 无性期冠状动脉灌注不足对循环死亡心脏移植术后捐献结果的影响。
The Journal of Heart and Lung Transplantation Pub Date : 2025-10-03 DOI: 10.1016/j.healun.2025.09.019
Yeahwa Hong,Umar Nasim,Ander Dorken-Gallastegi,Nidhi Iyanna,Brian E Woolley,Samantha N Machinski,Gavin W Hickey,Mary E Keebler,Edward T Horn,David J Kaczorowski
{"title":"Impact of Coronary Hypoperfusion During Agonal Phase on Outcomes Following Donation After Circulatory Death Heart Transplantation.","authors":"Yeahwa Hong,Umar Nasim,Ander Dorken-Gallastegi,Nidhi Iyanna,Brian E Woolley,Samantha N Machinski,Gavin W Hickey,Mary E Keebler,Edward T Horn,David J Kaczorowski","doi":"10.1016/j.healun.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.healun.2025.09.019","url":null,"abstract":"BACKGROUNDThis study evaluates the impact of low diastolic blood pressure and resultant coronary hypoperfusion during the agonal phase on outcomes following donation after circulatory death (DCD) heart transplantation.METHODSThe UNOS registry was queried to analyze adult recipients of isolated DCD heart transplants between 1/1/2019-9/30/2023. Recipients were stratified based on the proportion of the agonal phase with coronary hypoperfusion, defined as diastolic blood pressure <40 mmHg. Using threshold regression, coronary hypoperfusion was classified as extensive (>20% of the agonal phase) or limited (≤20% of the agonal phase). The primary outcome was 1-year post-transplant survival. Risk adjustment was performed using multivariable Cox regression and 1:1 propensity score-matching.RESULTSAmong 696 recipients of DCD hearts, 105 (15.1%) received hearts with limited coronary hypoperfusion during the agonal phase. The extensive coronary hypoperfusion group had a nominally shorter median agonal phase duration than the limited coronary hypoperfusion group (19 vs. 21 minutes, p=0.17). The recipients with extensive coronary hypoperfusion had significantly reduced 1-year post-transplant survival than those with limited coronary hypoperfusion (91.1% vs. 97.1%, p=0.039). These findings persisted in both multivariable Cox regression and propensity score-matched analyses.CONCLUSIONExtensive coronary hypoperfusion during the agonal phase in DCD donor hearts is associated with reduced post-transplant survival, even when the total agonal period is short. These findings suggest that the impact of the agonal phase is determined not only by its duration but also by the extent of allograft malperfusion, highlighting the need to reconsider rigid time-based criteria for DCD heart acceptance and utilization.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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