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Cardiac Transplante

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https://www.readbyqxmd.com/read/28227220/selection-of-an-optimal-feature-set-to-predict-heart-transplantation-outcomes
#1
Dennis Medved, Pierre Nugues, Johan Nilsson, Dennis Medved, Pierre Nugues, Johan Nilsson, Dennis Medved, Johan Nilsson, Pierre Nugues
Heart transplantation (HT) is a life saving procedure, but a limited donor supply forces the surgeons to prioritize the recipients. The understanding of factors that predict mortality could help the doctors with this task. The objective of this study is to find locally optimal feature sets to predict survival of HT patients for different time periods. To this end, we applied logistic regression together with a greedy forward and backward search. As data source, we used the United Network for Organ Sharing (UNOS) registry, where we extracted adult patients (>17 years) from January 1997 to December 2008...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224436/patients-60-years-of-age-and-older-should-have-the-same-chance-for-heart-transplantation-or-not
#2
Mahmoud H Alshirbini, Fei Xie, Nian-Guo Dong, Si Chen, Eman Borham
Heart transplantation is considered the best treatment modality for advanced heart disease. While old age has conventionally been considered a contraindication for heart transplantation due to the reported adverse effect of advanced age, however donor hearts' shortage continues to stimulate the discussion about the recipient's upper age limit. Our study was based on a retrospective analysis for the results of 52 (18%) patients aged 60 years and older undergoing heart transplantation between May 2008 and December 2015, and these patients were compared with 236 (82%) adult recipients who were younger than 60 years at the time of transplantation and during the same period...
February 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28220144/results-of-late-gadolinium-enhancement-in-children-affected-by-dilated-cardiomyopathy
#3
Giuseppe Muscogiuri, Paolo Ciliberti, Domenico Mastrodicasa, Marcello Chinali, Gabriele Rinelli, Teresa Pia Santangelo, Carmela Napolitano, Benedetta Leonardi, Aurelio Secinaro
BACKGROUND: Little is known about the clinical value of late gadolinium enhancement (LGE), in children affected by dilated cardiomyopathy (DCM). MATERIALS AND METHODS: We retrospectively evaluated 15 patients (8 ± 6 years, 6 males) with diagnosis of DCM who underwent cardiac magnetic resonance since 2014. All scans were performed with a 1.5 T system (Aera, Siemens). Study protocol included cine steady-state free precession sequences, followed by administration of 0...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28219921/predictive-value-of-dobutamine-stress-perfusion-echocardiography-in-contemporary-end-stage-liver-disease
#4
Bipul Baibhav, Chetaj A Mahabir, Feng Xie, Valerie K Shostrom, Timothy M McCashland, Thomas R Porter
BACKGROUND: The assessment of cardiac risk in contemporary liver transplantation (LT) has required more sensitive testing for the detection of occult coronary artery disease as well as microvascular and functional cardiac abnormalities. Because dobutamine stress perfusion echocardiography provides an assessment of both regional systolic and diastolic function as well as microvascular perfusion (MVP), we sought to examine its incremental value in this setting. METHODS AND RESULTS: We evaluated the predictive value of dobutamine stress perfusion echocardiography in 296 adult patients with end-stage liver disease and preserved systolic function who underwent LT between 2008 and 2014...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28219597/combined-heart-and-kidney-transplantation-a-23-year-experience
#5
M Awad, L S C Czer, F Esmailian, S Jordan, M A De Robertis, J Mirocha, J Patel, D H Chang, M Kittleson, D Ramzy, F Arabia, J S Chung, J L Cohen, A Trento, J A Kobashigawa
BACKGROUND: We report clinical experience with combined heart and kidney transplantation (HKTx) over a 23-year time period. METHODS: From June 1992 to August 2015, we performed 83 combined HKTx procedures at our institution. We compared the more recent cohort of 53 HKTx recipients (group 2, March 2009 to August 2015) with the initial 30 previously reported HKTx recipients (group 1, June 1992 to February 2009). Pre-operative patient characteristics, peri-operative factors, and post-operative outcomes including survival were examined...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219583/risk-factors-affecting-graft-and-patient-survivals-after-transplantation-from-deceased-donors-in-a-developing-country-a-single-center-experience
#6
Y Ayar, A Ersoy, G Ocakoglu, A Yildiz, A Oruc, H Soyak, M Calapkulu, A B Sahin, N Bolca Topal, E Okeer, B Coskun, O Kaygisiz, Y Kordan, H Vuruskan
AIM: The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. METHODS: We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219580/use-of-anti-thymocyte-globulin-for-induction-therapy-in-cardiac-transplantation-a-review
#7
V Ruan, L S C Czer, M Awad, M Kittleson, J Patel, F Arabia, F Esmailian, D Ramzy, J Chung, M De Robertis, A Trento, J A Kobashigawa
The most common causes of death after heart transplantation (HTx) include acute rejection and multi-organ failure in the early period and malignancy and cardiac allograft vasculopathy (CAV) in the late period. Polyclonal antibody preparations such as rabbit anti-thymocyte globulin (ATG) may reduce early acute rejection and the later occurrence of CAV after HTx. ATG therapy depletes T cells, modulates adhesion and cell-signaling molecules, interferes with dendritic cell function, and induces B-cell apoptosis and regulatory and natural killer T-cell expansion...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218990/renal-function-at-one-year-after-cardiac-transplantion-rather-than-acute-kidney-injury-is-highly-associated-with-long-term-patient-survival-and-loss-of-renal-function
#8
Gijs Fortrie, Olivier C Manintveld, Alina A Constantinescu, Pieter C van de Woestijne, Michiel G H Betjes
BACKGROUND: The current study aims to assess the association between acute kidney injury (AKI), renal function one year after transplantation and long-term adverse outcomes after cardiac transplantation. METHODS: A retrospective cohort study was performed including 471 adult cardiac transplantation recipients that survived the first postoperative year between 1984 and 2012. Primary outcome variables were long-term overall and renal survival. RESULTS: During the first postoperative week 40% (n=288) of the recipients developed AKI stage I, 22% (n=104) stage II, 13% (n=63) stage III and 4% (n=17) required temporary RRT...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28217310/the-impact-of-gender-mismatching-on-early-and-late-outcomes-following-heart-transplantation
#9
Yael Peled, Jacob Lavee, Michael Arad, Yedida Shemesh, Moshe Katz, Yigal Kassif, Elad Asher, Dan Elian, Yedael Har-Zahav, Ilan Goldenberg, Dov Freimark
AIMS: The role of donor/recipient gender matching on the long-term rejection process and clinical outcomes following heart transplantation (HT) outcomes is still controversial. We aim to investigate the impact of gender matching on early and long-term outcome HT. METHODS AND RESULTS: The study population comprised 166 patients who underwent HT between 1991 and 2013 and were prospectively followed up in a tertiary referral centre. Early and late outcomes were assessed by the type of donor-recipient gender match (primary analysis: female donor-male recipient [FD-MR, n = 36] vs...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28216453/quantification-of-myocardial-oxygenation-in-heart-failure-using-blood-oxygen-level-dependent-t2-magnetic-resonance-imaging-comparison-with-cardiopulmonary-exercise-test
#10
Michinobu Nagao, Yuzo Yamasaki, Satoshi Kawanami, Takeshi Kamitani, Koji Sagiyama, Taiki Higo, Tomomi Ide, Atsushi Takemura, Umiko Ishizaki, Kenji Fukushima, Yuji Watanabe, Hiroshi Honda
PURPOSE: Quantification of myocardial oxygenation (MO) in heart failure (HF) has been less than satisfactory. This has necessitated the use of invasive techniques to measure MO directly or to determine the oxygen demand during exercise using the cardiopulmonary exercise (CPX) test. We propose a new quantification method for MO using blood-oxygen-level-dependent (BOLD) myocardial T2* magnetic resonance imaging (M-T2* MRI), and investigate its correlation with CPX results. METHODS: Thirty patients with refractory HF who underwent cardiac MRI and CPX test for heart transplantation, and 24 healthy, age-matched volunteers as controls were enrolled...
February 16, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28216198/relationship-between-intraoperative-hypotension-and-acute-kidney-injury-after-living-donor-liver-transplantation-a-retrospective-analysis
#11
Toshiyuki Mizota, Miho Hamada, Shino Matsukawa, Hideya Seo, Tomoharu Tanaka, Hajime Segawa
OBJECTIVE: Acute kidney injury (AKI) is common after liver transplantation (LT) and has a significant impact on outcomes. Although several risk factors for post-LT AKI have been identified, the effect of intraoperative hemodynamic status on post-LT AKI remains unknown. Therefore, the authors aimed to investigate the relationship between hemodynamic parameters during LT and postoperative AKI. DESIGN: A retrospective observational study. SETTING: University hospital...
December 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28215569/cardiac-phenotype-and-long-term-prognosis-of-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-patients-with-late-presentation
#12
Aditya Bhonsale, Anneline S J M Te Riele, Abhishek C Sawant, Judith A Groeneweg, Cynthia A James, Brittney Murray, Crystal Tichnell, Thomas P Mast, Michelle J van der Pols, Maarten J M Cramer, Dennis Dooijes, Jeroen F van der Heijden, Harikrishna Tandri, J Peter van Tintelen, Daniel P Judge, Richard N W Hauer, Hugh Calkins
BACKGROUND: The clinical profile of Arrhythmogenic Right Ventricular Cardiomyopathy/ Dysplasia patients with late presentation (ARVC/D) is unknown. OBJECTIVE: To characterize the genotype, cardiac phenotype and long term outcomes of ARVC/D patients with late presentation (age≥ 50 years at diagnosis) METHODS: 502 patients with ARVC/D diagnosis from Johns Hopkins and Utrecht registries were studied and long term clinical outcomes ascertained. RESULTS: Late presentation was seen in 104 (21%) patients (38% PKP2 carriers) with 3% ≥ 65 years at diagnosis...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28212151/antibody-mediated-rejection-in-the-cardiac-allograft-diagnosis-treatment-and-future-considerations
#13
M Elizabeth H Hammond, Abdallah G Kfoury
PURPOSE OF REVIEW: This review summarizes the latest publications dealing with antibody-mediated rejection (AMR) and defines areas of controversy and future steps that may improve the outcome for patients with this virulent form of rejection. RECENT FINDINGS: Recent progress includes publication of standardized pathologic criteria for acute AMR by the International Society for Heart and Lung Transplantation (ISHLT) and guidelines for treatment of acute AMR by the American Heart Association, endorsed by ISHLT as well...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28212149/new-developments-for-the-detection-and-treatment-of-cardiac-vasculopathy
#14
Kevin J Clerkin, Ziad A Ali, Donna M Mancini
PURPOSE OF REVIEW: Cardiac allograft vasculopathy (CAV) is a major limitation to long-term survival after heart transplantation. Innovative new techniques to diagnose CAV have been applied to detect disease. This review will examine the current diagnostic and treatment options available to clinicians for CAV. RECENT FINDINGS: Diagnostic modalities addressing the pathophysiology underlying CAV (arterial wall thickening and decreased coronary blood flow) improve diagnostic sensitivity when compared to traditional (angiography and dobutamine stress echocardiography) techniques...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28211974/whole-exome-sequencing-identified-1-base-pair-novel-deletion-in-bcl2-associated-athanogene-3-bag3-gene-associated-with-severe-dilated-cardiomyopathy-dcm-requiring-heart-transplant-in-multiple-family-members
#15
Muhammad Arshad Rafiq, Ayeshah Chaudhry, Melanie Care, Danna A Spears, Chantal F Morel, Robert M Hamilton
Dilated cardiomyopathy (DCM) is characterized by dilation and impaired contraction of the left ventricle or both ventricles. Among hereditary DCM, the genetic causes are heterogeneous, and include mutations encoding cytoskeletal, nucleoskeletal, mitochondrial, and calcium-handling proteins. We report three severely affected males, in a four-generation pedigree, with DCM phenotype who underwent cardiac transplant. Cardiomegaly with marked biventricular dilation and fibrosis were noticeable histopathological findings...
March 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#16
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28209216/hypertrophic-cardiomyopathy-with-left%C3%A2-ventricular-apical-aneurysm-implications-for-risk-stratification-and-management
#17
Ethan J Rowin, Barry J Maron, Tammy S Haas, Ross F Garberich, Weijia Wang, Mark S Link, Martin S Maron
BACKGROUND: A previously under-recognized subset of hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) apical aneurysms is being identified with increasing frequency. However, risks associated with this subgroup are unknown. OBJECTIVES: The authors aimed to clarify clinical course and prognosis of a large cohort of HCM patients with LV apical aneurysms over long-term follow-up. METHODS: The authors retrospectively analyzed 1,940 consecutive HCM patients at 2 centers, 93 of which (4...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28207629/short-and-long-term-outcome-after-lung-transplantation-from-circulatory-dead-donors-a-single-center-experience
#18
David Ruttens, An Martens, Sofie Ordies, Stijn E Verleden, Arne P Neyrinck, Robin Vos, Marc Boada Collado, Bart M Vanaudenaerde, Geert M Verleden, Dirk Van Raemdonck
BACKGROUND: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown. METHODS: In this retrospective study, DCD LTx recipients (n=59) were compared with a cohort of donation after brain-death (DBD) LTx recipients (n=331) transplanted between February 2007 and September 2013; follow-up was until January 1st 2016. Short-term (duration of mechanical ventilation, ICU stay, hospital stay and highest PGD score within 72 hours) and long-term (CLAD-free and overall survival) follow-up were compared over a median follow-up of 50...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28203415/changes-in-the-action-potential-and-transient-outward-potassium-current-in-cardiomyocytes-during-acute-cardiac-rejection-in-rats
#19
Wenqi Luo, Yixin Jia, Shuai Zheng, Yan Li, Jie Han, Xu Meng
BACKGROUND: Acute cardiac rejection contributes to the changes in the electrophysiological properties of grafted hearts. However, the electrophysiological changes of cardiomyocytes during acute cardiac rejection are still unknown. An understanding of the electrophysiological mechanisms of cardiomyocytes could improve the diagnosis and treatment of acute cardiac rejection. So it is important to characterize the changes in the action potential (AP) and the transient outward potassium current (Ito ) in cardiomyocytes during acute cardiac rejection...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199780/cytomegalovirus-responsive-cd8-t-cells-expand-after-solid-organ-transplantation-in-the-absence-of-cmv-disease
#20
Lauren E Higdon, Jennifer Trofe-Clark, Sai Liu, Kenneth B Margulies, Malaya K Sahoo, Emily Blumberg, Benjamin A Pinsky, Jonathan S Maltzman
Cytomegalovirus (CMV) is a major cause of morbidity and mortality in solid-organ transplant recipients. Approximately 60% of adults are CMV seropositive indicating previous exposure. Following resolution of primary infection, CMV remains in a latent state. Reactivation is controlled by memory T cells in healthy individuals; transplant recipients have reduced memory T cell function due to chronic immunosuppressive therapies. In this study, CD8(+) T cell responses to CMV polypeptides IE-1 and pp65 were analyzed in sixteen CMV seropositive renal and cardiac transplant recipients longitudinally pre- and post-transplant...
February 15, 2017: American Journal of Transplantation
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