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Cardiac Transplante

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https://www.readbyqxmd.com/read/27932181/use-of-terlipressin-in-an-elderly-patient-with-moderate-aortic-valve-stenosis-accompanied-by-episodic-atrial-fibrillation-during-liver-transplantation-a-case-report
#1
Y J Won, B G Lim, D Chung, E Park, H Kim, I O Lee, M H Kong
Anesthesia for patients with moderate aortic stenosis accompanied by atrial fibrillation during high-risk surgery such as liver transplantation remains a challenge in maintaining control of heart rate and maintenance of cardiac output. The action of terlipressin on vasopressin receptors (mainly V1 receptors) leads to splanchnic vasoconstriction and is the key mechanism responsible for increasing systemic vascular resistance and reducing heart rate. We report successful anesthetic management using low-dose terlipressin infusion in an elderly patient who had moderate aortic stenosis with atrial fibrillation during urgent deceased-donor liver transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932139/de-novo-anti-hla-antibodies-after-heart-transplantation-are-associated-with-adverse-events-in-the-long-term-follow-up-of-cardiac-transplant-recipients
#2
E Solé-González, S Mirabet, V Brossa, L López-López, M Rivas-Lasarte, H Capellades-Olivella, A J Ginel-Iglesias, J Martorell-Pons, E Roig
BACKGROUND AND OBJECTIVES: Long-term morbidity and mortality after heart transplantation (HTx) remain very high. Several reports have suggested that anti-HLA antibodies (anti-HLA-AB) detected after HTx might be associated with poor survival, but the implication of isolated anti-HLA-AB is still under debate. The aim of the study was to analyze the incidence of de novo anti-HLA-AB and whether they are associated with adverse events after HTx. METHODS: This retrospective study analyzed the presence of anti-HLA-AB assessed by fluorimetry (Luminex) and quantified by a single-antigen bead assay in 119 HTx patients...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#3
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932093/midterm-results-of-renal-transplantation-from-controlled-cardiac-death-donors-are-similar-to-those-from-brain-death-donors
#4
O Lafuente, B Sánchez-Sobrino, M Pérez, P López-Sánchez, D Janeiro, E Rubio, A Huerta, M Marques, M R Llópez-Carratala, J J Rubio, J Portolés
BACKGROUND: The systematic use of grafts from controlled donors after cardiac death (cDCD) started in our country in 2012 and expanded with the strategic support of National Transplant Organization. We present our experience in kidney transplantation with organs from cDCD donors with a mean follow-up of 3 years. METHODS: Observational prospective study of all transplants performed in our center in 2012-2013 followed to 2016. The immunosuppression protocols were triple therapy for low-risk recipients from a standard brain death donor (DBD), adding basiliximab or thymoglobulin induction for extended-criteria donor or high-risk recipient, respectively, and thymoglobulin induction plus triple therapy for all cDCD recipients...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931578/pretransplant-left-ventricular-dysfunction-adversely-affects-perioperative-outcomes-in-pediatric-liver-transplantation-a%C3%A2-retrospective-observational-study
#5
D-M Jang, I-G Jun, Y-J Moon, W-J Shin, J-G Song, G-S Hwang
BACKGROUND: Although left ventricular diastolic dysfunction (LVDD) is a pronounced feature of adult cirrhotic cardiomyopathy and a major predictor of poor outcomes following liver transplantation (LT), little is known about if pretransplant cardiac dysfunction affects perioperative outcomes in pediatric LT. METHODS: We retrospectively evaluated pretransplant clinical and Doppler echocardiographic data for 45 consecutive pediatric LT recipients who were treated between 2007 and 2013 (median age = 15 months; interquartile range = 9 to 78 months)...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931565/ex%C3%A2-vivo-perfusion-characteristics-of-donation-after-cardiac-death-kidneys-predict-long-term-graft-survival
#6
M Sevinc, S Stamp, J Ling, N Carter, D Talbot, N Sheerin
BACKGROUND: Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. METHODS: All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931092/the-influence-of-race-and-common-genetic-variations-on-outcomes-after-pediatric-heart-transplantation
#7
D J Green, M M Brooks, G J Burckart, R E Chinnock, C Canter, L J Addonizio, D Bernstein, J K Kirklin, D C Naftel, D M Girnita, A Zeevi, S A Webber
Significant racial disparity remains in the incidence of unfavorable outcomes following heart transplantation. We sought to determine which pediatric post-transplantation outcomes differ by race and whether these can be explained by recipient demographic, clinical, and genetic attributes. Data were collected for 80 black and 450 non-black pediatric recipients transplanted at 1 of 6 centers between 1993 and 2008. Genotyping was performed for 20 candidate genes. Average follow-up was 6.25 years. Unadjusted five-year rates for death (p=0...
December 8, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27930666/development-of-pet-imaging-to-visualize-activated-macrophages-accumulated-in-the-transplanted-ipsc-derived-cardiac-myocytes-of-allogeneic-origin-for-detecting-the-immune-rejection-of-allogeneic-cell-transplants-in-mice
#8
Noriyuki Kashiyama, Shigeru Miyagawa, Satsuki Fukushima, Takuji Kawamura, Ai Kawamura, Shohei Yoshida, Akima Harada, Tadashi Watabe, Yasukazu Kanai, Koichi Toda, Jun Hatazawa, Yoshiki Sawa
Allogeneic transplantation (Tx) of induced pluripotent stem cells (iPSCs) is a promising tissue regeneration therapy. However, this inevitably induces macrophage-mediated immune response against the graft, limiting its therapeutic efficacy. Monitoring the magnitude of the immune response using imaging tools would be useful for prolonging graft survival and increasing the therapy longevity. Minimally invasive quantitative detection of activated macrophages by medical imaging technologies such as positron emission tomography (PET) imaging targets translocator protein (TSPO), which is highly expressed on mitochondrial membrane, especially in activated macrophage...
2016: PloS One
https://www.readbyqxmd.com/read/27930543/left-branch-of-portal-vein-thrombosis-in-a-liver-transplant-recipient-with-donation-after-cardiac-death-donor-a-case-report
#9
Maogen Chen, Weiqiang Ju, Xiaohong Lin, Qiang Zhao, Dongping Wang, Xiaoshun He
INTRODUCTION: Portal vein thrombosis (PVT) is one of the most severe complications after liver transplantation, which usually causes graft loss and recipient mortality. The founding of the embolic branch of portal system and its result are not well described in the literature. CLINICAL FINDINGS AND DIAGNOSES: We report here an unusual case of complete right branch thrombosis of portal vein after orthotopic liver transplantation from a donation after cardiac death donor, without obvious malaise...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27925367/transient-severe-tricuspid-regurgitation-after-transplantation-of-an-extremely-oversized-donor-heart-in-a-child-does-size-matter-a-case-report
#10
J Birnbaum, S M Ulrich, R Schramm, C Hagl, A Lehner, M Fischer, N A Haas, B Heineking
In pediatric heart transplantation, the size of the donor organ is an important criterion for organ allocation. Oversized donor hearts are often accepted with good results, but some complications in relation to a high donor-recipient ratio have been described. Our patient was transplanted for progressive heart failure in dilated cardiomyopathy. The donor-to-recipient weight ratio was 3 (donor weight 65 kg, recipient weight 22 kg). The intra-operative echocardiography before chest closure showed excellent cardiac function, no tricuspid valve regurgitation, and a normal central venous pressure...
December 7, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27922813/transcatheter-tricuspid-repair-with-mitraclip-for-severe-primary-tricuspid-regurgitation
#11
Neil P Fam, Kim A Connelly, Christoph Hammerstingl, Geraldine Ong, Anthony W A Wassef, Heather J Ross, Subodh Verma
Severe tricuspid regurgitation is an independent predictor of adverse outcomes, yet few patients undergo surgery and treatment with medical therapy is often inadequate. Recent studies have reported the use of the MitraClip system (Abbott Vascular) to treat secondary tricuspid regurgitation. We describe the first use of MitraClip to treat severe primary tricuspid regurgitation and right heart failure in a patient with previous cardiac transplantation and high surgical risk.
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27922771/giant-cell-myocarditis-a-brief-review
#12
Jin Xu, Erin G Brooks
Giant cell myocarditis (GCM) is a rapidly progressive and frequently fatal disease that mainly affects young to middle-aged previously healthy individuals. Early diagnosis is critical, as recent studies have shown that rapidly instituted cyclosporine-based immunosuppression can reduce inflammation and improve transplant-free survival. Before the 1980s, GCM was mainly a diagnosis made at autopsy. Owing to advancements in diagnostic and therapeutic options, it is now increasingly diagnosed on the basis of endomyocardial biopsies, explanted hearts, or apical wedge sections removed at the time of ventricular assist device placement...
December 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/27922691/microarray-expression-profiles-of-genes-in-lung-tissues-of-rats-subjected-to-focal-cerebral-ischemia-induced-lung-injury-following-bone-marrow-derived-mesenchymal-stem-cell-transplantation
#13
Yue Hu, Liu-Lin Xiong, Piao Zhang, Ting-Hua Wang
Ischemia-induced stroke is the most common disease of the nervous system and is associated with a high mortality rate worldwide. Cerebral ischemia may lead to remote organ dysfunction, particular in the lungs, resulting in lung injury. Nowadays, bone marrow-derived mesenchymal stem cells (BMSCs) are widely studied in clinical trials as they may provide an effective solution to the treatment of neurological and cardiac diseases; however, the underlying molecular mechanisms remain unknown. In this study, a model of permanent focal cerebral ischemia-induced lung injury was successfully established and confirmed by neurological evaluation and lung injury scores...
December 6, 2016: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/27920725/controlled-reperfusion-strategies-improve-cardiac-hemodynamic-recovery-after-warm-global-ischemia-in-an-isolated-working-rat-heart-model-of-donation-after-circulatory-death-dcd
#14
Emilie Farine, Petra Niederberger, Rahel K Wyss, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
Aims: Donation after circulatory death (DCD) could improve cardiac graft availability, which is currently insufficient to meet transplant demand. However, DCD organs undergo an inevitable period of warm ischemia and most cardioprotective approaches can only be applied at reperfusion (procurement) for ethical reasons. We investigated whether modifying physical conditions at reperfusion, using four different strategies, effectively improves hemodynamic recovery after warm ischemia. Methods and Results: Isolated hearts of male Wistar rats were perfused in working-mode for 20 min, subjected to 27 min global ischemia (37°C), and 60 min reperfusion (n = 43)...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27919740/metabolic-differences-between-cold-stored-and-machine-perfused-porcine-kidneys-a-1-h-nmr-based-study
#15
Jay Nath, Tom B Smith, Kamlesh Patel, Sam R Ebbs, Alex Hollis, Daniel A Tennant, Christian Ludwig, Andrew R Ready
Hypothermic machine perfusion (HMP) and static cold storage (SCS) are the two methods used to preserve deceased donor kidneys prior to transplant. This study seeks to characterise the metabolic profile of HMP and SCS porcine kidneys in a cardiac death donor model. Twenty kidneys were cold flushed and stored for two hours following retrieval. Paired kidneys then underwent 24 h of HMP or SCS or served as time zero controls. Metabolite quantification in both storage fluid and kidney tissue was performed using one dimensional (1)H NMR spectroscopy...
December 2, 2016: Cryobiology
https://www.readbyqxmd.com/read/27917264/systemic-to-pulmonary-artery-pressure-ratio-as-a-predictor-of-patient-outcome-following-liver-transplantation
#16
Annette Rebel, Dung Nguyen, Brooke Bauer, Paul A Sloan, Amy DiLorenzo, Zaki-Udin Hassan
AIM: To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS: A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27916652/exploring-pericyte-and-cardiac-stem-cell-secretome-unveils-new-tactics-for-drug-discovery
#17
REVIEW
Georgina M Ellison-Hughes, Paolo Madeddu
Ischaemic diseases remain a major cause of morbidity and mortality despite continuous advancements in medical and interventional treatments. Moreover, available drugs reduce symptoms associated with tissue ischaemia, without providing a definitive repair. Cardiovascular regenerative medicine is an expanding field of research that aims to improve the treatment of ischaemic disorders through restorative methods, such as gene therapy, stem cell therapy, and tissue engineering. Stem cell transplantation has salutary effects through direct and indirect actions, the latter being attributable to growth factors and cytokines released by stem cells and influencing the endogenous mechanisms of repair...
December 1, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27916323/donor-specific-anti-hla-antibodies-with-antibody-mediated-rejection-and-long-term-outcomes-following-heart-transplantation
#18
Kevin J Clerkin, Maryjane A Farr, Susan W Restaino, Emmanuel Zorn, Farhana Latif, Elena R Vasilescu, Charles C Marboe, Paolo C Colombo, Donna M Mancini
BACKGROUND: Donor-specific anti-HLA antibodies (DSA) are common after heart transplantation and are associated with rejection, cardiac allograft vasculopathy, and mortality. A noninvasive diagnostic test for pathologic antibody-mediated rejection (pAMR) does not exist. METHODS: From January 1, 2010, through August 31, 2013, 221 consecutive adult patients underwent heart transplantation and were followed through October 1, 2015. The primary objective was to determine whether the presence of DSA could detect AMR at the time of pathologic diagnosis...
November 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#19
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916039/-the-development-of-ex-vivo-lung-perfusion-in-lung-transplantation
#20
X F Pan, R Wang, S J Fu, Y H Yang, J Yang, H Zhao
The shortage of donor lung remains one of the major problem for lung transplantation. With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re-assessed and finally utilized for transplantation. The ex vivo lung perfusion technique (EVLP) was designed and has been developed for evaluation and repair of the lung. Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications. The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover-Madrid technique...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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