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Orthotopic Heart Transplant

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https://www.readbyqxmd.com/read/28184975/alkaline-phosphatase-a-biomarker-of-cardiac-function-in-pediatric-patients
#1
Elizabeth S Makil, Xinyu Tang, Elizabeth A Frazier, R Thomas Collins
Myocardial dysfunction and heart failure are common in pediatric patients with congenital and acquired heart disease. Alkaline phosphatase (AP) has been suggested as a biomarker for myocardial dysfunction after Fontan operation. We hypothesized that pediatric patients with myocardial dysfunction requiring orthotopic heart transplant (OHT) have diminished AP compared to normal. A retrospective review was performed in all patients who underwent OHT at Arkansas Children's Hospital between January 2007 and October 2012...
February 9, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#2
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28145044/a-single-center-tertiary-care-experience-utilizing-the-large-volume-mega-50cc-intra-aortic-balloon-counterpulsation-in-contemporary-clinical-practice
#3
Gautam K Visveswaran, Marc Cohen, Ahmed Seliem, Michael DiVita, Jonathan K R McNamara, Amar Dave, Najam Wasty, David A Baran
OBJECTIVE: Clinical outcomes and adverse events utilizing the large volume 50cc intra-aortic balloon (IAB) in contemporary clinical practice. BACKGROUND: The newer large volume 50cc IAB, recently introduced into clinical practice offers improved diastolic augmentation and better left ventricular (LV) unloading compared to the older 40cc IAB. METHODS: In 150 consecutive patients who received intra-aortic balloon counterpulsation (IABC) with a 50cc balloon from 2011 to 2015, we retrospectively analyzed demographic, clinical, laboratory, and hemodynamic variables, adverse events and survival to discharge from index hospitalization...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28139011/aortic-dissection-following-heart-transplantation
#4
REVIEW
Ali Hage, Fadi Hage, Hadi Toeg, Ross Davies, Munir Boodhwani
A 75-year-old male with a previous orthotopic heart transplantation performed 28 years ago was incidentally discovered to have an asymptomatic chronic type A aortic dissection. Catheter-induced dissection during coronary angiography was believed to be the culprit factor. Aortic root replacement and aortic valve reconstruction were successfully performed.
January 30, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28138813/noninvasive-pet-quantitative-myocardial-blood-flow-with-regadenoson-for-assessing-cardiac-allograft-vasculopathy-in-orthotopic-heart-transplantation-patients
#5
Miguel Hernandez Pampaloni, Uttam M Shrestha, Maria Sciammarella, Youngho Seo, Grant T Gullberg, Elias H Botvinick
BACKGROUND: Risk stratification and early detection of cardiac allograft vasculopathy (CAV) is essential in orthotopic heart transplantation (OHT) patients. This study assesses the changes in myocardial blood flow (MBF) noninvasively in OHT patients using quantitative cardiac PET with regadenoson. METHODS: Twelve patients (Group 1) (8 males, 4 females, mean age 55 ± 7 years) with no history of post OHT myocardial ischemia were enrolled 5.4 ± 2.0 years after OHT...
January 30, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28130881/transplantation-of-hepatocytes-from-genetically-engineered-pigs-into-baboons
#6
Hayato Iwase, Hong Liu, Eva Schmelzer, Mohamed Ezzelarab, Martin Wijkstrom, Hidetaka Hara, Whayoung Lee, Jagjit Singh, Cassandra Long, Eric Lagasse, Jörg C Gerlach, David K C Cooper, Bruno Gridelli
BACKGROUND: Some patients with acute or acute-on-chronic hepatic failure die before a suitable human liver allograft becomes available. Encouraging results have been achieved in such patients by the transplantation of human hepatocyte progenitor cells from fetal liver tissue. The aim of the study was to explore survival of hepatocytes from genetically engineered pigs after direct injection into the spleen and other selected sites in immunosuppressed baboons to monitor the immune response and the metabolic function and survival of the transplanted hepatocytes...
January 28, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28122485/validation-of-donor-specific-tolerance-of-intestinal-transplant-by-a-secondary-heart-transplantation-model
#7
Wang Pengcheng, Li Xiaosong, Li Xiaofeng, Li Zhongzhi
OBJECTIVES: It is well accepted that survival after a second organ transplant without immunosuppressive agents indicates tolerance for the first transplant. To validate donor-specific tolerance, we established a rat model with a secondary heart transplant after intestinal transplant, which has so far not been described in the literature. MATERIALS AND METHODS: We transplanted intestine from Fischer F344 rats to Lewis rats orthotopically. Lewis rats received tacrolimus pretreatment before transplant and a 14-day course of rapamycin 1 month after transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28101990/a-single-centre-study-of-1779-heart-transplant-patients-factors-affecting-pacemaker-implantation
#8
P Wellmann, F E M Herrmann, C Hagl, G Juchem
BACKGROUND: After around 10 % of heart transplants patients require pacemaker implantation. The bradyarrhythmias causing pacemaker requirement include sinus node dysfunction (SND) and atrioventricular block (AVB). This study sought to define clinical predictors for pacemaker requirement as well as identify differences in the patient groups developing SND and AVB. METHODS: Our operative data base was used to collect retrospective recipient, donor and operative data of all patients receiving orthotopic heart transplants between 1981 and 2016...
January 19, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#9
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#10
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28041860/transcatheter-aortic-valve-replacement-for-bicuspid-aortic-stenosis-13years-post-heart-transplant
#11
Maureen B Julien, Nimesh Desai, Susan Brozena, Howard C Herrmann
Despite the widespread use of transcatheter aortic valve replacement (TAVR) for moderate and high-risk patients with severe aortic stenosis, it is utilized less frequently in patients with bicuspid aortic valves (BAV). Orthotopic heart transplant (OHT) donors tend to be younger and may have undiagnosed BAV. We present a case of successful TAVR in a patient with BAV thirteen years after OHT.
December 16, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28017688/effect-of-position-on-the-residual-heart-rate-variability-in-patients-after-orthotopic-heart-transplantation
#12
Yi-Ying Lin, Wan-An Lu, Yuan-Chen Hsieh, Hsiao-Huang Chang, Chun-Che Shih, Mei-Jy Jeng, Cheng-Deng Kuo
BACKGROUND: This study investigated the effects of position on heart rate variability (HRV) in patients some years after orthotopic heart transplantation (OHT) surgery. METHODS: Spectral HRV analysis was performed on 15 patients after OHT and 16 patients with coronary artery disease (CAD). HRV measures were compared between OHT and CAD patients in four randomly ordered positions [supine, right lateral decubitus (RLD), left lateral decubitus (LLD), and upright]. Multivariable linear regression analysis was used to identify the factors associated with cardiac function and HRV of OHT patients in supine position, and the factors associated with the outcome (OHT or CAD) of the patients...
December 22, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28011759/-end-stage-heart-failure-therapy-potential-lessons-from-congenital-heart-disease-from-pulmonary-artery-banding-and-interatrial-communication-to-parallel-circulation
#13
REVIEW
Dietmar Schranz, Hakan Akintuerk, Norbert F Voelkel
The final therapy of 'end-stage heart failure' is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductus arteriosus for survival of newborns with persistent pulmonary hypertension, the current review introduces some therapeutical strategies that may be applicable to selected patients with heart failure...
February 15, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27986561/-portopulmonar-hypertension-updated-review
#14
Nielzer Rodríguez-Almendros, Liz N Toapanta-Yanchapaxi, Jonathan Aguirre Valadez, Nilda Espinola Zavaleta, Sergio G Muñoz-Martínez, Ignacio García-Juárez
Portopulmonary hypertension (PPH) is a rare global entity, although epidemiological data are unknown in Mexico. However, chronic liver diseases are very prevalent in Mexico. The PPH is the 4th subtype in frequency in the group of pulmonary arterial hypertension. Its diagnosis is within 2 groups: patients with suspected pulmonary hypertension and candidates for orthotopic liver transplantation (OLT). Both echocardiogram and a right cardiac catheterization are crucial for diagnosis in both scenarios. The PPH is a challenge for OLT since it can increase perioperative mortality significantly...
December 13, 2016: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27968785/qtc-prolongation-may-be-a-late-biomarker-of-orthotopic-heart-transplantation-oht-rejection
#15
Erik V Carter, Carmen Castillo, Belinda Chen, Lynn V Doering, Barbara J Drew, Kathleen T Hickey, David Pickham, Robert R Sciacca
No abstract text is available yet for this article.
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27927755/characteristics-and-outcomes-of-patients-with-myocarditis-listed-for-heart-transplantation
#16
Chantal A ElAmm, Sadeer G Al-Kindi, Guilherme H Oliveira
BACKGROUND: Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. METHODS AND RESULTS: We queried the UNOS database (United Network for Organ Sharing) for all adults listed for orthotopic heart transplantation (2000-2015) with a listed diagnosis of myocarditis...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27908284/obscured-hemorrhagic-pancreatitis-after-orthotopic-heart-transplantation-complicated-with-acute-right-heart-failure-and-hepatic-dysfunction-a-case-report
#17
Ting-Wei Lin, Meng-Ta Tsai, Jun-Neng Roan, Yi-Sheng Liu, Hong-Ming Tsai, Chwan-Yau Luo
BACKGROUND: Pancreatitis is a serious complication after cardiac surgery and can lead to significant morbidities and mortality. The incidence of pancreatitis is even higher in patients undergoing heart transplantation than in those undergoing other cardiac surgeries. Nevertheless, the clinical presentations of pancreatitis are frequently atypical in these patients. CASE PRESENTATION: We report a heart recipient who was complicated with acute right heart failure initially after orthotopic heart transplantation and developed devastating unanticipated hemorrhagic pancreatitis 1 month after the transplantation...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27888756/isolated-heart-transplant-and-combined-heart-liver-transplant-in-adult-congenital-heart-disease-patients-insights-from-the-united-network-of-organ-sharing
#18
Elisa A Bradley, Krong-On Pinyoluksana, Melissa Moore-Clingenpeel, Yongjie Miao, Curt Daniels
BACKGROUND/METHODS: The aging patient with severe congenital heart disease (CHD) faces many challenges: heart failure, arrhythmia, and in the Fontan patient, liver disease. Our goal was to define combined heart liver transplant (CHLT) and isolated orthotopic heart transplant (OHT) outcomes in U.S. adult CHD patients. The U.S. United Network for Organ Sharing (UNOS) thoracic and liver databases were queried for cardiac and CHD diagnoses, from inception-2014. RESULTS: In CHLT, CHD made up 22% of waitlist patients (non-CHD n=262 vs...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27878627/right-ventricular-dysfunction-as-an-echocardiographic-measure-of-acute-rejection-following-heart-transplantation-in-children
#19
Sanjeev Aggarwal, Jennifer Blake, Swati Sehgal
Noninvasive biomarkers of acute allograft rejection (AAR) following orthotopic heart transplantation (OHT) are needed. The aim of this study was to investigate the accuracy of echocardiographic (ECHO) right ventricular (RV) global functional and resistance indices in the detection of AAR. This retrospective chart review included children with biopsy-proven AAR (grade ≥ 2R cellular or CD4 + antibody-mediated rejection) following OHT and an ECHO within 12 h of the biopsy. ECHO measures: (a) ratio of systolic to diastolic duration (S/D), (b) RV myocardial performance index (MPI) and (c) tricuspid regurgitant gradient to RV outflow tract velocity time integral ratio (TRG/VTI), were derived at baseline, during AAR and at two follow-ups...
November 23, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27861476/-combined-heart-kidney-transplantation-in-mexic
#20
Guillermo Careaga-Reyna, Hugo Jesús Zetina-Tun, Carlos Alberto Lezama-Urtecho, José Mariano Hernández-Domínguez, Marlene Santos-Caballero
BACKGROUND: In our country, heart and kidney transplantation is a novel option for treatment of combined terminal heart and kidney failure. This program began in 2012 for selected patients with documented terminal heart failure and structural kidney damage with renal failure. Description of cases: Between January 1, 2012 and April 30, 2016, we made 92 orthotopic heart transplantations. In five of these cases the heart transplantation was combined with kidney transplantation. RESULTS: There were three male and two female patients with a mean age 25...
November 2016: Gaceta Médica de México
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