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Orthotopic Heart Transplant

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https://www.readbyqxmd.com/read/29150986/memory-t-cells-are-significantly-increased-in-rejecting-liver-allografts-of-rhesus-monkeys
#1
Hwajung Kim, Hyeyoung Kim, Sun-Kyung Lee, Xue-Li Jin, Tae Jin Kim, Chanho Park, Jae-Il Lee, Hyo-Sin Kim, Suk Kyun Hong, Kyung Chul Yoon, Sung Woo Ahn, Kyoung-Bun Lee, Nam-Joon Yi, Jaeseok Yang, Kwang-Woong Lee, Wayne J Hawthorne, Kyung-Suk Suh
INTRODUCTION: The Rhesus monkey (RM) is an excellent preclinical model in kidney, heart and islet transplantation that has provided the basis for new immunosuppressive protocols for clinical studies. However, there remain relatively few liver transplantation (LT) models in nonhuman primates. In this study, we analyzed the immune cell populations of PBMCs and secondary lymphoid organs along with livers of normal rhesus monkeys and compared them to those of rejecting liver transplanted recipient's following withdrawal of immunosuppression...
November 18, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29149978/perioperative-prophylaxis-for-total-artificial-heart-transplantation
#2
H E Chambers, P Pelish, F Qiu, D F Florescu
BACKGROUND: Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs. METHODS: An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29141071/usefulness-of-total-12-lead-qrs-voltage-as-a-clue-to-diagnosis-of-patients-with-cardiac-sarcoidosis-severe-enough-to-warrant-orthotopic-heart-transplant
#3
William C Roberts, Tiffany M Becker, Shelley A Hall
Importance: Severe heart failure caused by cardiac sarcoidosis is difficult to diagnosis without biopsy. Objective: To assess whether total electrocardiographic 12-lead QRS voltage may be a clue to diagnosis. Design, Setting, Participants: Case-series study with cases collected at Baylor University Medical Center at Dallas, Dallas, Texas, from January 13, 2005, to January 24, 2017. The clinical records of 16 patients with severe heart failure caused by cardiac sarcoidosis were studied...
November 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29110791/preanesthetic-evaluation-of-the-patient-with-end-stage-heart-failure
#4
REVIEW
Michele Sumler, Ratna Vadlamudi
Heart failure (HF) currently affects more than 5 million patients in the United States [1]. Advanced HF is associated with high mortality and poor quality of life. It is estimated that between 5% and 10% of all patients with HF have an advanced form of the disease [1]. Orthotopic heart transplantation (OHT) is an accepted therapy for stage D HF [3] (Fig. 1). Unfortunately, the number of patients with the disease exceeds the number of available organs. This makes appropriate patient selection vital in the field of heart transplantation...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29110789/long-term-management-of-end-stage-heart-failure
#5
REVIEW
Marlena V Habal, A Reshad Garan
End-stage heart failure manifests as severe and often relentless symptoms that define the clinical syndrome of heart failure, namely congestion and hypoperfusion. These patients suffer from dyspnea, fatigue, abdominal discomfort, and ultimately cardiac cachexia. Renal and hepatic dysfunction frequently further complicates the process. Recurrent hospitalizations, cardiac arrhythmias, and intolerance to standard heart failure therapies are common as the disease progresses. Management focuses on controlling symptoms, correcting precipitants, avoiding triggers, and maximizing therapies with demonstrable survival benefit...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29106559/outcome-of-heart-transplantation-after-bridge-to-transplant-strategy-using-various-mechanical-circulatory-support-devices
#6
Daisuke Yoshioka, Boyangzi Li, Hiroo Takayama, Reshad A Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: Orthotopic heart transplantation (OHT) is limited by a chronic shortage of donors. With the evolution of technology, more patients have been bridged to transplant (BTT) through various pathways using various types of mechanical circulatory support. We compared short- and long-term outcomes among these various strategies of BTT. METHODS: We retrospectively reviewed 410 patients who had OHT between January 2009 and April 2015. Patients were divided into 4 groups according to BTT status: primary OHT without bridging (Group A, n  = 246); bridge with implantable continuous-flow left ventricular assist device (CF-LVAD) (Group B, n  = 130); bridge with short-term mechanical circulatory support (Group C, n  = 16) and bridge with multiple mechanical circulatory supports, including short-term mechanical circulatory support and CF-LVAD (Group D, n  = 18)...
July 4, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29101671/abnormal-pulmonary-18-f-florbetapir-uptake-in-a-patient-evaluated-for-recurrent-cardiac-amyloidosis-following-orthotopic-heart-transplant
#7
Sarah Pittman, Pooja Sethi, Robert R Flavell, Teresa De Marco, Miguel Hernandez Pampaloni
No abstract text is available yet for this article.
November 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29100644/a-comprehensive-risk-score-to-predict-prolonged-hospital-length-of-stay-after-heart-transplantation
#8
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Alejandro Suarez-Pierre, Nishant Patel, Christopher M Sciortino, Kenton J Zehr, Kaushik Mandal, Ryan J Tedford, Stuart D Russell, John V Conte, Robert S Higgins, Duke E Cameron, Glenn J Whitman
BACKGROUND: Prolonged hospital length of stay (PLOS) after heart transplantation increases cost and morbidity. To better inform care, we developed a risk score to identify patients at risk for PLOS after heart transplantation. METHODS: We queried the United Network for Organ Sharing Scientific Registry of Transplant Recipients database for adult patients who underwent isolated heart transplantation from 2003 to 2012. The population was randomly divided into a derivation cohort (80%) and a validation cohort (20%)...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29077666/direct-ultrasound-of-the-pulmonary-artery-helps-diagnose-a-rare-cause-of-right-ventricular-failure-after-heart-transplantation-a-case-report
#9
John S McNeil, Si M Pham, Julie L Huffmyer
Pulmonary artery anastomosis stenosis is a rare cause of right ventricular failure after orthotopic heart transplantation. In this case report, direct ultrasound of the pulmonary artery helped diagnose stenosis at a location not visible on transesophageal echocardiography or even with standard epicardial ultrasound views. It is important to evaluate all vascular anastomoses after heart or lung transplantation because surgical revision of these lesions is facile, but if left undiagnosed, significant morbidity or mortality is likely...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29054235/acquired-cor-triatriatum-sinister-after-the-fontan-operation-and-successful-resection-in-a-child
#10
S Javed Zaidi, Rishi R Adhikari, Chawki El-Zein, Saad Siddiqui
Cor triatriatum sinister is a rare congenital lesion encountered in children. It consists of a fibromuscular membrane that separates the left atrium into two chambers resulting in a triatrial heart and often occurs with other structural cardiac anomalies. The acquired form is uncommon and has only been reported after orthotopic heart transplantation or as a complication of infective endocarditis in adults. These cases were mostly because of hypertrophied atrial tissue or suture lines and torsion of the atrium...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29033052/regular-tachycardia-despite-wenckebach-atrioventricular-conduction
#11
Stephen Fuest, Marye J Gleva, Amit Noheria
We present a 21-year-old woman status post orthotopic heart transplantation initially presenting with a regular narrow complex tachycardia at 159beats/min. With intravenous diltiazem the rhythm transitioned to a regular tachycardia at 106beats/min, 2/3rd of the initial heart rate. We demonstrate this to be a novel description of 3:2second-degree Mobitz type I atrioventricular block (Wenckebach) with the absence of the hallmark regularly irregular (grouped beating) pattern.
September 1, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29028740/coronary-vasospasm-a-silent-enemy-in-orthotopic-heart-transplant
#12
Arthur Omondi, David Briceno, Pedro A Villablanca
No abstract text is available yet for this article.
October 12, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28991130/autoimmune-lymphoproliferative-syndrome-masquerading-as-posttransplant-lymphoproliferative-disorder
#13
Sarah M Jeffreys, Rebecca A Levy, Shelley E Crary
We present a case of a 2-year-old female presenting with diffuse lymphadenopathy 2 years following orthotopic heart transplant. Initially, she was diagnosed with posttransplant lymphoproliferative disease based on clinical presentation and pathology and she was treated accordingly. Because of persistent lymphadenopathy following the completion of chemotherapy and new onset of autoimmune cytopenias, repeat flow of the lymph node showed an elevated double negative T-cell population prompting evaluation for autoimmune lymphoproliferative syndrome (ALPS)...
October 4, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28960322/impact-of-intraoperative-factor-concentrates-on-blood-product-transfusions-during-orthotopic-liver-transplantation
#14
A Carmine Colavecchia, David A Cohen, Jesse E Harris, Jeena M Thomas, Scott Lindberg, Christopher Leveque, Eric Salazar
BACKGROUND: Major bleeding in orthotopic liver transplantation is associated with significant morbidity and mortality. Limited literature exists regarding comparative effectiveness of prothrombin complex concentrate and fibrinogen concentrate during orthotopic liver transplantation on blood product utilization. STUDY DESIGN AND METHODS: This retrospective, single-institution study evaluated the impact of prothrombin complex concentrate and fibrinogen concentrate on blood product utilization during orthotopic liver transplantation from December 2013 to April 2016...
September 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28951657/sleeve-gastrectomy-and-left-ventricular-assist-device-for-heart-transplant
#15
Joseph Greene, Tung Tran, Timothy Shope
BACKGROUND AND OBJECTIVES: Heart failure (HF) is a severe obesity-related comorbidity. Many patients with end-stage HF eventually require cardiac transplantation for long-term survival. These patients may be precluded from enrollment in heart transplant programs secondary to morbid obesity. We propose a pathway involving sleeve gastrectomy (SG) for patients with morbid obesity and HF to afford cardiac transplantation eligibility. METHODS: Three patients with HF and morbid obesity underwent implantation of a left ventricular assist device (LVAD) and SG at an academic tertiary care institution in Washington, DC...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28948364/worsening-in-longitudinal-strain-and-strain-rate-anticipates-development-of-pediatric-transplant-coronary-artery-vasculopathy-as-soon-as-one%C3%A2-year-following-transplant
#16
Richard J Boruta, Shelley D Miyamoto, Adel K Younoszai, Sonali S Patel, Bruce F Landeck
Transplant coronary artery vasculopathy (TCAV) following orthotopic heart transplantation (OHT) continues to be the primary reason for late graft failure in children. The current gold standard of diagnosis of TCAV is coronary angiography with or without intravascular ultrasound. This study investigates the longitudinal use of speckle-tracking echocardiographic strain imaging as an early non-invasive marker to screen for development of TCAV. Echocardiograms from patients who underwent OHT between 2006 and 2010 at Children's Hospital Colorado (n = 50) were retrospectively assessed...
September 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28941612/recipient-atrial-fibrillation-manifesting-as-an-irregular-monomorphic-atrial-tachycardia-in-the-donor-heart
#17
Nicolas Johner, Mehdi Namdar, Andréa Buttu, Sophie Perenet, Philippe Meyer, Dipen C Shah
A 63-year-old man presented with a 1-year history of atrial tachycardia (AT) 6 years after orthotopic heart transplantation with bicaval anastomosis. Twelve-lead electrocardiogram showed monomorphic AT with isoelectric intervals across all leads and strikingly irregular PP intervals. At electrophysiology study, the native left atrium's rhythm was atrial fibrillation (AF) while the donor atria exhibited centrifugal activation of irregular cycle length originating from a site along the left atrial anastomosis...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28932571/management-of-pulmonary-hypertension-from-left-heart-disease-in-candidates-for-orthotopic-heart-transplantation
#18
REVIEW
Anna Koulova, Alan L Gass, Saikrishna Patibandla, Chhaya Aggarwal Gupta, Wilbert S Aronow, Gregg M Lanier
Pulmonary hypertension in left heart disease (PH-LHD) commonly complicates prolonged heart failure (HF). When advanced, the PH becomes fixed or out of proportion and is associated with increased morbidity and mortality in patients undergoing orthotopic heart transplant (OHT). To date, the only recommended treatment of out of proportion PH is the treatment of the underlying HF by reducing the pulmonary capillary wedge pressure (PCWP) with medications and often along with use of mechanical circulatory support...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28879059/pulmonary-hypertension-and-cardiac-hypertrophy-in-children-recipients-of-orthotopic-living-related-liver-transplantation
#19
Magd A Kotb, Inas Abd El Satar, Ahmed M Badr, Nancy H Anis, Hoda Abd El Rahman Ismail, Alaa F Hamza, Hesham M Abdelkader
Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler...
November 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28878572/dabigatran-reversal-with-idarucizumab-in-a-patient-undergoing-heart-transplantation-first-european-report
#20
António Tralhão, Carlos Aguiar, Jorge Ferreira, Maria José Rebocho, Emília Santos, Dinis Martins, José Pedro Neves
BACKGROUND: Dabigatran is a direct thrombin inhibitor with a favorable effectiveness and safety profile when compared to vitamin K antagonists, both in randomized trials and real world registries of atrial fibrillation patients. Yet, physicians' fear of high bleeding risk scenarios in daily clinical practice still precludes a more widespread use of oral anticoagulation. We hereby report a successful case of dabigatran reversal with the novel monoclonal antibody fragment idarucizumab in a patient undergoing heart transplantation...
2017: Thrombosis Journal
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