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Heart transplant review

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https://www.readbyqxmd.com/read/27922771/giant-cell-myocarditis-a-brief-review
#1
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/27918214/immunosuppression-and-adult-heart-transplantation-emerging-therapies-and-opportunities
#2
Nicholas Furiasse, Jon A Kobashigawa
Immunosuppression following heart transplantation has improved graft longevity through the reduction of cellular and antibody mediated rejection. The attempt to limit the unintended consequences of immunosuppressive therapies and address sensitized patients has led to a revolution in immunosuppression. Areas Covered: This review will focus on the current emerging immunosuppressive therapies in heart transplantation while reviewing the effective contemporary treatments, and explore the potential development of new immunomodulatory therapies...
December 5, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27906830/heterotopic-abdominal-rat-heart-transplantation-as-a-model-to-investigate-volume-dependency-of-myocardial-remodeling
#3
Kálmán Benke, Alex Ali Sayour, Csaba Mátyás, Bence Ágg, Balázs Tamás Németh, Attila Oláh, Mihály Ruppert, István Hartyánszky, Zoltán Szabolcs, Tamás Radovits, Béla Merkely, Gábor Szabó
Heterotopic abdominal rat heart transplantation has been extensively used to investigate ischemic/reperfusion injury, immunological consequences during heart transplantations and also to study remodeling of the myocardium due to volume unloading. We provide a unique review on the latter and present a summary of the experimental studies on rat heart transplantation to illustrate changes that occur to the myocardium due to volume unloading. We divided the literature based on whether normal or failing rat heart models were used...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#4
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#5
Jonathan Merola, Daniel D Jane-Wit, Jordan S Pober
PURPOSE OF REVIEW: Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS: Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA)...
November 24, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27894980/natural-killer-cells-in-inflammatory-heart-disease
#6
REVIEW
SuFey Ong, Noel R Rose, Daniela Čiháková
Despite of a multitude of excellent studies, the regulatory role of natural killer (NK) cells in the pathogenesis of inflammatory cardiac disease is greatly underappreciated. Clinical abnormalities in the numbers and functions of NK cells are observed in myocarditis and inflammatory dilated cardiomyopathy (DCMi) as well as in cardiac transplant rejection [1-6]. Because treatment of these disorders remains largely symptomatic in nature, patients have little options for targeted therapies [7,8]. However, blockade of NK cells and their receptors can protect against inflammation and damage in animal models of cardiac injury and inflammation...
November 25, 2016: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/27891727/rehospitalization-after-pediatric-heart-transplantation-incidence-indications-and-outcomes
#7
Seth A Hollander, Doff B McElhinney, Christopher S Almond, Nancy McDonald, Sharon Chen, Beth D Kaufman, Daniel Bernstein, David N Rosenthal
We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59...
November 27, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27885446/post-cardiotomy-rescue-extracorporeal-cardiopulmonary-resuscitation-in-neonates-with-single-ventricle-after-intractable-cardiac-arrest-attrition-after-hospital-discharge-and-predictors-of-outcome
#8
Anastasios C Polimenakos, Vincent Rizzo, Chawki F El-Zein, Michel N Ilbawi
Extracorporeal cardiopulmonary resuscitation (ECPR) in children with cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) has been reported with encouraging results. We reviewed outcomes of neonates with functional single ventricle (FSV) surviving post-cardiotomy ECPR after hospital discharge. Fifty-eight patients who required post-cardiotomy extracorporeal membrane oxygenation (ECMO) since the introduction of our ECPR protocol (January 2007-December 2011) were identified. Forty-one were neonates...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27878916/can-the-outcomes-of-mesenchymal-stem-cell-based-therapy-for-myocardial-infarction-be-improved-providing-weapons-and-armour-to-cells
#9
REVIEW
Andrey A Karpov, Daria V Udalova, Michael G Pliss, Michael M Galagudza
Use of mesenchymal stem cell (MSC) transplantation after myocardial infarction (MI) has been found to have infarct-limiting effects in numerous experimental and clinical studies. However, recent meta-analyses of randomized clinical trials on MSC-based MI therapy have highlighted the need for improving its efficacy. There are two principal approaches for increasing therapeutic effect of MSCs: (i) preventing massive MSC death in ischaemic tissue and (ii) increasing production of cardioreparative growth factors and cytokines with transplanted MSCs...
November 23, 2016: Cell Proliferation
https://www.readbyqxmd.com/read/27878627/right-ventricular-dysfunction-as-an-echocardiographic-measure-of-acute-rejection-following-heart-transplantation-in-children
#10
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/27878626/reducing-fluoroscopic-radiation-exposure-during-endomyocardial-biopsy-in-pediatric-transplant-recipients
#11
Jeffrey G Gossett, Christina L Sammet, Anya Agrawal, Karen Rychlik, David F Wax
Endomyocardial biopsy (EMB) with fluoroscopy is used for rejection surveillance in pediatric heart transplantation. Lowering frame rate may reduce radiation, but decreases temporal resolution and image quality. We undertook a quality initiative reducing frame rate from 10 frames per second (FPS) to 5 FPS. To assess whether lowering frame rate can reduce radiation exposure without compromising safety, data on EMBs from 9/2009 to 4/2013 without angiography or intervention were reviewed. Effective dose was calculated from dose area product (DAP) and fluoroscopy time...
November 23, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27872804/pulmonary-hypertension-secondary-to-pulmonary-veno-occlusive-disease-complicated-by-right-heart-failure-hypotension-and-acute-kidney-injury
#12
Nima Golzy, Stuti Fernandes, Justin Sharim, Rikin Tank, Henry D Tazelaar, Howard E Epstein, Victor Tapson, Antoine Hage
Pulmonary veno-occlusive disease (PVOD) is rare condition which can lead to severe pulmonary hypertension, right ventricular dysfunction, and cardiopulmonary failure. The diagnosis of PVOD can be challenging due to its nonspecific symptoms and its similarity to idiopathic pulmonary arterial hypertension and interstitial lung disease in terms of diagnostic findings. This case describes a 57 year old female patient who presented with a 5-month history of progressive dyspnea on exertion and nonproductive cough...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27870978/towards-the-standardization-of-stem-cell-therapy-studies-for-ischemic-heart-diseases-bridging-the-gap-between-animal-models-and-the-clinical-setting
#13
REVIEW
Fábio Trindade, Adelino Leite-Moreira, João Ferreira-Martins, Rita Ferreira, Inês Falcão-Pires, Rui Vitorino
Today there is an increasing demand for heart transplantations for patients diagnosed with heart failure. Though, shortage of donors as well as the large number of ineligible patients hurdle such treatment option. This, in addition to the considerable number of transplant rejections, has driven the clinical research towards the field of regenerative medicine. Nonetheless, to date, several stem cell therapies tested in animal models fall by the wayside and when they meet the criteria to clinical trials, subjects often exhibit modest improvements...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867479/donor-pretreatment-with-carbon-monoxide-prevents-ischemia-reperfusion-injury-following-heart-transplantation-in-rats
#14
Noritomo Fujisaki, Keisuke Kohama, Takeshi Nishimura, Hayato Yamashita, Michiko Ishikawa, Akihiro Kanematsu, Taihei Yamada, Sungsoo Lee, Tetsuya Yumoto, Kohei Tsukahara, Joji Kotani, Atsunori Nakao
Because inhaled carbon monoxide (CO) provides potent anti-inflammatory and antioxidant effects against ischemia reperfusion injury, we hypothesized that treatment of organ donors with inhaled CO would decrease graft injury after heart transplantation. Hearts were heterotopically transplanted into syngeneic Lewis rats after 8 hours of cold preservation in University of Wisconsin solution. Donor rats were exposed to CO at a concentration of 250 parts per million for 24 hours via a gas-exposure chamber. Severity of myocardial injury was determined by total serum creatine phosphokinase and troponin I levels at three hours after reperfusion...
July 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27866925/extracorporeal-membrane-oxygenation-support-and-post-heart-transplant-outcomes-among-united-states-adults
#15
Sandip Zalawadiya, Marat Fudim, Geetha Bhat, William Cotts, JoAnn Lindenfeld
BACKGROUND: Patients supported with extracorporeal membrane oxygenation (ECMO) are given priority listing status for heart transplant (HT). Data on post-HT outcomes for adults with ECMO support at the time of HT are limited. METHODS: We analyzed data from the United Network for Organ Registry (UNOS) registry for 157 ECMO-supported adults (age ≥ 18 years) undergoing HT after January 1, 2000. Data at the time of HT were examined for their association with post-transplant mortality using multivariable Cox proportional hazard analyses...
October 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27863348/outpatient-follow-up-during-the-first-year-after-heart-transplantation-is-it-feasible
#16
Ana Ayesta, Iago Sousa-Casasnovas, Edwin Gómez, Manuel Martínez-Sellés, Francisco Fernández-Avilés
INTRODUCTION: First year follow-up after heart transplantation requires invasive tests. Although patients used to be hospitalized for this purpose, ambulatory invasive procedures now offer the possibility of outpatient follow-up. The feasibility and security of this strategy is unknown. METHODS: From 2007 we transitioned to outpatient follow-up. We have retrospectively reviewed the clinical course of the outpatient group (2007 to 2014) and an inpatient group (2000-2006)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27859378/mechanical-circulatory-support-devices-for-pediatric-patients-with-congenital-heart-disease
#17
REVIEW
Steven G Chopski, William B Moskowitz, Randy M Stevens, Amy L Throckmorton
The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assist devices, cavopulmonary assist devices, and total artificial heart pumps continue to gain acceptance as viable treatment strategies for both adults and pediatric patients as bridge-to-transplant, bridge-to-recovery, and longer-term circulatory support alternatives. We present a review of the current and future MCS devices for patients having congenital heart disease (CHD) with biventricular or univentricular circulations...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27852680/successful-recovery-and-allogeneic-stem-cell-transplant-following-chemotherapy-induced-severe-cardiomyopathy-literature-review-of-management-and-prognostic-factors
#18
Muhammad Asim Shahzad, Rizwan Ishtiaq, Umar Zahid, Faiz Anwer
Chemotherapy-induced cardiomyopathy is one of the major possible hazards that can result from potential cardiotoxic agents while treating cancer. Prognostic risk factors include the rate of drug administration, history of hypertension, female gender, extremes of age, previous history of mediastinal irradiation, cumulative dose and pre-existing heart disease. Close monitoring of the patients, timely diagnosis, use of well-known biomarkers including cardiac troponins, NT-ProBNP and imaging studies like 2D Echo or cardiac MRI are essential...
November 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27843561/predictors-of-poor-outcome-among-children-with-heterotaxy-syndrome-a-retrospective-review
#19
Eiméar McGovern, Eoin Kelleher, James E Potts, John O'Brien, Kevin Walsh, Lars Nolke, Colin J McMahon
OBJECTIVE: To determine predictors of poor outcome in patients with heterotaxy syndrome. METHODS: A retrospective review of children with heterotaxy syndrome, in a single tertiary paediatric cardiology centre, was conducted between 1 January 1997 and 1 January 2014 to determine predictors of poor outcome. Poor outcome was defined as death, cardiac transplantation or New York Heart Association (NYHA) functional class III or IV. RESULTS: There were 35 patients diagnosed with heterotaxy syndrome, 17 of whom were diagnosed antenatally...
2016: Open Heart
https://www.readbyqxmd.com/read/27836946/heart-transplantation-in-adult-congenital-heart-disease
#20
REVIEW
Luke J Burchill
Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades...
December 1, 2016: Heart: Official Journal of the British Cardiac Society
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