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Heart transplant review

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https://www.readbyqxmd.com/read/28551379/review-of-1-000-consecutive-extracorporeal-membrane-oxygenation-runs-as-a-quality-initiative
#1
Harold N Lovvorn, Daphne C Hardison, Heidi Chen, Ashly C Westrick, Melissa E Danko, Brian C Bridges, William F Walsh, John B Pietsch
BACKGROUND: Extracorporeal membrane oxygenation is a resource-intensive mode of life-support potentially applicable when conventional therapies fail. Given the initial success of extracorporeal membrane oxygenation to support neonates and infants in the 1980s, indications have expanded to include adolescents, adults, and selected moribund patients during cardiopulmonary resuscitation. This single-institution analysis was conducted to evaluate programmatic growth, outcomes, and risk for death despite extracorporeal membrane oxygenation across all ages and diseases...
May 24, 2017: Surgery
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#2
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28540143/association-between-coronary-artery-disease-and-microrna-literature-review-and-clinical-perspective
#3
Rehan Malik, Raja S Mushtaque, Usman A Siddiqui, Adnan Younus, Muhammad A Aziz, Choudhry Humayun, Kanaan Mansoor, Muhammad A Latif, Salman Waheed, Salman Assad, Idrees Khan, Syed M Bukhari, Daniel DelCampo, Ali Adus, Swetha Gannarapu
BACKGROUND: Until recently, circulating micro-RNAs (miRNAs) have attracted major interest as novel biomarkers for the early diagnosis of coronary artery disease (CAD). This review article summarizes the available evidence on the correlation of micro-RNAs with both the clinical and subclinical coronary artery disease and highlights the necessity for exploring miRNAs as a potential diagnostic and prognostic biomarker of early CAD in an adult population. METHODS: A systematic literature analysis and retrieval online systems Public/Publisher MEDLINE/ Excerpta Medica Database /Medical Literature Analysis and Retrieval System Online,(PUBMED/EMBASE/MEDLINE) search were conducted for relevant information...
April 23, 2017: Curēus
https://www.readbyqxmd.com/read/28538243/bk-virus-as-a-mediator-of-graft-dysfunction-following-kidney-transplantation
#4
Stephanie G Yi, Richard J Knight, Keri E Lunsford
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients. RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy...
May 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28538050/molecular-imaging-of-acute-cardiac-transplant-rejection-animal-experiments-and-prospects
#5
Yihan Chen, Li Zhang, Jinfeng Liu, Pingyu Zhang, Xiaoyuan Chen, Mingxing Xie
Acute rejection (AR) remains the biggest challenge during the 1st year after heart transplantation despite advances in immunosuppressive therapy. The early detection and curbing of AR are crucial to the survival of transplant recipients. However, as the gold standard for AR, endomyocardial biopsy has several limitations because of its inherent invasiveness and morbidity. Traditional imaging techniques such as echocardiography and cardiac magnetic resonance imaging are of certain value for AR, but their diagnostic criteria and accuracy remain in question...
May 19, 2017: Transplantation
https://www.readbyqxmd.com/read/28536746/characteristics-of-clinically-diagnosed-pediatric-myocarditis-in-a-contemporary-multi-center-cohort
#6
Ryan J Butts, Gerard J Boyle, Shriprasad R Deshpande, Katheryn Gambetta, Kenneth R Knecht, Carolina A Prada-Ruiz, Marc E Richmond, Shawn C West, Ashwin K Lal
The objective of this study was to describe a contemporary cohort of pediatric patients hospitalized for clinically suspected myocarditis. A retrospective chart review was performed at seven tertiary pediatric hospitals. Electronic medical records were searched between 2008 and 2012 for patients ≤18 years admitted with an ICD-9 code consistent with myocarditis. Patients were excluded if the admitting or consulting cardiologist did not suspect myocarditis during the admission or an alternative diagnosis was determined...
May 23, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28536222/giant-cell-myocarditis-presenting-with-acute-heart-failure
#7
Ioannis Kasouridis, Joaquim Majo, Guy MacGowan, Andrew L Clark
Idiopathic giant cell myocarditis (GCM) is a rare and rapidly progressing form of myocarditis predominantly affecting younger people. We report a case of a 23-year-old athletic patient who presented with features of acute heart failure due to GCM and discuss his management that included a left ventricular assist device as a bridge to transplant. He died immediately following the transplant.We also review the literature on this rare disease, highlighting the advances in the management of the disease including immunosuppressive therapy, ventricular assist devices and heart transplantation...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28529939/naturally-engineered-maturation-of-cardiomyocytes
#8
REVIEW
Gaetano J Scuderi, Jonathan Butcher
Ischemic heart disease remains one of the most prominent causes of mortalities worldwide with heart transplantation being the gold-standard treatment option. However, due to the major limitations associated with heart transplants, such as an inadequate supply and heart rejection, there remains a significant clinical need for a viable cardiac regenerative therapy to restore native myocardial function. Over the course of the previous several decades, researchers have made prominent advances in the field of cardiac regeneration with the creation of in vitro human pluripotent stem cell-derived cardiomyocyte tissue engineered constructs...
2017: Frontiers in Cell and Developmental Biology
https://www.readbyqxmd.com/read/28527833/evaluation-of-the-sipat-instrument-to-assess-psychosocial-risk-in-heart-transplant-candidates-a-retrospective-single-center-study
#9
Elizabeth Vandenbogaart, Lynn Doering, Belinda Chen, Ann Saltzman, Tamara Chaker, Julie W Creaser, Darlene Rourke, Richard W Cheng, Gregg C Fonarow, Mario Deng
OBJECTIVES: We evaluated the reliability of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) in heart transplant (HT) recipients and explored its usefulness in predicting post-transplant outcomes. BACKGROUND: Pre-transplant psychosocial and behavioral risk is associated with post-transplant clinical outcomes. SIPAT is a risk assessment tool created for pre-transplant psychosocial evaluation. METHODS: Via retrospective chart review, three examiners applied the SIPAT to 51 adult HT recipients...
May 17, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28526502/hemodynamic-parameters-predict-adverse-outcomes-following-biventricular-conversion-with-single-ventricle-palliation-takedown
#10
Melissa A Herrin, David Zurakowski, Christopher W Baird, Puja Banka, Jesse J Esch, Pedro J Del Nido, Sitaram M Emani
OBJECTIVE: Patients with a borderline left ventricular hypoplasia in the hypoplastic left heart syndrome variant or an unbalanced atrioventricular canal who undergo initial single-ventricle palliation may be candidates for biventricular (BiV) conversion following left ventricle (LV) recruitment procedures. We investigated associations among preoperative parameters and postoperative outcomes in patients undergoing BiV conversion. METHODS: We performed a retrospective review of patients who underwent BiV conversion to determine variables associated with clinical outcomes...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28523441/progress-in-the-presence-of-failure-updates-in-chronic-systolic-heart-failure-management
#11
REVIEW
Katie M Murphy, Julie L Rosenthal
The therapeutic heart failure armamentarium has evolved from drugs to transplantation to devices through further understanding of its complex pathophysiology and pathogenesis. Current medications capitalize on our evolving understanding of the sympathetic and renin-angiotensin-aldosterone systems that subsequently promote both beneficial and maladaptive responses that ultimately yield a decrease in cardiac function. Despite these advancements, the prevalence of heart failure continues to rise and carries a significant burden on our patients and health care system...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28516902/role-of-transient-receptor-potential-channels-in-heart-transplantation-a-potential-novel-therapeutic-target-for-cardiac-allograft-vasculopathy
#12
Shuo Ma, Yue Jiang, Weiting Huang, Xintao Li, Shuzhuang Li
Heart transplantation has evolved as the criterion standard therapy for end-stage heart failure, but its efficacy is limited by the development of cardiac allograft vasculopathy (CAV), a unique and rapidly progressive form of atherosclerosis in heart transplant recipients. Here, we briefly review the key processes in the development of CAV during heart transplantation and highlight the roles of transient receptor potential (TRP) channels in these processes during heart transplantation. Understanding the roles of TRP channels in contributing to the key procedures for the development of CAV during heart transplantation could provide basic scientific knowledge for the development of new preventive and therapeutic approaches to manage patients with CAV after heart transplantation...
May 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28511069/ischaemic-preconditioning-current-knowledge-and-potential-future-applications-after-30-years-of-experience
#13
REVIEW
Karolina Stokfisz, Anna Ledakowicz-Polak, Maciej Zagorski, Marzenna Zielinska
Ischaemic preconditioning (IPC) phenomenon has been known for thirty years. During that time several studies showed that IPC provided by brief ischaemic and reperfusion episodes prior to longer ischaemia can bestow a protective effect to both preconditioned and also remote organs. IPC affecting remote organs is called remote ischaemic preconditioning. Initially, most IPC studies were focused on enhancing myocardial resistance to subsequent ischaemia and reperfusion injury. However, preconditioning was found to be a universal phenomenon and was observed in various organs and tissues including the heart, liver, brain, retina, kidney, skeletal muscles and intestine...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28505026/combined-heart-lung-transplantation-an-updated-review-of-the-current-literature
#14
Shravani Pasupneti, Gundeep Dhillon, Bruce Reitz, Kiran Khush
Heart lung transplantation is a viable treatment option for patients with many end stage heart and lung pathologies. However, given the complex nature of the procedure, it is imperative that patients are selected appropriately and the clinician is aware of the many unique aspects in management of this population. This review seeks to describe updated organ selection policies, peri and postoperative management strategies, monitoring of graft function, and clinical outcomes for patients following combined heart-lung transplantation in the current era...
May 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28489781/clinical-characteristics-and-outcomes-of-patients-with-myocarditis-mimicking-st-segment-elevation-myocardial-infarction-analysis-of-a-case-series
#15
Shuang Wu, Yan-Min Yang, Jun Zhu, Huai-Bin Wan, Juan Wang, Han Zhang, Xing-Hui Shao
Acute myocarditis mimicking ST-segment elevation myocardial infarction (STEMI) is highly deceptive for an accurate diagnosis, and a systematic study is lacking with regard to the clinical features and prognosis of this distinct clinical entity.Patients with suspected STEMI and eventually diagnosed with myocarditis by cardiac magnetic resonance (CMR) from January 2012 to April 2016 at Fuwai Hospital were identified by reviewing medical records and electronic databases. Follow-up was conducted by clinical visits and phone contacts in a median duration of 17 months...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28488842/sleep-disordered-breathing-in-heart-failure-patients-after-ventricular-assist-device-implantation-and-heart-transplantation
#16
Anindita Chowdhury, Reeba Mathew, Richard J Castriotta
Chronic heart failure (CHF) represents a major health and economic burden and is associated with high rates of hospital admission, morbidity, mortality and decreased quality-adjusted life years. New advances in the treatment of CHF such as ventricular assist devices (VADs) and heart transplantation have helped improve outcomes. Sleep-disordered breathing (SDB) is highly prevalent in CHF patients and the associated morbidity makes it essential for physicians to be more cognizant about its existence, interaction and need for treatment...
May 8, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28486624/ventricular-assist-device-support-in-patients-with-single-ventricles-the-melbourne-experience%C3%A2
#17
Chin L Poh, Roberto Chiletti, Diana Zannino, Christian Brizard, Igor E Konstantinov, Stephen Horton, Johnny Millar, Yves d'Udekem
OBJECTIVES: The capacity and limitations of ventricular assist device (VAD) support in single-ventricle physiology remains poorly understood. We aimed to review our experience in the use of VAD support in the single-ventricle circulation to determine its feasibility in this population. METHODS: We reviewed our experience with VAD support in patients with single ventricles over the past 25 years. Fifty-seven patients received 64 runs of VAD support between 1990 and 2015 at a median age of 13 days [interquartile range (IQR) 4...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28484466/the-st2-il-33-axis-in-immune-cells-during-inflammatory-diseases
#18
REVIEW
Brad Griesenauer, Sophie Paczesny
Il1rl1 (also known as ST2) is a member of the IL-1 superfamily, and its only known ligand is IL-33. ST2 exists in two forms as splice variants: a soluble form (sST2), which acts as a decoy receptor, sequesters free IL-33, and does not signal, and a membrane-bound form (ST2), which activates the MyD88/NF-κB signaling pathway to enhance mast cell, Th2, regulatory T cell (Treg), and innate lymphoid cell type 2 functions. sST2 levels are increased in patients with active inflammatory bowel disease, acute cardiac and small bowel transplant allograft rejection, colon and gastric cancers, gut mucosal damage during viral infection, pulmonary disease, heart disease, and graft-versus-host disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28482761/lack-of-association-between-adrenoreceptor-genotype-and-the-vasoconstriction-response-to-dexmedetomidine
#19
Robert H Friesen, Dobromir Slavov, Shelley D Miyamoto, Richard John Ing, Wells B LaRiviere, Matthew R G Taylor
An exaggerated vasoconstriction response to dexmedetomidine, an α-2 adrenergic agonist, has been associated with 2 genotypes: a deletion in the α-2B adrenoreceptor gene ( ADRA2B deletion) and SNP rs9922316 in the gene for protein kinase C type β ( PRKCB). We hypothesized that children with a marked systemic vascular resistance index (SVRI) increase following intravenous dexmedetomidine bolus would carry these genotypes. Following institutional review board approval, DNA samples from 16 children with transplanted hearts who participated in a study in the cardiac catheterization laboratory of hemodynamic responses to dexmedetomidine boluses underwent genotyping by polymerase chain reaction (PCR) amplification and PCR Sanger sequencing for the ADRA2B deletion and for PRKCB rs9922316...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28480572/acute-cellular-rejection-later-than-one-year-after-heart-transplantation-a-single-center-retrospective-study-at-sk%C3%A3-ne-university-hospital-in-lund-1988-2010
#20
Carl Söderlund, Göran Rådegran
Routine endomyocardial biopsy (EMB) to detect acute cellular rejection (ACR) late (> 1 year) after heart transplantation (HT) remains debated. To gain knowledge on late ACR and thereby approach this issue, we studied the incidence, predictors, and outcome of late ACR. 815 late EMBs from 183 patients transplanted 1988-2010 were retrospectively reviewed until June 30, 2012. Only 4.4% of the routine and 17.6% of the additional clinically indicated late EMBs showed ACR ≥ grade 2. With time post-HT, there was a clear trend towards fewer ACRs, a lower incidence of ACR per patient per year, and a deceleration in the decrease in the proportion of patients free from ACR...
May 8, 2017: Clinical Transplantation
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