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Heart transplant review

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https://www.readbyqxmd.com/read/28212151/antibody-mediated-rejection-in-the-cardiac-allograft-diagnosis-treatment-and-future-considerations
#1
M Elizabeth H Hammond, Abdallah G Kfoury
PURPOSE OF REVIEW: This review summarizes the latest publications dealing with antibody-mediated rejection (AMR) and defines areas of controversy and future steps that may improve the outcome for patients with this virulent form of rejection. RECENT FINDINGS: Recent progress includes publication of standardized pathologic criteria for acute AMR by the International Society for Heart and Lung Transplantation (ISHLT) and guidelines for treatment of acute AMR by the American Heart Association, endorsed by ISHLT as well...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28212150/desensitization-strategies-in-the-patient-awaiting-heart-transplantation
#2
David H Chang, Jon A Kobashigawa
PURPOSE OF REVIEW: The aim of this review is to discuss the impact of antibody sensitization on heart transplant recipients. RECENT FINDINGS: We will discuss the current state of antibody identification, antibody strength and potential antibody pathogenicity. The prevalence of antibody sensitization has increased with increased utilization of mechanical circulatory support (MCS). Data on MCS-related antibody sensitization are reviewed. Important considerations to minimize the prozone effect in antibody testing will be discussed...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28212149/new-developments-for-the-detection-and-treatment-of-cardiac-vasculopathy
#3
Kevin J Clerkin, Ziad A Ali, Donna M Mancini
PURPOSE OF REVIEW: Cardiac allograft vasculopathy (CAV) is a major limitation to long-term survival after heart transplantation. Innovative new techniques to diagnose CAV have been applied to detect disease. This review will examine the current diagnostic and treatment options available to clinicians for CAV. RECENT FINDINGS: Diagnostic modalities addressing the pathophysiology underlying CAV (arterial wall thickening and decreased coronary blood flow) improve diagnostic sensitivity when compared to traditional (angiography and dobutamine stress echocardiography) techniques...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28199763/disseminated-cat-scratch-disease-presenting-as-nausea-diarrhea-and-weight-loss-without-fever-in-a-heart-transplant-recipient
#4
Annukka A R Antar, Amit Goyal, Karly Murphy, Matthew Schimmel, Nisha A Gilotra, Isabella Martin, Genevieve Marie Crane, Christopher Sciortino, Robin K Avery, Brian A Houston
We report the case of an afebrile 59-year-old heart transplant recipient presenting with nausea, vomiting, diarrhea, weight loss, and diffuse lymphadenopathy. Lymph node biopsies revealed non-caseating granulomatous inflammation. Cat-scratch disease was confirmed by serologic studies, Warthin-Starry staining, and polymerase chain reaction testing of lymph node tissue. The patient's symptoms resolved with 3 months of doxycycline. We review clinical presentations of Bartonella henselae infection in and review diagnostic approaches for B...
February 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28198133/left-ventricular-assist-device-therapy-in-advanced-heart-failure-patient-selection-and-outcomes
#5
REVIEW
Finn Gustafsson, Joseph G Rogers
Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy...
February 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28194324/cell-therapies-in-cardiomyopathy-current-status-of-clinical-trials
#6
REVIEW
Ming Hao, Richard Wang, Wen Wang
Because the human heart has limited potential for regeneration, the loss of cardiomyocytes during cardiac myopathy and ischaemic injury can result in heart failure and death. Stem cell therapy has emerged as a promising strategy for the treatment of dead myocardium, directly or indirectly, and seems to offer functional benefits to patients. The ideal candidate donor cell for myocardial reconstitution is a stem-like cell that can be easily obtained, has a robust proliferation capacity and a low risk of tumour formation and immune rejection, differentiates into functionally normal cardiomyocytes, and is suitable for minimally invasive clinical transplantation...
2017: Analytical Cellular Pathology (Amsterdam)
https://www.readbyqxmd.com/read/28191532/the-role-of-heat-shock-proteins-in-kidney-disease
#7
REVIEW
Shobhana Nayak Rao
Heat Shock Proteins (HSP) belong to the family of intracellular proteins that are constitutively expressed and are upregulated by various stressors including heat, oxidative and chemical stress. HSP helps in reparative processes, including the refolding of damaged proteins and the removal of irreparably damaged proteins that would initiate cellular death or apoptosis. A growing body of evidence has expanded the role of HSP and defined their role in diseases such as neurodegenerative disorders, cancer, ischemic heart disease and kidney diseases...
September 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28191005/significance-of-anti-hla-antibodies-on-adult-and-pediatric-heart-allograft-outcomes
#8
REVIEW
Massimo Mangiola, Marilyn Marrari, Brian Feingold, Adriana Zeevi
As methods for human leukocyte antigens (HLA) antibody detection have evolved and newer solid phase assays are much more sensitive, the last 15 years has seen a renewed focus on the importance of HLA antibodies in solid organ transplant rejection. However, there is still much controversy regarding the clinical significance of antibody level as depicted by the mean fluorescence intensity of a patient's neat serum. Emerging techniques, including those that identify antibody level and function, show promise for the detection of individuals at risk of allograft rejection, determination of the effectiveness of desensitization prior to transplant, and for monitoring treatment of rejection...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28188009/heart-transplant-and-mechanical-circulatory-support-in-patients-with-advanced-heart-failure
#9
Cristina Sánchez-Enrique, Ulrich P Jorde, José González-Costello
Patients with advanced heart failure have a poor prognosis and heart transplant is still the best treatment option. However, the scarcity of donors, long waiting times, and an increasing number of unstable patients have favored the development of mechanical circulatory support. This review summarizes the indications for heart transplant, candidate evaluation, current immunosuppression strategies, the evaluation and treatment of rejection, infectious prophylaxis, and short and long-term outcomes. Regarding mechanical circulatory support, we distinguish between short- and long-term support and the distinct strategies that can be used: bridge to decision, recovery, candidacy, transplant, and destination therapy...
February 7, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28184975/alkaline-phosphatase-a-biomarker-of-cardiac-function-in-pediatric-patients
#10
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/28181361/a-systematic-review-of-parent-and-family-functioning-in-pediatric-solid-organ-transplant-populations
#11
REVIEW
Melissa K Cousino, Kelly E Rea, Kurt R Schumacher, John C Magee, Emily M Fredericks
The process of pediatric solid organ transplantation (SOT) places new and increased stressors on patients and family members. Measures of family functioning may predict psychological and health outcomes for pediatric patients and their families, and provide opportunity for targeted intervention. This systematic review investigated parent and family functioning and factors associated with poorer functioning in the pediatric SOT population. Thirty-seven studies were identified and reviewed. Studies featured a range of organ populations (eg, heart, liver, kidney, lung, intestine) at various stages in the transplant process...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28181355/measures-of-and-changes-in-heart-rate-variability-in-pediatric-heart-transplant-recipients
#12
T Williams, X Tang, G Gilmore, J Gossett, K R Knecht
Heart rate variability is primarily regulated by the autonomic nervous system. Heart transplant recipients undergo surgical denervation of the graft, which results in interruption of autonomic innervation with resultant diminished heart rate variability although some degree of autonomic control may return. This study aimed to characterize heart rate variability in this population. We report a retrospective review of Holter monitor data from transplanted patients between 2005 and 2013. Studies with significant atrial or ventricular arrhythmias were excluded...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28176387/bridge-with-a-left-ventricular-assist-device-to-a-simultaneous-heart-and-kidney-transplant-review-of-the-united-network-for-organ-sharing-database
#13
Ann C Gaffey, Carol W Chen, Jennifer Chung, Edward Wilson Grandin, Paige M Porrett, Michael A Acker, Pavan Atluri
BACKGROUND: Left ventricular assist device (LVAD) implantation as a bridge to cardiac transplantation (BTT) is an effective treatment for end-stage heart failure patients. Currently, there is an increasing number of patients with a LVAD who need a heart and kidney transplant (HKT). Little is known of the prognostic outcomes in these patients. This study was undertaken to determine whether an equivalent outcome would be present in HKTs as compared to a non-LVAD primary HKT cohort. METHODS: We reviewed the United Network for Organ Sharing database from 2004 to 2013...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28174392/-heart-transplantation-allograft-and-xenograft
#14
Norihide Fukushima
Prior to starting clinical cardiac allotransplantation, cardiac xenotransplantation was performed in human in 1960s. In 1964, Hardy performed cardiac transplantation using a chimpanzee heart and Bailey performed cardiac transplantation using a baboon heart to an infant with hypoplastic left heart. The use of cyclosporine has greatly improved the outcome of clinical cardiac transplantation and cardiac allotransplantation became an established treatment strategy for the patients with end-stage heart failure. Although concordant cardiac xenotransplantation from a primate to a human may be successfully performed using current immunosuppressive regimen, a primate heart is not a good candidate for cardiac xenograft due to animal light issues and its size...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28169191/stem-cell-technology-in-cardiac-regeneration-a-pluripotent-stem-cell-promise
#15
REVIEW
Robin Duelen, Maurilio Sampaolesi
Despite advances in cardiovascular biology and medical therapy, heart disorders are the leading cause of death worldwide. Cell-based regenerative therapies become a promising treatment for patients affected by heart failure, but also underline the need for reproducible results in preclinical and clinical studies for safety and efficacy. Enthusiasm has been tempered by poor engraftment, survival and differentiation of the injected adult stem cells. The crucial challenge is identification and selection of the most suitable stem cell type for cardiac regenerative medicine...
January 27, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28166377/multidrug-resistant-tuberculosis-in-transplant-recipients-case-report-and-review-of-the-literature
#16
Moises A Huaman, Robert Brawley, David Ashkin
Transplant recipients are at increased risk of tuberculosis (TB). We describe a case of pulmonary and vertebral multidrug-resistant TB (MDR-TB) in a kidney transplant patient who required neurosurgical intervention and unfortunately developed fatal nosocomial complications. Thirteen transplant recipients with MDR-TB were previously reported in the literature (1 hematopoietic cell transplant, 1 heart transplant, 1 lung transplant, 1 heart-lung ransplant, and 9 kidney transplant recipients). Extrapulmonary disease, severe treatment complications, and deaths were observed in patients who developed MDR-TB after transplantation...
February 6, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28161770/posterior-ventricular-restoration-treatment-for-heart-failure-a-review-past-present-and-future-aspects
#17
REVIEW
Tadashi Isomura, Yasuhisa Fukada, Takuya Miyazaki, Minoru Yoshida, Akimasa Morisaki, Masahiro Endo
Congestive heart failure (CHF) is one of the major causes of death and occurs in more than 15,000,000 patients worldwide. The incidence is expected to increase in parallel with the aging population. Most current therapies for CHF are medications, and biventricular pacing implantation as appropriated by cardiologists, or surgical interventions. The heart transplantation for indicated patients is still gold standard surgery although the 10-year survival rate is approximately 60% based on the worldwide data. However, the cardiac transplantation remains epidemiologically insignificant because of donor pool limitations...
February 4, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28151005/allograft-heart-valves-current-aspects-and-future-applications
#18
Milan Lisy, Guenay Kalender, Katja Schenke-Layland, Kelvin G M Brockbank, Anna Biermann, Ulrich Alfred Stock
Human heart valve allografts continue to represent almost perfect substitutes for heart valves. They have optimal hemodynamic characteristics and are highly resistant to infections. The first clinical use of allograft heart valves was as homovitals being transplanted after antibiotic incubation without any preservation. Since 1968, relatively standardized frozen cryopreservation (SFC) has been employed, including storage in vapor-phase liquid nitrogen. Disadvantages, particularly in pediatric patients, are limited availability due to organ scarcity, inability to grow, degeneration, immune response, and long-term failure...
February 2, 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28146193/-cytomegalovirus-disease-in-post-heart-transplant-patients-at-a-national-reference-center
#19
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Bryan Valcarcel-Valdivia
INTRODUCTION: Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. AIMS: To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. MATERIALS AND METHODS: A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015...
December 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28145649/clinical-characteristics-of-transplant-associated-encephalopathy-in-children
#20
Yun Jeong Lee, Mi Sun Yum, Eun Hee Kim, Min Jee Kim, Kyung Mo Kim, Ho Joon Im, Young Hwue Kim, Young Seo Park, Tae Sung Ko
We aimed to analyze characteristics of encephalopathy after both hematopoietic stem cell and solid organ pediatric transplantation. We retrospectively reviewed medical records of 662 pediatric transplant recipients (201 with liver transplantation [LT], 55 with heart transplantation [HT], and 67 with kidney transplantation [KT], 339 with allogeneic hematopoietic stem cell transplantation [HSCT]) who received their graft organs at Asan Medical Center between January 2000 and July 2014. Of the 662 patients, 50 (7...
March 2017: Journal of Korean Medical Science
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