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Heart transplant review

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https://www.readbyqxmd.com/read/28439697/heart-transplantation-for-adults-with-congenital-heart-disease-current-status-and-future-prospects
#1
REVIEW
Hikaru Matsuda, Hajime Ichikawa, Takayoshi Ueno, Yoshiki Sawa
Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved...
April 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#2
Elie Haddad, François-Xavier Lescure, Walid Ghodhbane, Laurent Lepage, Camille D'humieres, William Vindrios, Yazdan Yazdanpanah, Patrick Nataf, Matthias Kirsch
BACKGROUND: Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28425200/high-dose-calcineurin-inhibitor-free-everolimus-as-a-maintenance-regimen-for-heart-transplantation-may-be-a-risk-factor-for%C3%A2-pneumocystis-pneumonia
#3
Yu-Ning Hu, Nan-Yao Lee, Jun-Neng Roan, Chi-Hsin Hsu, Chwan-Yao Luo
BACKGROUND: Everolimus reduces the incidence of cardiac-allograft vasculopathy (CAV) and is less renally toxic than are calcineurin inhibitors (CNIs). We evaluated the safety of CNI-free everolimus for post-heart transplant (HTx) patients. METHODS: We retrospectively reviewed the records of 36 consecutive patients who had undergone an HTx between January 2006 and December 2013 in National Cheng Kung University Hospital. All patients initially had been treated with the standard tacrolimus regimen...
April 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28420666/prevalence-and-clinical-implication-of-double-mutations-in-hypertrophic-cardiomyopathy-revisiting-the-gene-dose-effect
#4
Dana Fourey, Melanie Care, Katherine A Siminovitch, Adaya Weissler-Snir, Waseem Hindieh, Raymond H Chan, Michael H Gollob, Harry Rakowski, Arnon Adler
BACKGROUND: Available data suggests that double mutations in patients with hypertrophic cardiomyopathy are not rare and are associated with a more severe phenotype. Most of this data, however, is based on noncontemporary variant classification. METHODS AND RESULTS: Clinical data of all hypertrophic cardiomyopathy patients with 2 rare genetic variants were retrospectively reviewed and compared with a group of patients with a single disease-causing variant. Furthermore, a literature search was performed for all studies with information on prevalence and outcome of patients with double mutations...
April 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28419703/exercise-capacity-following-pediatric-heart-transplantation-a-systematic-review
#5
Sara Peterson, Jennifer A Su, Jacqueline R Szmuszkovicz, Robert Johnson, Barbara Sargent
Pediatric HTs account for 13% of all HTs with >60% of recipients surviving at least 10 years post-HT. The purpose of this systematic review is to synthesize the literature on exercise capacity of pediatric HT recipients to improve understanding of the mechanisms that may explain the decreased exercise capacity. Six databases were searched for studies that compared the exercise capacity of HT recipients ≤21 years old with a control group or normative data. Sixteen studies were included. Pediatric HT recipients, as compared to controls or normative data, exhibit significantly higher resting HR, and at peak exercise exhibit significantly decreased HR, VO2 , power, work, minute ventilation, and exercise duration...
April 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28413579/metabolic-recovery-of-the-failing-heart-emerging-therapeutic-options
#6
Dale J Hamilton
Heart failure has mortality rates that parallel those of breast cancer. Current management strategies include neurohormonal blockade, rate control measures, natriuretic peptide preservation, implantation of mechanical assist devices, and heart transplantation. Despite these strategies, however, the failing myocardium remains energy depleted. New strategies to promote metabolic recovery are being developed to potentially augment current treatment guidelines. For example, an unexpected finding of our own studies showed that mechanical unloading with assist devices in advanced-stage heart failure restored metabolic flux...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28412426/unraveling-the-rv-ejection-doppler%C3%A2-envelope-insight-into-pulmonary-artery-hemodynamics-and-disease%C3%A2-severity
#7
Hiroko Takahama, Robert B McCully, Robert P Frantz, Garvan C Kane
OBJECTIVES: The purpose of this study was to characterize the profiles of right ventricular outflow tract (RVOT) Doppler flow velocity envelopes in patients with pulmonary arterial hypertension (PAH) and to establish whether changes in the RVOT flow profile related to patient outcome. BACKGROUND: The RVOT systolic flow profile is frequently abnormal, with findings of a mid-systolic flow deceleration and notching, previously proposed as an indicator of elevated pulmonary vascular resistance (PVR)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28410774/maintaining-the-gift-of-life-achieving-adherence-in-adolescent-heart-transplant-recipients
#8
Rachael Steuer, Sabrina Opiola McCauley
Since the beginning of United Network of Organ Sharing data collection in 1987, a total of 8,333 pediatric patients have received a heart transplant in the United States. Because these patients now have longer graft success with improved care and immunosuppression, many of them are entering adolescence and young adulthood. Primary care pediatric nurse practitioners need to be alert to the prevalence of noncompliance with treatment in heart transplant patients, which continues to be highest in adolescence. Low compliance in adolescence increases morbidity, contributes to decreasing quality of life, and is the leading reason for graft failure and mortality in this age group...
April 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28407402/cirrhotic-cardiomyopathy-implications-for-liver-transplantation
#9
REVIEW
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of the patients on a waiting list for liver transplantation have end-stage liver disease. Due to the marked peripheral vasodilatation of end stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes such as enlargement or hypertrophy of cardiac chambers and electrophysiological repolarization changes including a prolonged QT interval can be observed...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28396989/cardiac-surgery-2016-reviewed
#10
REVIEW
Torsten Doenst, Yasin Essa, Khalil Jacoub, Alexandros Moschovas, David Gonzalez-Lopez, Hristo Kirov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2016, more than 20,000 published references can be found in Pubmed when entering the search term "cardiac surgery". Publications last year have helped to more clearly delineate the fields where classic surgery and modern interventional techniques overlap. The field of coronary bypass surgery (partially compared to percutaneous coronary intervention) was enriched by five large prospective randomized trials. The value of CABG for complex coronary disease was reconfirmed and for less complex main stem lesions, PCI was found potentially equal...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#11
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28391767/alginate-based-microcapsules-generated-with-the-coaxial-electrospray-method-for-clinical-application
#12
Catherine Barron, Jia-Qiang He
Alginate-based microencapsulation of cells has made a significant impact on the fields of regenerative medicine and tissue engineering mainly because of its ability to provide immunoisolation for the encapsulated material. This characteristic has allowed for the successful transplantation of non-autologous cells in several clinical trials for life threatening conditions, such as diabetes, myocardial infarction, and neurodegenerative disorders. Methods for alginate hydrogel microencapsulation have been well developed for various types of cells and can generate microcapsules of different diameters, degradation time, and composition...
April 20, 2017: Journal of Biomaterials Science. Polymer Edition
https://www.readbyqxmd.com/read/28390796/handle-with-care-a-systematic-review-on-frailty-in-cardiac-care-and-its-usefulness-in-heart-transplantation
#13
REVIEW
Oliver Mauthner, Veerle Claes, Mieke Deschodt, Sunita R Jha, Sandra Engberg, Peter S Macdonald, Phillip J Newton, Sabina De Geest
BACKGROUND: There is growing consensus that frailty, a state of vulnerability and a decline in functioning across multiple physiological body systems, is a valuable criterion to guide clinicians' risk prediction for poor outcomes in adult transplant candidates. In its 2016 listing criteria for heart transplantation the International Society for Heart Lung Transplantation recommends frailty assessment. We aimed to summarize the usefulness of frailty assessment in heart transplant candidates or recipients reported throughout the literature...
March 30, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28388919/scope-and-quality-of-cochrane-reviews-of-nutrition-interventions-a-cross-sectional-study
#14
Celeste E Naude, Solange Durao, Abigail Harper, Jimmy Volmink
BACKGROUND: All countries face significant challenges from complex manifestations of malnutrition, which affects one in three people globally. Systematic reviews provide ready-to-use syntheses of quality-appraised evidence to inform decision-making for actions. To enhance the utility and quality of future Cochrane nutrition evidence, we described the scope and quality of all nutrition systematic reviews in the Cochrane Database of Systematic Reviews (CDSR). METHODS: We screened all active CDSR records (31 July 2015) to identify reviews and protocols using pre-specified eligibility criteria and definitions...
April 7, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28387838/temporary-mechanical-circulatory-support-after-orthotopic-heart-transplantation-a-single-centre-experience
#15
Vakhtang Tchantchaleishvili, Katherine L Wood, Laura A Carlson, Bryan Barrus, Michael F Swartz, Himabindu Vidula, Juan M Lehoux, H Todd Massey, Leway Chen
OBJECTIVES: There are various strategies in the use of temporary mechanical circulatory support following orthotopic heart transplant (OHT). We sought to examine the outcomes following different temporary mechanical circulatory support strategies for acute graft failure. METHODS: Patients who received an OHT between 2001 and 2015 at a single institution were retrospectively reviewed. Patients were divided into 2 groups based on the need for temporary mechanical circulatory support (TMCS)...
April 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28385314/management-of-ventricular-arrhythmias-in%C3%A2-patients-with-advanced-heart-failure
#16
REVIEW
Pasquale Santangeli, J Eduardo Rame, Edo Y Birati, Francis E Marchlinski
Advanced heart failure (A-HF) is characterized by progressive symptoms of heart failure despite optimal therapy. In patients with A-HF, ventricular arrhythmias (VAs) are common. Clinical studies evaluating different therapies to prevent VAs had very limited representation of patients with A-HF. Among antiarrhythmic drugs, only amiodarone reduces VAs, although its use may be associated with increased mortality. Catheter ablation with substrate modification is effective to achieve VA suppression in patients with A-HF, including those with left ventricular assist devices...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28385177/effect-of-fontan-associated-morbidities-on-survival-with-intact-fontan-circulation
#17
Kiona Y Allen, Tacy E Downing, Andrew C Glatz, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Stephanie Fuller, Lisa M Montenegro, James M Steven, Thomas L Spray, Susan C Nicolson, James William Gaynor, David J Goldberg
Although survival after the Fontan operation has improved, little is known about the burden of major medical morbidities associated with the modern total cavopulmonary connection (TCPC). A total of 773 consecutive patients who underwent a first Fontan operation at our institution between 1992 and 2009 were retrospectively reviewed. All subjects underwent TCPC (53% lateral tunnel, 47% extracardiac conduit). Median length of follow-up was 5.3 years (interquartile range 1.4 to 11.2), and 30% had follow-up >10 years...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28379853/donation-after-circulatory-death-heart-transplantation
#18
Kumud K Dhital, Hong C Chew, Peter S Macdonald
PURPOSE OF REVIEW: Despite continued expansion in the use of extended-criteria donor hearts following donation after brain death, there remains an unacceptable discrepancy between the supply of suitable donor hearts and the demand from increasing recipient numbers on transplant wait lists. Until recently, the additional approach of utilizing organs following donation after circulatory death (DCD) had not been possible for clinical heart transplantation in the modern era. This review describes relevant advances in translational research and provides an update on the favourable adoption of this donation pathway for clinical heart transplantation...
April 4, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28375548/exercise-based-cardiac-rehabilitation-in-heart-transplant-recipients
#19
REVIEW
Lindsey Anderson, Tricia T Nguyen, Christian H Dall, Laura Burgess, Charlene Bridges, Rod S Taylor
BACKGROUND: Heart transplantation is considered to be the gold standard treatment for selected patients with end-stage heart disease when medical therapy has been unable to halt progression of the underlying pathology. Evidence suggests that aerobic exercise training may be effective in reversing the pathophysiological consequences associated with cardiac denervation and prevent immunosuppression-induced adverse effects in heart transplant recipients. OBJECTIVES: To determine the effectiveness and safety of exercise-based rehabilitation on the mortality, hospital admissions, adverse events, exercise capacity, health-related quality of life, return to work and costs for people after heart transplantation...
April 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28366682/indications-for-lung-resection-surgery-and-lung-transplant-in-south-american-children-with-cystic-fibrosis
#20
REVIEW
Fabíola Villac Adde, Sílvia Vidal Campos, Ricardo Henrique de Oliveira Braga Teixeira, Joaquim Carlos Rodrigues
The current available literature evaluating lung resection surgery and lung transplantation in children with cystic fibrosis (CF) was reviewed through a PubMed search and references from selected studies were additionally included. Pulmonary resections, i.e. lobectomy, segmentectomy, and pneumonectomy, are seldom performed in CF. The main indications, in patients with a forced expiratory volume in 1second (FEV1) that is greater than 30% predicted, are localized bronchiectasis/atelectasis, severe hemoptysis, and bronchopleural fistula refractory to medical management...
February 16, 2017: Paediatric Respiratory Reviews
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