Journal of Heart and Lung Transplantation

BACKGROUND: There is limited evidence regarding the prevalence and impact of iron deficiency (ID) in children with dilated cardiomyopathy (DCM). METHODS: Retrospective single-centre review of all children between 2010-2020 with a diagnosis of DCM and complete iron studies. ID was defined as ≥ 2 of ferritin < 20 μg/L, iron < 9 μmol/L, transferrin > 3 g/L or transferrin saturation < 15%. Clinical and laboratory indices, and freedom from a composite adverse event (CAE) of mechanical circulatory support, heart transplant or death were compared between children with and without ID...

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One of the most important goals of the organ allocation system is to prioritize candidates by their relative medical urgency. Ensuring that this aim is achieved translates to a challenging biostatistical problem. Motivated by a recent example in exception priority listings for heart transplant candidates, we developed a set of best practices for comparing medical urgency between groups of waitlisted candidates. We propose that researchers 1) consider time-varying covariates, 2) model cause-specific hazards, 3) account for deaths that occur during inactive periods, and 4) perform motivated risk adjustment specific to the study question...

BACKGROUND: Long-term changes in exercise capacity and cardiopulmonary hemodynamics, after pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) have been poorly described. METHODS: We analysed the data from two prospective surgical CTEPH cohorts in Hammersmith Hospital, London and Amsterdam UMC. A structured multi-modal follow-up was adopted, consisting of right heart catheterisation, cardiac MRI and cardiopulmonary exercise testing before and after PEA...

BACKGROUND: Optimizing donor use and achieving maximal survival following lung transplantation (LTx) requires a pre-transplant assessment that identifies clinical, physiological and psychosocial patient factors associated with both poor and optimal post-LTx survival. We examined the utility of a psychosocial tool, the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) to identify patient suitability for LTx, as well as its association with clinical outcomes before and after LTx...

No abstract text is available yet for this article.

RATIONALE: The administration of inhaled prostanoids to patients with pulmonary hypertension (PH) related to idiopathic pulmonary fibrosis (IPF) and other fibrotic interstitial lung diseases improves functional outcomes. Selection of patients with IPF at high risk for concomitant PH to undergo right heart catheterization (RHC) remains challenging. OBJECTIVE: To develop a simple clinical prediction tool based on commonly measured non-invasive parameters to facilitate the identification of PH in patients with IPF METHODS: A clinical prediction model based on non-invasive parameters was derived in patients enrolled in the ARTEMIS-IPF randomized, placebo-controlled clinical trial...

Limited data is available for American Indians /Alaska Natives (AI/AN) undergoing lung transplant. The goal of our study was to assess outcomes for AI/AN lung transplant recipients (LTR). A retrospective review of data from the Organ Procurement and Transplant Network was performed comparing AI/AN (n=88) and Caucasian (n=22,767) LTRs between May 4, 2005 and October 31, 2019. AI/AN LTRs had worse functional parameters prior to transplantation but had similar post-transplant outcomes compared to Caucasians LTRs...

BACKGROUND: The changing demographic of heart failure (HF) increases the exposure to non-cardiovascular (non-CV) events. We investigated the distribution of non-CV mortality/morbidity and the characteristics associated with higher risk of non-CV events in patients with advanced HF. METHODS: Patients from the HELP-HF registry were stratified according to the number of 2018 HFA-ESC criteria for advanced HF. Endpoints were non-CV mortality and non-CV hospitalization...

BACKGROUND: The association between Organizing Pneumonia (OP) after lung transplantation with the development of acute rejection (AR) remains undefined. In addition, molecular allograft injury, as measured by donor-derived cell-free DNA (dd-cfDNA), during episodes of OP and its relationship to episodes of AR, chronic lung allograft dysfunction (CLAD) or death is unknown. METHODS: This multicenter, prospective cohort study collected serial plasma samples from 188 lung transplant recipients for dd-cfDNA at the time of bronchoscopy with biopsy...

PURPOSE: The Minnesota Pectoralis Risk Score (MPRS) utilizes CT-quantified thoracic muscle and clinical variables to predict survival after left ventricular assist device (LVAD) implantation. The model has not been prospectively tested in HeartMate 3 recipients. METHODS: A single-center HeartMate 3 cohort from July 2016-July 2021 (n=108) was utilized for this analysis. Cohort subjects with complete co-variates for MPRS calculation (pectoralis muscle measures, Black race, creatinine, total bilirubin, body mass index, bridge to transplant status and presence/absence of contrast) implanted after MPRS development were included...

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BACKGROUND: Previous retrospective studies suggest a good diagnostic performance of 18 F-FDG-PET/CT in left ventricular assist device (LVAD) infections. Our aim was to prospectively evaluate the role of PET/CT in the characterization and impact on clinical management of LVAD infections. METHODS: 40 patients (58[53-62] years) with suspected LVAD infection and 5 controls (69[64-71] years) underwent 18 F-FDG-PET/CT. Four LVAD components were evaluated: exit site and subcutaneous driveline (peripheral), pump pocket, and outflow graft...

BACKGROUND: Advances in mechanical circulatory support and changes in allocation policy have shifted waitlisting practices for heart transplantation (HT) in the US. This analysis reports waitlist and transplant outcomes among HT candidates bridged with temporary endovascular right ventricular assist devices (tRVADs). METHODS: Patients awaiting HT from 2008-2022 in the UNOS registry were grouped by presence of tRVAD while waitlisted and propensity matched. Waitlist outcomes were HT and a competing outcome of death/deterioration requiring waitlist inactivation...

BACKGROUND: Disturbance in bodily experience (BE) is a potential adverse consequence of ventricular assist device (VAD) implantation. The concept BE encompasses all cognitive and affective processes related to the subjective experience of one's own body. METHODS: A cross-sectional, multi-center study was performed, involving 365 VAD patients (85 % male; time post-implant: 3 - 36 months). Patients completed a BE questionnaire (BE-S, 5-point Likert scale), and the disturbance in BE was analyzed based on sex, time since implantation (in the first, second or third year post implant), and patient acuity (elective vs...

BACKGROUND: Cold static storage (CSS) preservation of donor hearts for periods longer than 4 hours increases the risk of primary graft dysfunction (PGD). The aim of the study was to determine if hypothermic oxygenated perfusion (HOPE) could safely prolong the preservation time of donor hearts. METHODS: We conducted a non-randomised, single arm, multi-center investigation of the effect of HOPE using the XVIVO Heart Preservation System on donor hearts with a projected preservation time of 6-8 hours on 30-day recipient survival and allograft function post-transplant...

OBJECTIVE: Right heart failure is the major cause of death in pulmonary hypertension. Lung transplantation is the only long-term treatment option for patients who fail medical therapy. Due to the scarcity of donor lungs, there is a critical need to develop durable mechanical support for the failing right heart. A major design goal for durable support is to reduce the size and complexity of devices to facilitate ambulation. Toward this end, we sought to deploy wearable mechanical support technology in a sheep disease model of chronic right heart failure...

OBJECTIVES: Drug overdose (DO) deaths rose to unprecedented levels during the COVID-19 pandemic. This study examines the impact of COVID-19 on the availability of cardiac allografts from DO donors and the implications of DO donor use on recipient survival. METHODS: Heart transplants reported to the United Network for Organ Sharing (UNOS) from January 2017-November 2019 ("pre-COVID") and March 2020-June 2021 ("COVID pandemic") were analyzed with respect to DO donor status...

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BACKGROUND: Heart failure results in significant morbidity and mortality for young children with hypoplastic left heart syndrome (HLHS) following the Norwood procedure. The trajectory in later childhood is not well described. METHODS: We studied the outcome into adolescence of participants enrolled in the Single Ventricle Reconstruction (SVR) trial who underwent the Fontan procedure or survived to 6 years without having undergone Fontan procedure. The primary outcome was heart failure events, defined as heart transplant listing or death attributable to heart failure...