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Am J Transplant 2019 Jan 17. Epub 2019 Jan 17.

Lung Transplant Service, Alfred Hospital, Melbourne, Australia.

Antibody mediated rejection (AMR), whereby transplant recipient B cells and/or plasma cells produce allo-reactive anti-human leukocyte antigen (HLA) antibodies, negatively influences transplant outcomes and is a major contributor to graft loss. An early humoral immune response is suggested by the production of anti-HLA donor-specific antibodies (DSA) that can be measured using solid phase assays. We report the early post-transplant co-existence of a shared anti-HLA antibody profile in five solid organ transplant recipients who received organs from the same donor. Read More

J Clin Oncol 2019 Jan 17:JCO1800685. Epub 2019 Jan 17.

City of Hope, Los Angeles, CA.

Purpose: Single-cycle melphalan 200 mg/m and autologous hematopoietic cell transplantation (AHCT) followed by lenalidomide (len) maintenance have improved progression-free survival (PFS) and overall survival (OS) for transplantation-eligible patients with multiple myeloma (MM). We designed a prospective, randomized, phase III study to test additional interventions to improve PFS by comparing AHCT, tandem AHCT (AHCT/AHCT), and AHCT and four subsequent cycles of len, bortezomib, and dexamethasone (RVD; AHCT + RVD), all followed by len until disease progression.

Patients And Methods: Patients with symptomatic MM within 12 months from starting therapy and without progression who were age 70 years or younger were randomly assigned to AHCT/AHCT + len (n = 247), AHCT + RVD + len (n = 254), or AHCT + len (n = 257). Read More

J Heart Lung Transplant 2018 Dec 15. Epub 2018 Dec 15.

Section of Advanced Heart Failure and Transplantation, Division of Cardiology, Department of Medicine; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colorado, USA.

Background: Trial and registry data have reported mortality rates and causes of death in patients with left ventricular assist devices (LVADs); however, a more granular description is needed of end of life, including location of death and quality of life (QOL), to better guide expectations and care.

Methods: To identify where patients with an LVAD died, characterize QOL before death, and cause of death over time, we evaluated patients in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) implanted with a continuous-flow LVAD.

Results: From 18,733 patients implanted with an LVAD during the period 2008 to 2016, 4,916 patients were known to have died, of whom 98% had a recorded location of death. Read More

J Heart Lung Transplant 2018 Dec 20. Epub 2018 Dec 20.

Department of Medical and Surgical Science and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Background: Lung metabolism during ex vivo lung perfusion (EVLP) is increasingly studied. Microdialysis (MD) allows metabolic monitoring by sampling parenchymal interstitial fluid. This study investigated lung metabolism using MD during EVLP and evaluated whether microdialysate metabolites could improve selection and discriminate outcome of donor lungs. Read More

J Heart Lung Transplant 2018 Dec 18. Epub 2018 Dec 18.

Ted Rogers Centre for Heart Research, Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.

Background: In 2014, the International Society for Heart and Lung Transplantation (ISHLT) developed a classification instrument for left ventricular (LV) and isolated right ventricular (RV) primary graft dysfunction post‒heart transplant. The instrument classifies LV-PGD as mild, moderate, or severe. In this study, we evaluated the predictive validity of this instrument. Read More

J Heart Lung Transplant 2018 Dec 6. Epub 2018 Dec 6.

Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases, Metabolism & Ageing, Division of Respiratory Diseases, KU Leuven, Leuven, Belgium.

Background: Chronic lung allograft dysfunction (CLAD) is a major cause of post‒lung transplant mortality, with limited medical treatment options. In this study we assessed the association of montelukast treatment with pulmonary function and outcome in lung transplant recipients with progressive CLAD.

Methods: We performed a retrospective study of all lung transplant recipients transplanted between July 1991 and December 2016 at our center and who were treated for at least 3 months with montelukast for progressive CLAD, despite at least 3 months of prior azithromycin therapy. Read More

J Heart Lung Transplant 2018 Dec 6. Epub 2018 Dec 6.

Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.

Background: Heart transplantation is the definitive treatment for end-stage heart failure. A shortage of donor hearts forced transplant programs to accept older donors and longer ischemic times. Previous studies have suggested that administration of mesenchymal stem cells (MSCs) or their conditioned medium (CM) protects the heart against ischemia/reperfusion injury (IRI). Read More

J Heart Lung Transplant 2018 Dec 21. Epub 2018 Dec 21.

The Pauley Heart Center, Virginia Commonwealth University Medical Center, Richmond, Virginia.

J Heart Lung Transplant 2018 Dec 7. Epub 2018 Dec 7.

Division of Allergy and Infectious Diseases.

J Magn Reson Imaging 2019 Jan 13. Epub 2019 Jan 13.

Department of Cardiology, Barbara and Donald Zucker School of Medicine at Hofstra Northwell, Manhasset, New York, USA.

Myocarditis encompasses both primary and secondary processes causing inflammation of the myocardium. Viral infections are a common secondary cause of myocarditis with important clinical relevance. Viral myocarditis has a varied clinical presentation, potentially resulting in significant morbidity and mortality. Read More

J Extracell Vesicles 2018 23;7(1):1535750. Epub 2018 Nov 23.

Jagiellonian University, Faculty of Biochemistry, Biophysics and Biotechnology, Department of Cell Biology, Kraków, Poland.

The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles ("MISEV") guidelines for the field in 2014. Read More

Heart 2019 Jan 12. Epub 2019 Jan 12.

Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.

Background: Increased longevity in patients with congenital heart disease (CHD) is associated with late complications, mainly heart failure, which may not be amenable to redo surgery and become refractory to medical therapy and so, trigger referral for transplantation. We assessed the current role and future prospects of heart and heart-lung transplantation for patients with CHD in England.

Methods: We performed a retrospective analysis of hospital episodes for England for 1997-2015, identifying patients with a CHD code (ICD-10 'Q2xx. Read More

Front Immunol 2018 19;9:3002. Epub 2018 Dec 19.

Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands.

The best treatment for patients with end-stage renal disease is kidney transplantation. Although graft survival rates have improved in the last decades, patients still may lose their grafts partly due to the detrimental effects of donor-specific antibodies (DSA) against human leukocyte antigens (HLA) and to a lesser extent also by antibodies directed against non-HLA antigens expressed on the donor endothelium. Assays to detect anti-HLA antibodies are already in use for many years and have been proven useful for transplant risk stratification. Read More

Crit Rev Microbiol 2019 Jan 10:1-21. Epub 2019 Jan 10.

at Department of Microbiology and Immunology , Catholic University Leuven , Leuven , Belgium.

Invasive Scedosporium spp. and Lomentospora prolificans infections are an emerging threat in immunocompromised and occasionally in healthy hosts. Scedosporium spp. Read More

Nat Rev Endocrinol 2019 Jan 8. Epub 2019 Jan 8.

Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.

Solid organ transplantation (SOT) is a life-saving procedure and an established treatment for patients with end-stage organ failure. However, transplantation is also accompanied by associated cardiovascular risk factors, of which post-transplant diabetes mellitus (PTDM) is one of the most important. PTDM develops in 10-20% of patients with kidney transplants and in 20-40% of patients who have undergone other SOT. Read More

Front Physiol 2018 14;9:1794. Epub 2018 Dec 14.

Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, United States.

Although cell survival post-transplantation is very low, emerging evidence using stem cell therapy for myocardial repair points toward a primary role of paracrine signaling mechanisms as the basis for improved cardiac function, decreased fibrosis, and increased angiogenesis. Recent studies have demonstrated that extracellular vesicles (EVs) such as exosomes secreted by stem cells stimulate angiogenesis, provide cytoprotection, and modulate apoptosis. However, the angiogenic potential of EVs secreted from human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), a terminally differentiated cell type, has not been elucidated yet. Read More

Clin Transplant 2019 Jan 7:e13477. Epub 2019 Jan 7.

Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden.

Bone mineral density (BMD) in the lumbar spine and femoral neck, the incidence of osteoporosis, and survival up to 10 years after heart transplantation (HT) were investigated in 169 patients who underwent HT at Skåne University Hospital in Lund, Sweden, 1988-2016. Within the first year post-transplantation, mean (SD) BMD decreased by 3.9% (10. Read More

Arthritis Rheumatol 2019 Jan 7. Epub 2019 Jan 7.

Centre for Pulmonary Hypertension, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany.

Objective: The objective of this prospective study was to evaluate right ventricular function and pulmonary arterial compliance (PAC=stroke volume/pulse pressure) at rest and during exercise in patients with systemic sclerosis (SSc) with normal mean pulmonary artery pressures (mPAP) at rest, mildly elevated mPAP (mPAP 21-24mmHg) and manifest pulmonary hypertension (mPAP≥25mmHg).

Methods: Patients with SSc (n=112) underwent clinical assessment and right heart catheterization at rest and during exercise and were divided into three groups according to their resting mPAP values: normal mPAP (≤20mmHg), mildly elevated mPAP (21-24mmHg) and pulmonary hypertension (PH, mPAP ≥25mmHg). Results were compared between groups by ANOVA followed by post-hoc student's t-test. Read More

Am J Transplant 2019 Jan 7. Epub 2019 Jan 7.

Department of Cardiothoracic Surgery, Newark Beth Israel Medical Center, and Children's Hospital of New Jersey, Newark, USA.

Calcineurin inhibitor (CNI) therapy after lung transplantation increases risk of kidney failure. Early everolimus-based quadruple low CNI immunosuppression may improve renal function without compromising efficacy or safety. A prospective, randomized, open-label, 12-month multicenter trial was conducted at eight German sites. Read More

Br J Haematol 2019 Jan 6. Epub 2019 Jan 6.

Department of Pediatrics, New York Medical College, Valhalla, NY, USA.

Patients with relapsed, refractory or advanced stage B non-Hodgkin lymphoma (NHL) continue to have a dismal prognosis. This review summarises current and novel cellular and immunotherapy for these high-risk populations, including haematopoietic stem cell transplant, bispecific antibodies, viral-derived cytotoxic T cells, chimeric antigen receptor (CAR) T cells, and natural killer (NK) cell therapy, as discussed at the 6th International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma on September 26th-29th 2018 in Rotterdam, the Netherlands, and explores the future of NK/CAR NK therapies. Read More

PM R 2019 Jan 4. Epub 2019 Jan 4.

Department of Rehabilitation, St Vincent's Hospital Sydney, NSW, Australia.

Background: Cardiopulmonary transplant is becoming a more common treatment option for advanced heart and/or lung disease. Specialist rehabilitation programs may assist recovery and enhance functional independence following transplant.

Objective: To quantify the outcomes of multidisciplinary inpatient rehabilitation following cardiopulmonary transplant, and describe cohort characteristics. Read More

Am Surg 2018 Dec;84(12):1894-1899

The objective of the study is to evaluate the impact of the Affordable Care Act (ACA) on accessibility to solid organ transplant and outcomes. Data source registry: United Network of Organ Sharing database. Patients aged ≥18 years listed for kidney, liver, heart, and lung transplant between years 2010 and 2016 were classified by insurance and status of Medicaid adoption under ACA to evaluate insurance distribution. Read More

ASAIO J 2018 Dec 28. Epub 2018 Dec 28.

Department of Cardiothoracic Surgery, St George Hospital, Kogarah, New South Wales, Australia.

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in acute reversible cases of severe respiratory failure and as a bridge to lung transplantation. Venovenous extracorporeal membrane oxygenation using a bicaval double-lumen cannula (BCDLC) has several advantages over the traditional ECMO configuration; however, it also presents with several unique challenges. The assessment and quantification of venous admixture is difficult due to the specific position of BCDLC within the circulatory system. Read More

Bioorg Med Chem 2018 Dec 16. Epub 2018 Dec 16.

Division of Pharmaceutics & Pharmaceutical Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH 43210, United States; The Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, United States; Department of Biomedical Engineering, The Ohio State University, Columbus, OH 43210, United States; The Center for Clinical and Translational Science, The Ohio State University, Columbus, OH 43210, United States; Dorothy M. Davis Heart & Lung Research Institute, The Ohio State University, Columbus, OH 43210, United States; Department of Radiation Oncology, The Ohio State University, Columbus, OH 43210, United States. Electronic address:

Daratumumab, an FDA approved antibody drug, displays specific targeting ability to abnormal white blood cells overexpressing CD38 and provides efficacious therapy for multiple myeloma. Here, in order to achieve enhanced remission of multiple myeloma, we designed Dara-DM4, antibody drug conjugates (ADCs) by conjugating Daratumumab and DM4 via a disulfide linker. Dara-DM4 showed significantly higher cellular uptake and inhibitory efficacy on MM1S cells that overexpressing CD38 with an IC of 0. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Dec;30(12):1167-1172

Department of Intensive Care Unit, Affiliated Wuxi People's Hospital, Nanjing Medical University, Wuxi 214023, Jiangsu, China (Xia W, Xu HY); Department of Thoracic Surgery, Affiliated Wuxi People's Hospital, Nanjing Medical University, Wuxi 214023, Jiangsu, China (Mao WJ, Chen JY). Corresponding author: Xu Hongyang, Email:

Objective: To evaluate the effect of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (LTx).

Methods: The clinical data of 18 patients with end-stage lung diseases was retrospectively reviewed, using ECMO as a bridge to LTx in intensive care unit of Affiliated Wuxi People's Hospital from January 2015 to December 2017. Clinical parameters were obtained from these patients, including gender, age, primary disease, preoperative lactate level, preoperative leukocyte, operation modality (unilateral or bilateral), type of ECMO, ECMO support time as a bridge to LTx, ECMO support time after operation, total usage time of ECMO, ECMO associated complications, primary graft dysfunction (PGD), successful ECMO weaning, and survival. Read More

European J Pediatr Surg Rep 2018 Jan 26;6(1):e100-e103. Epub 2018 Dec 26.

Department of Neonatal Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

Lung hypoplasia and pulmonary hypertension (PH) in association with congenital diaphragmatic hernia (CDH) may cause fatal respiratory failure. Lung transplantation (Ltx) may represent an option for CDH-related end-stage pulmonary failure. The aim of this study is to report a patient with CDH who underwent Ltx or combined heart-lung transplantation (H-Ltx). Read More

Circulation 2018 Nov 28. Epub 2018 Nov 28.

Institute for Cardiovascular Regeneration, Goethe University Frankfurt, GERMANY.

Background: The majority of the human genome comprises non-coding sequences, which are in part transcribed as long non-coding RNAs (lncRNAs). LncRNAs exhibit multiple functions including the epigenetic control of gene expression. Here we studied the effect of the lncRNA MALAT1 on atherosclerosis. Read More

Am J Transplant 2018 Dec 26. Epub 2018 Dec 26.

Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany.

We report data obtained from a retrospective multicenter pediatric survey on behalf of the European Society for Blood and Marrow Transplantation (EBMT). Information on Solid Organ Transplantation (SOT) performed in pediatric recipients of either autologous or allogeneic hematopoietic stem cell transplantation (HSCT) between 1984 and 2016 were collected in 20 pediatric EBMT Centers (25.6%). Read More

Transplant Direct 2018 Dec 27;4(12):e410. Epub 2018 Nov 27.

Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Background: Despite age-related differences in biology, physiology, and behavior, transplant immunosuppression is not tailored by age. This likely contributes to high graft failure and posttransplant complications. We present the aims, design, and methods of the Pediatric Outcomes in Transplant: PersOnaliSing Immunosuppression To ImproVe Efficacy Study aimed at personalizing posttransplant immunosuppression in children and young adults. Read More

Perfusion 2018 Dec 25:267659118813043. Epub 2018 Dec 25.

3 Division of Cardiac Surgery, London Health Sciences Centre, London, Ontario, Canada.

A 44-year-old male with ongoing chest pain and left ventricular ejection fraction <20% was transferred from a peripheral hospital with intra-aortic balloon pump placement following a non-ST-elevation myocardial infarction (STEMI). The patient underwent emergent multi-vessel coronary artery bypass grafting requiring veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) on post-operative day (POD)#9 secondary to cardiogenic shock with biventricular failure. Due to clot formation, an oxygenator change-out was necessary shortly after initiation. Read More

J Heart Lung Transplant 2018 Dec 7. Epub 2018 Dec 7.

Paris-Saclay University, School of Medicine, Kremlin-Bicêtre, France; Surgical Research Lab; Department of Thoracic and Vascular Surgery and Heart‒Lung Transplantation, DHU Thorax Innovation, Marie Lannelongue Hospital, Le Plessis Robinson, France.

J Heart Lung Transplant 2018 Dec 14. Epub 2018 Dec 14.

Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.

Am Heart J 2018 Nov 24;208:91-99. Epub 2018 Nov 24.

Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands. Electronic address:

Background: This study aimed to investigate the prognostic value of six different biomarkers in patients with pulmonary hypertension (PH) and to explore whether a multi-biomarker approach can contribute to a better risk stratification.

Methods: In this prospective study, patients with PH were included at the day of the diagnostic right heart catheterization between May 2012 and October 2016. Venous blood sampling included; NT-proBNP, high sensitive troponin-T, high sensitive CRP, galectin-3, red blood cell distribution width and eGFR. Read More

Leuk Res 2019 Jan 4;76:70-75. Epub 2018 Dec 4.

Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

Germline mutation in GATA2 can lead to GATA2 deficiency characterized by a complex multi-system disorder that can present with many manifestations including variable cytopenias, bone marrow failure, myelodysplastic syndrome/acute myeloid leukemia (MDS/AML), and severe immunodeficiency. Penetrance and expressivity within families is often variable. There is a spectrum of bone marrow disease in symptomatic cytopenic patients ranging from hypocellular marrows without overt dysplasia to those with definitive MDS, AML, or chronic myelomonocytic leukemia. Read More

Clin Chim Acta 2018 Dec 19;490:63-68. Epub 2018 Dec 19.

Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, Beijing 100029, China. Electronic address:

Background: Patients with heart failure (HF) having non-ischemic dilated cardiomyopathy (DCM) have high mortality rates. Syndecan-1 is reportedly associated with cardiac fibrosis and inflammation. This study explored the role of syndecan-1 in patients with non-ischemic DCM. Read More

Clin Transplant 2018 Dec 21:e13466. Epub 2018 Dec 21.

Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Background: Despite a survival benefit from transplantation and acceptable outcomes, patients with human immunodeficiency virus (HIV+) face barriers to kidney transplantation. Little is known about the acceptance or decline of organ offers on their behalf because waitlist registry data do not include HIV serostatus.

Methods: We performed a retrospective cohort study using match run data from the Organ Procurement and Transplantation Network, including every kidney offer from May 1, 2007, to July 3, 2013. Read More

Transplant Proc 2018 Dec 7;50(10):3739-3747. Epub 2018 Sep 7.

Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.

Background And Objectives: Heart and lung transplantation is a high-risk procedure, requiring intensive immunosuppressive therapy for preventing organ rejection. Alemtuzumab, a CD52-specific monoclonal antibody, is increasingly used for induction therapy compared with conventional agents. However, there has been no systematic review comparing its efficacy with traditional therapeutic drugs. Read More

Transplant Proc 2018 Dec 7;50(10):3723-3731. Epub 2018 Sep 7.

Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China. Electronic address:

Background And Objectives: Heart and lung transplantation is a high-risk procedure requiring intensive immunosuppressive therapy for preventing organ rejection. Alemtuzumab, a CD52-specific monoclonal antibody, is increasingly used for induction therapy compared with conventional agents. However, there has been no systematic review comparing its efficacy with traditional therapeutic drugs. Read More

Transplant Proc 2018 Dec 22;50(10):3111-3112. Epub 2018 Jun 22.

Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA. Electronic address:

Background: Heart-lung transplantation is a well-established therapeutic modality for concomitant end-stage heart and lung failure. With growing organ scarcity, the rates of these transplants are declining, and center experience is waning.

Methods: With over 35 years of experience performing heart-lung transplantation, we describe our procurement protocol herein, as well as offer suggestions to avoid potential pitfalls in order to ensure technical excellence in harvesting these valuable grafts. Read More

J Am Heart Assoc 2018 Dec;7(23):e008251

1 Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong, SAR.

Background Although frailty has been associated with increased risks for hospitalization and mortality in chronic heart failure, the precise average effect remains uncertain. We performed a systematic review and meta-analysis to summarize the hazards for mortality and incident hospitalization in patients with heart failure and frailty compared with those without frailty and explored the heterogeneity underlying the effect size estimates. Methods and Results MEDLINE , EMBASE, and Cochrane databases were queried for articles published between January 1966 and March 2018. Read More

Am J Hematol 2018 Dec 19. Epub 2018 Dec 19.

Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota.

Innate immune complement activation may contribute to sickle cell disease (SCD) pathogenesis. Ischemia-reperfusion physiology is a key component of the inflammatory and vaso-occlusive milieu in SCD and is associated with complement activation. C5a is an anaphylatoxin, a potent pro-inflammatory mediator that can activate leukocytes, platelets, and endothelial cells, all of which play a role in vaso-occlusion. Read More

Int J Mol Sci 2018 Dec 18;19(12). Epub 2018 Dec 18.

Department of Neuroscience, Section of Human Anatomy, University of Padova, Via A. Gabelli 65, 35121 Padova, Italy.

Tissue engineering and regenerative medicine involve many different artificial and biologic materials, frequently integrated in composite scaffolds, which can be repopulated with various cell types. One of the most promising scaffolds is decellularized allogeneic extracellular matrix (ECM) then recellularized by autologous or stem cells, in order to develop fully personalized clinical approaches. Decellularization protocols have to efficiently remove immunogenic cellular materials, maintaining the nonimmunogenic ECM, which is endowed with specific inductive/differentiating actions due to its architecture and bioactive factors. Read More

Am J Transplant 2018 Dec 18. Epub 2018 Dec 18.

Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.

Lung transplant recipients have an increased risk of lung cancer that is poorly understood. Prior studies are largely descriptive and single-center, and have not examined risk factors or outcomes in this population. This registry-linkage study utilized matched transplant and cancer registry data from 17 US states/regions during 1987-2012. Read More

Clin Transplant 2018 Dec 13:e13462. Epub 2018 Dec 13.

Division of Cardiac Surgery, University of California, Los Angeles, California.

Employment status may capture elements of patients' physical strength, mental resilience, and socioeconomic status to better prognosticate transplant outcomes. This study characterized the effect of working status on thoracic transplant outcomes by evaluating the United Network for Organ Sharing registry for adult lung or heart transplants from 2005 to 2016. Kaplan-Meier estimates illustrated 5-year and 10-year survival by working status at transplant, while multivariable Cox proportional hazards regressions controlled for baseline differences, including functional and socioeconomic status. Read More

Am J Transplant 2018 Dec 12. Epub 2018 Dec 12.

Department of Surgery, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom.

Tissue resident lymphocytes are present within many organs, and are presumably transferred at transplantation, but their impact upon host immunity is unclear. Here we examine whether transferred donor natural regulatory CD4 T cells (nT-regs) inhibit host alloimmunity and prolong allograft survival. Transfer of donor-strain lymphocytes was first assessed by identifying circulating donor-derived CD4 T cells in 21 consecutive human lung transplant recipients, with three patterns of chimerism apparent: transient; intermediate; and persistent (detectable for up to 6 weeks, 6 months, and beyond one year, respectively). Read More

Pediatr Cardiol 2018 Dec 13. Epub 2018 Dec 13.

Department of Pediatric Cardiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University, 2200 Children's Way, Suite 5230 DOT, Nashville, TN, 37232-9119, USA.

Right ventricular (RV) failure is a potentially fatal complication following heart transplantation (HTx). Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that is used to decrease pulmonary vascular resistance immediately post-HTx to reduce the risk of RV failure. The aim of this study was to describe utilization patterns, costs, and outcomes associated with post-transplant iNO use in children. Read More

Mol Ther Methods Clin Dev 2018 Dec 25;11:143-154. Epub 2018 Oct 25.

Hematology Branch, National Heart, Lung and Blood Institute, NIH, Bethesda, MD 20892, USA.

Gene therapies using integrating retrovirus vectors to modify hematopoietic stem and progenitor cells have shown great promise for the treatment of immune system and hematologic diseases. However, activation of proto-oncogenes via insertional mutagenesis has resulted in the development of leukemia. We have utilized cellular bar coding to investigate the impact of different vector designs on the clonal behavior of hematopoietic stem and progenitor cells (HSPCs) during expansion, as a quantitative surrogate assay for genotoxicity in a non-human primate model with high relevance for human biology. Read More

Eur Respir J 2018 Dec 13. Epub 2018 Dec 13.

Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.

Intensive care of patients with pulmonary hypertension (PH) and right-sided heart failure includes treatment of factors causing or contributing to heart failure, careful fluid management, and strategies to reduce ventricular afterload and improve cardiac function. Extracorporeal membrane oxygenation (ECMO) should be considered in distinct situations, especially in candidates for lung transplantation (bridge to transplant) or, occasionally, in patients with a reversible cause of right-sided heart failure (bridge to recovery). ECMO should not be used in patients with end-stage disease without a realistic chance for recovery or for transplantation. Read More

Eur Respir J 2018 Dec 13. Epub 2018 Dec 13.

Cardiovascular Medicine, The University of Michigan, Ann Arbor, MI, USA.

Pulmonary arterial hypertension (PAH) remains a severe clinical condition despite the availability over the past 15 years of multiple drugs interfering with the endothelin, nitric oxide and prostacyclin pathways. The recent progress observed in medical therapy of PAH is not, therefore, related to the discovery of new pathways, but to the development of new strategies for combination therapy and on escalation of treatments based on systematic assessment of clinical response. The current treatment strategy is based on the severity of the newly diagnosed PAH patient as assessed by a multiparametric risk stratification approach. Read More

Respiration 2018 Dec 13:1-12. Epub 2018 Dec 13.

Department of Pulmonary Disease, Erasmus Medical Centre, University Hospital Rotterdam, Rotterdam, The Netherlands.

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with a dismal survival rate of only 3 years and no curative pharmacological therapy. The recent approval of 2 anti-fibrotic drugs (nintedanib and pirfenidone) that slow disease progression has provided some hope for patients. However, effectively managing anti-fibrotic treatment can be a challenge due to tolerability issues, the presence of pulmonary and extra-pulmonary comorbidities, and the need for concomitant medications in many patients. Read More