12,570 results match your criteria cardiac allograft

Impact of prior sternotomy on survival and allograft function after heart transplantation: A single center matched analysis.

J Card Surg 2022 Jan 14. Epub 2022 Jan 14.

Division of Cardiac Surgery IRCCS Azienda Ospedaliero-Universitaria di Bologna, St. Orsola Policlinic-Alma Mater Studiorum, University of Bologna, Bologna, Italy.

Background: Orthotopic heart transplantation (OHT) remains the gold standard for the treatment of end-stage heart failure. The number of patients who have had at least one prior sternotomy while awaiting transplantation has increased over the years reaching 50% in the last ISHLT registry report. We analysed our institutional transplant activity focusing on prior-sternotomy setting to identify the real burden of this preoperative variable and its potential consequences. Read More

View Article and Full-Text PDF
January 2022

Long-term outcomes after heart transplantation using ex-vivo allograft perfusion in standard risk donors: A single center experience.

Clin Transplant 2022 Jan 14:e14591. Epub 2022 Jan 14.

Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Introduction: The Organ Care System (OCS) is an ex-vivo perfusion platform for donor heart preservation. Short/mid-term post-transplant outcomes after its use are comparable to standard cold storage (CS). We evaluated long-term outcomes following its use. Read More

View Article and Full-Text PDF
January 2022

Cytosporone B (Csn-B), an NR4A1 agonist, attenuates acute cardiac allograft rejection by inducing differential apoptosis of CD4+T cells.

Int Immunopharmacol 2022 Jan 10;104:108521. Epub 2022 Jan 10.

Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

CD4+T cell-mediated acute rejection remains a major factor that affects the early survival of transplanted organs post-transplantation. Here, we reveal that nuclear receptor subfamily 4 Group A member 1 (Nr4A1) was upregulated during cardiac allograft rejection and that the increased Nr4A1 was primarily localized in intragraft-infiltrating CD4+T cells. Nr4A1 acts as a transcription factor with an important role in CD4+T cell apoptosis, differentiation and T cell dysfunction, which indicates that Nr4A1 may play a critical role in transplant rejection. Read More

View Article and Full-Text PDF
January 2022

Outcomes of diabetic patients with end-stage heart failure listed for heart transplantation: A propensity-matched analysis.

Clin Transplant 2022 Jan 12:e14590. Epub 2022 Jan 12.

Division of Heart Failure and Transplant, University of Iowa Hospitals and Clinics, Iowa, IA, United States.

Background: We investigated the current trends and outcomes of diabetic patients listed for heart transplants in the U.S. and provided a method for risk-stratification. Read More

View Article and Full-Text PDF
January 2022

Non-Invasive Imaging in the Evaluation of Cardiac Allograft Vasculopathy in Heart Transplantation: A Systematic Review.

Curr Probl Cardiol 2022 Jan 8:101103. Epub 2022 Jan 8.

Department of Medicine, University Hospitals, Cleveland, Ohio; Harrington Heart and Vascular Institute, University Hospitals and School of Medicine, Case Western Reserve University, Cleveland, Ohio. Electronic address:

Cardiac allograft vasculopathy (CAV) is the leading cause of long-term graft dysfunction in patients with heart transplantation and is linked with significant morbidity and mortality. Currently, the gold standard for diagnosing CAV is coronary imaging with intravascular ultrasound (IVUS) during traditional invasive coronary angiography (ICA). Invasive imaging, however, carries increased procedural risk and expense to patients in addition to requiring an experienced interventionalist. Read More

View Article and Full-Text PDF
January 2022

Higher levels of allograft injury in black patients early after heart transplantation.

J Heart Lung Transplant 2021 Dec 23. Epub 2021 Dec 23.

Genomic Research Alliance for Transplantation (GRAfT), Bethesda, Maryland; Laborarory of Applied Precision Omics (APO), Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland; Department of Medicine, Stanford University School of Medicine, Palo Alto, California. Electronic address:

Black patients suffer higher rates of antibody-mediated rejection and have worse long-term graft survival after heart transplantation. Donor-derived cell free DNA (ddcfDNA) is released into the blood following allograft injury. This study analyzed %ddcfDNA in 63 heart transplant recipients categorized by Black and non-Black race, during the first 200 days after transplant. Read More

View Article and Full-Text PDF
December 2021

The role of mechanical ventilation in primary graft dysfunction in the postoperative lung transplant recipient: A single center study and literature review.

Acta Anaesthesiol Scand 2022 Jan 11. Epub 2022 Jan 11.

Dept. of Cardiothoracic Anesthesia and Intensive Care and Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund University, Sweden.

Background: Primary graft dysfunction (PGD) is still a major complication in patients undergoing lung transplantation (LTx). Much is unknown about the effect of postoperative mechanical ventilation on outcomes, with debate on the best approach to ventilation.

Aim/purpose: The goal of this study is to generate hypotheses on the association between postoperative mechanical ventilation settings and allograft size matching in PGD development. Read More

View Article and Full-Text PDF
January 2022

Fatal Allograft Rejection and Cardiac Allograft Vasculopathy After Treatment With Pembrolizumab for Metastatic Melanoma in a Heart Transplant Recipient: A Case Report.

Transplant Proc 2022 Jan 7. Epub 2022 Jan 7.

Moffitt Cancer Center, Tampa, Florida.

Checkpoint inhibitors decrease the progression of many cancers. However, the experience in immunosuppressed patients is limited, with reports of possible serious adverse events. We present a heart transplant recipient treated with pembrolizumab for metastatic melanoma who developed fatal rejection. Read More

View Article and Full-Text PDF
January 2022

The Impact of Machine Perfusion of the Heart on Warm Ischemia Time and Organ Yield in Donation After Circulatory Death.

Am J Transplant 2022 Jan 10. Epub 2022 Jan 10.

TransMedics, Inc, Andover, MA, USA.

Successful normothermic machine perfusion of heart allografts (MPH) has led to rapid growth in transplantation of donation after circulatory death (DCD) heart allografts but has introduced complexity in the procurement process. This study examines the impact of MPH use in DCD procurements on warm ischemia time (WIT) and organ yield. DCD procurements from 2019-2020 were identified using the OPTN database. Read More

View Article and Full-Text PDF
January 2022

The novel proteomic signature for cardiac allograft vasculopathy.

ESC Heart Fail 2022 Jan 10. Epub 2022 Jan 10.

Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 7, Box 7001, Leuven, BE-3000, Belgium.

Aims: Cardiac allograft vasculopathy (CAV) is the major long-term complication after heart transplantation, leading to mortality and re-transplantation. As available non-invasive biomarkers are scarce for CAV screening, we aimed to identify a proteomic signature for CAV.

Methods And Results: We measured urinary proteome by capillary electrophoresis coupled with mass spectrometry in 217 heart transplantation recipients (mean age: 55. Read More

View Article and Full-Text PDF
January 2022

Anti-C4d chimeric antigen receptor regulatory T cells suppressed allograft rejection in ABO-incompatible heart transplantation.

Genes Dis 2022 Jan 28;9(1):1-4. Epub 2021 Jul 28.

Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.

View Article and Full-Text PDF
January 2022

Complement blockade with eculizumab to treat acute symptomatic humoral rejection after heart transplantation.

Xenotransplantation 2022 Jan 10:e12726. Epub 2022 Jan 10.

Center for Organ Transplantation, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.

Antibody-mediated rejection (AMR) is a major barrier preventing successful discordant organ xenotransplantation, but it also occurs in allotransplantation due to anti-HLA antibodies. Symptomatic acute AMR is rare after heart allograft but carries a high risk of mortality, especially >1 year after transplant. As complement activation may play a major role in mediating tissue injury in acute AMR, drugs blocking the terminal complement cascade like eculizumab may be useful, particularly since "standards of care" like plasmapheresis are not based on strong evidence. Read More

View Article and Full-Text PDF
January 2022

Low-Density Lipoprotein Cholesterol Level Trends and the Development of Cardiac Allograft Vasculopathy After Heart Transplantation.

CJC Open 2021 Dec 16;3(12):1453-1462. Epub 2021 Jul 16.

Heart Failure and Transplantation, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Background: Unlike the relationship with atherosclerotic coronary artery disease, that between low-density lipoprotein cholesterol (LDL-C) and cardiac allograft vasculopathy (CAV) is unclear. Our objectives were to characterize lipid profiles early after heart transplantation (HT) and evaluate the relationship between early LDL-C and the development of CAV.

Methods: We retrospectively reviewed consecutive adults who underwent HT at 2 centres during the time period 2010-2018. Read More

View Article and Full-Text PDF
December 2021

Risk factors of early liver dysfunction after liver transplantation using grafts from donation after citizen death donors.

Transpl Immunol 2022 Jan 3;71:101525. Epub 2022 Jan 3.

Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China. Electronic address:

Background: As an early complication after liver transplantation, early allograft dysfunction (EAD) indicates a poor prognosis. This study analyzes the risk factors related to early allograft dysfunction (EAD) after liver transplantation using grafts from donation after citizen death (DCD) to provide a reference for the prevention of EAD after DCD liver transplantation.

Methods: A total of 32 patients who underwent DCD liver transplantation in the organ transplantation center of our hospital from September 2013 to January 2021 were enrolled in this study. Read More

View Article and Full-Text PDF
January 2022

Cardiac allograft vasculopathy: A review.

Pediatr Transplant 2022 Jan 5:e14218. Epub 2022 Jan 5.

Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.

Background: Heart transplantation has become the standard of care for pediatric patients with end-stage heart disease, and outcomes have consistently improved over the last few decades. CAV, however, remains a leading cause of morbidity and mortality in heart transplantation and is the leading cause of death beyond 3 years post-transplantation. We sought out to provide an in-depth overview of CAV in the pediatric heart transplant population. Read More

View Article and Full-Text PDF
January 2022

Impact of Portable Normothermic Blood-Based Machine Perfusion on Outcomes of Liver Transplant: The OCS Liver PROTECT Randomized Clinical Trial.

JAMA Surg 2022 Jan 5. Epub 2022 Jan 5.

University of California, San Diego, La Jolla.

Importance: Ischemic cold storage (ICS) of livers for transplant is associated with serious posttransplant complications and underuse of liver allografts.

Objective: To determine whether portable normothermic machine perfusion preservation of livers obtained from deceased donors using the Organ Care System (OCS) Liver ameliorates early allograft dysfunction (EAD) and ischemic biliary complications (IBCs).

Design, Setting, And Participants: This multicenter randomized clinical trial (International Randomized Trial to Evaluate the Effectiveness of the Portable Organ Care System Liver for Preserving and Assessing Donor Livers for Transplantation) was conducted between November 2016 and October 2019 at 20 US liver transplant programs. Read More

View Article and Full-Text PDF
January 2022

Portal Steal Syndrome From a Large Linton's Splenorenal Shunt after Liver Transplantation: Successful Endovascular Management Through Off-Label Application of a 30 mm Amplatzer Cardiac Plug.

Vasc Endovascular Surg 2022 Jan 3:15385744211068614. Epub 2022 Jan 3.

Department of General Surgery and Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy.

A 34-year-old patient underwent liver transplantation for progressive hepatic failure in the setting of congenital hepatic fibrosis. In past medical history, the patient had undergone splenectomy with proximal Linton's splenorenal surgical shunt creation for symptomatic portal hypertension with hypersplenism. The patient developed an early allograft dysfunction, with radiologic evidence of a reduced portal flow associated to portal steal from the patent surgical shunt. Read More

View Article and Full-Text PDF
January 2022

Evaluation of Antibodies Directed Against Two GPCRs, Anti-AT1R and Anti-ETAR, on Kidney Transplant Outcome.

Curr Protein Pept Sci 2021 ;22(10):745-757

Immunology Services, University Clinical Hospital Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.

Background: The role of an alloimmune response against non-self-antigens is established in organ transplantation. HLA incompatibilities are mainly responsible for this recognition between donor and recipient, but they may also be involved in the reactivity against other alloantigens expressed on the allograft resulting from an autoimmune response developed against selfantigens.

Objective: Our study aimed to determine the presence of non-anti-HLA antibodies (anti-AT1R and anti-ETAR) in sera from patients with end-stage renal disease, who underwent kidney transplantation in pre- and post-transplantation samples to study their influence on the development and evolution of acute humoral rejections and DSAs. Read More

View Article and Full-Text PDF
January 2021

Analysis of Fibrotic Plaques in Angiographic Manifest Cardiac Allograft Vasculopathy in Long-term Heart Transplanted Patients Using Optical Coherence Tomography.

Transplant Direct 2022 Jan 23;8(1):e1266. Epub 2021 Dec 23.

Department of Medicine I, University Hospital, LMU Munich, Germany.

Background: The development and progression of cardiac allograft vasculopathy documented by coronary angiography (CAV) after heart transplantation (HTx) has prognostic relevance. Yet there are limited data regarding the role of concomitant intracoronary imaging in the presence CAV. In particular, atherosclerotic plaques might represent a potential target for prevention, but their impact on stenosis is understudied. Read More

View Article and Full-Text PDF
January 2022

Combination of Early Allograft Dysfunction and Protein Expression Patterns Predicts Outcome of Liver Transplantation From Donation After Cardiac Death.

Front Med (Lausanne) 2021 8;8:775212. Epub 2021 Dec 8.

Department of Hepatobiliary and Pancreatic Surgery, The Center for Integrated Oncology and Precision Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Early allograft dysfunction (EAD) after liver transplantation (LT) accompanies poor prognosis. This study aims to explore the relationship between pretransplant intrahepatic proteins and the incidence of EAD, and the value of combined EAD and protein profiles for predicting recipient and graft survival prognosis. Liver biopsy specimens of 105 pretransplant grafts used for LT were collected and used for immunohistochemistry analysis of 5 proteins. Read More

View Article and Full-Text PDF
December 2021

Outcome of Liver Transplants Using Donors After Cardiac Death With Normothermic Regional Perfusion.

Transplant Proc 2021 Dec 22. Epub 2021 Dec 22.

Department of Hepatic Surgery and Transplants, Hospital Regional Universitario, Málaga, Spain; Faculty of Medicine, University of Malaga, Malaga, Spain.

Background And Aims: The incorporation of normothermic regional perfusion (NRP) to donors after cardiac death (DCD) allows the recovery of liver grafts without the deleterious effects on graft survival the super-rapid technique may cause. The aim of the present report is to determine if the use of NRP in Maastricht type III DCD donors achieves short- and medium-term results comparable to donors after brain death (DBD).

Patients And Methods: This is an observational cohort study including 117 liver transplants executed between November 2016 and April 2021, divided into NRP (n = 39) and DBD (n = 78). Read More

View Article and Full-Text PDF
December 2021

Current status and challenges of Pediatric heart transplantation in Japan.

Mikiko Ishido

J Cardiol 2021 Dec 21. Epub 2021 Dec 21.

Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan. Electronic address:

It has been about 10 years since the revised Japanese Organ Transplant Law came into action. Organ donation from brain dead donors has increased in the past decade, but the number of recipients waiting for transplant is increasing more rapidly. Implantable continuous flow ventricular assist device, such as Jarvik 2000 and HeartWare, available from 2011, and Berlin heart EXCOR, available from 2015, has changed the scene for children with severe heart failure. Read More

View Article and Full-Text PDF
December 2021

Portal Perfusion Through the Splenic Vein During Liver Procurement.

Exp Clin Transplant 2021 Dec;19(12):1286-1290

From the Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.

Objectives: Livers procured via donation after cardiac death have produced good outcomes. Some centers use only aortic perfusion; others add portal perfusion.

Materials And Methods: We report a series of organ procurements in which portal perfusion was performed via cannulation of the splenic vein instead of the inferior mesenteric vein in 4 donors after cardiac death and 2 donors after brain death. Read More

View Article and Full-Text PDF
December 2021

Effect of Statin Intensity on the Progression of Cardiac Allograft Vasculopathy.

Card Fail Rev 2021 Mar 12;7:e15. Epub 2021 Nov 12.

Vanderbilt Transplant Center Nashville, TN, US.

: In the non-transplant population, hyperlipidaemia has shifted from targeting LDL goals to statin intensity-based treatment. It is unknown whether this strategy is also beneficial in cardiac transplantation. : This single-centre retrospective study evaluated the effect of statin use and intensity on time to cardiac allograft vasculopathy (CAV) after cardiac transplantation. Read More

View Article and Full-Text PDF

The Role of Echocardiography in the Management of Heart Transplant Recipients.

Diagnostics (Basel) 2021 Dec 11;11(12). Epub 2021 Dec 11.

Heart Failure Unit, Department of Cardiology, AORN dei Colli-Monaldi Hospital, 80131 Naples, Italy.

Transthoracic echocardiography is the primary non-invasive modality for the investigation of heart transplant recipients. It is a versatile tool that provides comprehensive information on cardiac structure and function. Echocardiography is also helpful in diagnosing primary graft dysfunction and evaluating the effectiveness of therapeutic approaches for this condition. Read More

View Article and Full-Text PDF
December 2021

Cardiac rehabilitation for heart transplant patients: Considerations for exercise training.

Prog Cardiovasc Dis 2021 Dec 20. Epub 2021 Dec 20.

Department of Cardiovascular Medicine, Division of Preventive Cardiology, Mayo Clinic, Rochester, MN, United States of America.

Heart transplantation (HT) is the treatment of choice for eligible patients with end-stage chronic heart failure (HF). One-year survival world-wide is >85%. Many patients experience a reasonable functional ability post-HT, but episodes of acute rejection, as well as multiple co-morbidities such as hypertension, diabetes, chronic kidney disease and cardiac allograft vasculopathy are common. Read More

View Article and Full-Text PDF
December 2021

Failing Heart Transplants and Rejection-A Cellular Perspective.

J Cardiovasc Dev Dis 2021 Dec 12;8(12). Epub 2021 Dec 12.

Transplantation Laboratory, Helsinki University Hospital and University of Helsinki, 00014 Helsinki, Finland.

The median survival of patients with heart transplants is relatively limited, implying one of the most relevant questions in the field-how to expand the lifespan of a heart allograft? Despite optimal transplantation conditions, we do not anticipate a rise in long-term patient survival in near future. In order to develop novel strategies for patient monitoring and specific therapies, it is critical to understand the underlying pathological mechanisms at cellular and molecular levels. These events are driven by innate immune response and allorecognition driven inflammation, which controls both tissue damage and repair in a spatiotemporal context. Read More

View Article and Full-Text PDF
December 2021

Noninvasive biomarkers in heart transplant: 2020-2021 year in review.

Curr Opin Organ Transplant 2022 Feb;27(1):7-14

Genomic Research Alliance for Transplantation (GRAfT).

Purpose Of Review: Endomyocardial biopsy (EMB), the current gold standard for cardiac allograft monitoring is invasive, may have a low sensitivity and is associated with significant variability in histopathologic interpretation. Fortunately, on-going research is identifying noninvasive biomarkers that address some of these limitations. This review provides an update on noninvasive blood-based methods for rejection surveillance and diagnosis in heart transplantation. Read More

View Article and Full-Text PDF
February 2022

Novel left and right ventricular strain analysis to detect subclinical myocardial dysfunction in cardiac allograft rejection.

Int J Cardiovasc Imaging 2021 Dec 22. Epub 2021 Dec 22.

Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.

Early detection of acute cellular rejection (ACR) by echocardiography shows potential clinical benefit as ACR remains a significant contributor to morbidity and mortality. This retrospective, longitudinal study sought to investigate the use of novel left (LV) and right ventricular (RV) strain analysis to detect biopsy proven ACR. 46 heart transplant patients (Mean age 46 ± 16 years) with biopsy proven ACR were grouped according to biopsy results: 1R-ACR (n = 36) and 2R-ACR (n = 10). Read More

View Article and Full-Text PDF
December 2021