Background Current assessments remain insensitive for detecting right heart failure post left ventricular assist device (LVAD). Sensitive pressure-volume loop assessments of right ventricle (RV) contractility may improve our appreciation of post-LVAD RV dysfunction. Methods Thirteen LVAD patients and 20 reference (non-LVAD) subjects underwent comparison of echocardiographic, right heart cath hemodynamic

Abstract not available

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

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

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

Abstract not available

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

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

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

Abstract not available

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

Abstract not available

Abstract not available

Abstract not available

Abstract not available

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

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

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

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

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

Abstract not available

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

Objective The development of modern antiviral therapy for hepatitis C virus (HCV) has allowed for the transplantation of HCV nucleic acid amplification testing positive (NAT+) donor lungs with acceptable short-term outcomes. We sought to evaluate trends and mid-term outcomes of lung transplant recipients of HCV NAT+ donor allografts. Methods All adults undergoing isolated lung transplantation in the

Objective Recently, several centers in the US have begun performing donation after circulatory death (DCD) heart transplants (HT) in adults. We sought to characterize the recent use of DCD HT, waitlist-time, and outcomes compared to donation after brain death (DBD). Methods Using the UNOS database, 10,402 adult (>18yo) HT recipients from January 2019-June 2022 were identified: 425(4%) were DCD and

Abstract not available

Background Lung transplant recipients (LTRs) are at increased risk of COVID-19-related morbidity and mortality; however, the disease severity has changed as SARS-CoV-2 variants have mutated. We compared COVID-19-related clinical outcomes in LTRs at different stages of the pandemic. We also identified risk factors for the development of severe COVID-19 independent of the dominant SARS-CoV-2 variant

Background No proven treatment after the development of primary graft dysfunction (PGD) is currently available. Here we established a novel strategy of in vivo lung perfusion (IVLP) for the treatment of PGD. IVLP involves the application of an in vivo isolated perfusion circuit to an implanted lung. This study aimed to explore the effectiveness of IVLP versus conventional post-lung transplant (LTx)

Background Left ventricular assist device (LVAD) support offers remodelling potential in some patients. Our goal was to use non-invasively derived pressure-volume (PV) loops to understand the effect of demographic and device variables on serial changes in cardiac function under pump support. Methods Thirty-two consecutive Medtronic HVAD patients (mean 55.9±12.3 years, 81.3% male) were prospectively

Abstract not available

Abstract not available

Abstract not available

Abstract not available

Abstract not available

Purpose Our program uses a desensitization protocol that includes intraoperative therapeutic plasma exchange (iTPE) for crossmatch positive lung transplants, which improves access to lung transplant for sensitized candidates while mitigating immunologic risk. Although we have reported excellent outcomes for sensitized patients with the use of this protocol, concern for peri-operative bleeding appears

Background Cardiac allograft vasculopathy (CAV) limits long-term survival after heart transplantation (HT). This study evaluates the relationship between clinically significant CMV infection (CS-CMVi) and CAV using cardiac positron emission tomography (PET). Methods We retrospectively evaluated HT patients from 2005-2019 who underwent cardiac PET for CAV evaluation. Multivariable linear and logistic

Background Pulmonary antibody-mediated rejection is still a challenging diagnosis as C4d has poor sensitivity. Previous studies have indicated that the phosphorylated S6 ribosomal protein, a component of the mammalian target of rapamycin (mTOR) pathway, is correlated with de novo donor-specific antibodies in lung transplantation. The objective of this study was to evaluate the phosphorylation of S6

Purpose Primary graft dysfunction (PGD) is a leading cause of early morbidity and mortality following heart transplantation (HT). Human leukocyte antigen (HLA) sensitization increases the risk of rejection and adverse outcomes after HT. We sought to determine the association between pre-transplant HLA sensitization, as measured using the calculated panel reactive antibody (cPRA) value, and the risk

Abstract not available

Background Urogenital Mollicutes, i.e., Mycoplasma hominis and Ureaplasma spp., can colonize the urogenital tract. While urogenital colonization is frequent, infections are rare but should not be missed. Furthermore, extragenital infections are even rarer. Over the past years, they have been increasingly documented as a cause of hyperammonemia syndrome (HS) and post-surgical infections. We review the

Background Sensitization to human leukocyte antigens (HLA) is a persistent problem in heart transplant (HT) candidates. We sought to characterize the anti-HLA antibody and circulating B cell repertoire in a cohort of highly sensitized HT candidates. Methods We assessed IgG and IgM anti-HLA antibodies using luminex single antigen bead assays in a cohort of 11 highly sensitized (HS; calculated panel

Background Right ventricular failure (RVF) is a leading cause of morbidity and mortality in multiple cardiovascular diseases, but there are no approved treatments for RVF as therapeutic targets are not clearly defined. Contemporary transcriptomic/proteomic evaluations of RVF are predominately conducted in small animal studies, and data from large animal models are sparse. Moreover, a comparison of

Lung transplantation remains the best option for patients with end-stage lung disease.However, this operation has historically carried significant potential morbidity. To improve near-term patient outcomes, attempts have been made to decrease invasiveness, but this is limited by the complex nature of the operation and the anatomy of the chest. To facilitate further reduction in incision size and augment

Background Assessment and selection of donor lungs remains largely subjective, and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo CT images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs prior to transplantation. Methods Clinical measures and ex-situ CT scans

Introduction Recent work has suggested that outcomes among heart transplant patients listed at the lower-urgency (United Network for Organ Sharing Status 4 or 6) status may not be significantly impacted by donor comorbidities. The purpose of this study was to investigate outcomes of extended criteria donors (ECD) in lower vs. higher urgency patients undergoing heart transplantation. Methods The United

Background Selexipag is an oral prostacyclin receptor agonist, indicated for pulmonary arterial hypertension to delay disease progression and reduce the risk of pulmonary arterial hypertension-related hospitalization. SelexiPag: tHe usErs dRug rEgistry (NCT03278002) was a US-based, prospective, real-world registry of selexipag-treated patients. Methods Adults with pulmonary hypertension (enrolled 2016-2020)

Many patients with severe COVID-19 have been affected by acute respiratory distress syndrome, which has been associated with increased mortality, and up to 31% of these survivors had persistent interstitial lung abnormalities with impaired lung function and quality of life even after 6 to 24 months after initial disease. Lung transplantation quickly emerged as a viable therapy for select patients with

Abstract not available

Abstract not available

Abstract not available

Purpose The purpose of the study is to investigate the relationship between blood and tissue-derived rejection-related transcripts from blood gene expression profiling (GEP) and molecular microscope in the setting of allograft rejection in heart transplant. Methods All heart transplant patients from August 2021 to May 2022 with both circulating blood GEP (AlloMap; CareDx) and endomyocardial biopsy

Background Aortic root thrombus (ART) formation is a complication of continuous flow left ventricular assist device (LVAD) therapy. However, the incidence and related complications of ART in HeartMate 3 (HM3) patients remains unknown. Methods Patients who underwent HM3 implantation from November 2014 through August 2020 at a quaternary academic medical center were included. Demographics and outcomes

Background Pulmonary endarterectomy(PEA) is the guideline recommended treatment for patients with chronic thromboembolic pulmonary hypertension(CTEPH). However, some patients develop severe cardiopulmonary compromise either prior to surgery, intraoperatively or early postoperatively. This may result from advanced CTEPH, reperfusion pulmonary oedema, massive endobronchial bleeding or right ventricular(RV)

Background Donation after circulatory death (DCD) heart transplantation has promising early survival, but effects on rejection remain unclear. Methods The United Network for Organ Sharing (UNOS) database was queried for adult heart transplants from 12/01/2019 to 12/31/2021. Multiorgan transplants and loss to follow-up were excluded. Primary outcome was acute rejection, comparing DCD and donation after

Heart transplant recipients have been reported to be at a significantly elevated risk of poor outcomes from COVID-19 infection owing to their underlying comorbidities and immunosuppression. We conducted a single-centre retrospective cohort of all heart transplant recipients who were known to have contracted COVID-19 between January 2020 to September 2022. Electronic medical records were used to collect

Background Cardiac allograft vasculopathy (CAV) is an important cause of mortality after pediatric heart transplantation (HT) but there is a paucity of data regarding its incidence and impact on survival in pediatric recipients transitioned to adult care. Methods We conducted a retrospective review of consecutive pediatric HT patients from 1989-2017 at the Hospital for Sick Children who transitioned