The Approach to Antibodies After Heart Transplantation
AbstractPurpose of ReviewThis review summarizes recent data about antibodies after cardiac transplantation, what testing modalities are available and how frequently to employ them, and when treatment is necessary.Recent FindingsTechnologies available for antibody detection have progressed over the past couple decades. New and preformed antibodies are associated with worse outcomes in transplant recipients.SummaryThe frequency of screening for post-transplant antibodies and for antibody-mediated rejection (AMR) should be based on risk stratification. The presence of antibodies alone post transplant does not constitute a diagnosis of AMR. Treatment of post-transplant antibodies and AMR should be made in conjunction with consideration of AMR grade and graft dysfunction. Future directions will involve improved detection methods and further understanding of non-HLA antibodies and de novo antibodies in the post-transplant population. Additionally, aggressive efforts are currently underway to provide more therapeutic options.
AbstractVentricular assist device (VAD) implantation is a widely used procedure in children with cardiac failure refractory to medical therapy as a long-term bridge to recovery or transplant. This strategy has proved to be of an enormous advantage in the cure of these children. The aim of this review is to evaluate the current strategies used for clinical monitoring of paediatric patients with a VAD, focusing on the management of several aspects such as anticoagulant and antiplatelet therapy, haemorrhagic and thrombotic complications, as well as the effects that VADs have on the exposure, effectiveness and the safety of dr...
Providence Heart Institute has appointed two new leaders to head the heart transplant program it is rebuilding eight years after it was discontinued. Dr. Brian Bruckner will serve as surgical director of the program. He was recruited from Methodist DeBakey Heart and Vascular Center in Houston, where he has served as the surgical director of the heart transplant program. "We’ve had a nationwide recruitment process for last several months and looked at a number of candidates who were very interested…
ConclusionsCardiac allografts deemed high-risk by utilization and survival based methods led to equivalent post-transplant survival as matched recipients with low-risk donors. This study demonstrates that traditionally high-risk donors may have been associated with worst post-transplant survival because of the recipients that utilized them. Therefore, accepting these “high-risk” donor grafts should be considered as a potential approach to reduce waiting list times and mortality while maintaining comparable post-transplant survival.
Analyst, 2019, Accepted Manuscript DOI: 10.1039/C9AN01696A, PaperJing Huang, Anuradha Ramoji, Shuxia Guo, Thomas Bocklitz, Val érie Jahns, Jan Möller, Michael Kiehntopf, Michel Noutsias, Jürgen Popp, Ute Neugebauer Dilated cardiomyopathy (DCM) is a leading cardiomyopathy entity and is the leading reason for heart transplantation. Due to high etiologic and genetic heterogeneity of the pathologies, different therapeutic treatment strategies... The content of this RSS Feed (c) The Royal Society of Chemistry
This article discusses the basic science and clinical data that support the hypothesis that these changes pose pathophysiologic and potential novel therapeutic challenges.
Conclusions: The present study seeks to provide new insight in the pathophysiological mechanisms linking reduced kidney function to cardiovascular disease. In addition, we aim to enlighten predictors of adverse cardiovascular outcome in living kidney donors. The study is registered at Clinical-Trials.gov (identifier: NCT03729557). PMID: 31718316 [PubMed - as supplied by publisher]
' High survival benefit'centers are transplanting much sicker candidates and effectively saving more lives with the scarce resource than'low benefit'centers, researchers say.Medscape Medical News
Despite advances in treatment of idiopathic pulmonary arterial hypertension (IPAH), there remains no medical cure and patients can experience disease progression leading to right heart failure, progressive exercise intolerance and death. The reversed Potts shunt (left pulmonary artery to descending aorta) was re-introduced for treatment of end-stage IPAH to permit decompression of the suprasystemic right ventricle by right to left shunting, with preservation of upper body oxygenation. The shunt has the potential to delay the need for lung transplantation and offer a treatment for those who are transplant ineligible.
To develop a risk score to predict mortality or transplant in the interstage period.
We report on the prespecified secondary outcome, echocardiographic indexes of LV function, from a previously reported study of the effect of lung ultrasound (US)-guided dry weight reduction on systolic blood pressure.Study DesignSingle-blind randomized trial.Settings &Participants71 clinically euvolemic hypertensive hemodialysis patients in Greece and Slovenia.InterventionThe active intervention group’s (n = 35) volume removal was guided by the total number of lung US B-lines observed every week before a midweek dialysis session. The usual-care group (n = 36) was treated using standard-of-care...