NHS no longer uses post-it notes for heart transplants
The pioneering system is 300 times faster, NHS Blood and Transplant experts claim, and has removed around 40 lengthy steps from the organ matching process.
Continuous-flow ventricular assist devices (CF-VAD) have been widely used in end-stage heart failure in adult patients for both bridge to transplantation and destination therapy. Technology improvement has enabled miniaturization of the CF-VAD, which may greatly benefit the pediatric patients with sufficient body size in advanced heart failure. There are still, however, challenging situations for CF-VAD implantation, such as in single ventricle physiology, anatomically abnormal heart, small children and infants.
Background: Severe heart failure (HF) patients often have renal dysfunction because of low cardiac output. Methods and Results: 39 patients underwent a centrifugal-type, continuous-flow left ventricular assist device (LVAD) (EVAHEART) implantation as a bridge to cardiac transplantation at our institute between 2005 and 2015. We investigated the changes in renal function over 2 years among 36 patients with supported by EVAHEART over 6 months. The median estimated glomerular filtration rate (eGFR) at implantation was 62 ± 32 mL/min/1.73 m2 and 47% of the patients showed eGFR
Heart failure syndrome (HF) is one of the major public health concerns, since the number of aged people who are susceptible for HF are increasing and donor supply for cardiac transplantation is limited in Japan. Several clinical trials have established that beta-adrenergic receptor blockers are most useful in prolonging life expectancy in general population of HF in addition to renin-angiotensin system blockade. However, several problems remain to be solved. HF is accompanied by multiple comorbidities, especially in elderly patients.
A 61-year-old man was admitted to our hospital for further treatment of worsening congestive heart failure with a mechanical ventilation. He had undergone a heart transplant due to dilated cardiomyopathy complicated with congenital myopathy at the age of 43. He had been suffering from cardiac allograft vasculopathy and had a history of right ventricular infarction complicated with acute inferior myocardial infarction when he was 59. Since then, refractory right-sided heart failure occurred and additional diuretics were required.
Introduction: Refractory right ventricular failure (RVF) after the implantation of left ventricular assisted device (LVAD) is induced with increased morbidity and mortality. Case: A 23- year-old man with severe heart failure was hospitalized due to dilated cardiomyopathy with severe heart failure. Despite intensive care including intra-aortic balloon pumping and intravenous dobutamine, his cardiac function declined progressively and we decided to implant a LVAD as a bridge to transplantation. Three months after implantation, RVF was suspected due to the presence of leg edema and pleural effusion.
Background: Although the level of B-type natriuretic peptide (BNP) before discharge is a well-known predictor for prognosis among chronic heart failure patients, its impact on patients with implantable left ventricular assist device (iLVAD) is still uncertain. Methods: Those who received iLVAD implantation between 2008 and 2016 in our institute and have been followed up for>1 year were enrolled. Those who were converted from extracorporeal VAD, who deceased, or received heart transplantation within 1 year after iLVAD implantation were excluded.
Background: The numbers of heart transplant recipients are growing in japan. It is important to manage advanced heart failure patients not only in transplant institutions but also in non-transplant institutions. We evaluated clinical outcomes of heart transplant recipients in our institution. Method: We retrospectively reviewed 25 potential heart transplant candidates in our institution from 2005 to 2017. Result: Underlying disease of the patients were dilated cardiomyopathy (n = 10, 56%), fulminant myocarditis (n = 4, 22%), and the others (ischemic cardiomyopathy, secondary cardiomyopathy and ...
Background: Transplantation of autologous myoblast cells has been shown to yield functional recovery of the failing heart via paracrine effects. We have introduced skeletal myoblast cell (SMBc) sheet methods for treating severe heart failure (HF), in which scaffold-free cell-sheets are attached on the epicardial surface to maximize the paracrine effects. Aim: The aim of this study is to evaluate the mid-term outcome and therapeutic efficacy of SMBc sheet transplantation for treating severe HF due to ischemic cardiomyopathy.
A 55-year-old man with dilated cardiomyopathy (DCM) showed refractory heart failure despite of optical medical therapy and was admitted to our hospital in July 10, 2012. He was registered as a candidate for heart transplantation in Japan, and underwent implantation of a left ventricular assist device (LVAD) (EVAHEART). During the following period, however, he suffered brain hemorrhagic infarction several times and his cognitive function drastically declined, and he had to be moved from Status 1 to 3.
We report the results of these children. Patients: 7 DCM children, from 2 month to 12 years old have undergone LVAD (Excor 10, 15, 30 cc) implantation in our hospital. Body weight was from 2.6 kg to 25 kg. Methods: 1. All procedures were done by median sternotomy, under cardiopulmonary bypass. 2. Under the heart beating, LV apex was incised and drainage cannula was anastomosed.