Donor Fraction Cell-Free DNA and Rejection in Adult and Pediatric Heart Transplantation
Endomyocardial biopsy (EMB) is the current standard for rejection surveillance in heart transplant recipients. Quantification of donor-specific cell-free DNA (cfDNA) may be an appropriate biomarker for non-invasive rejection surveillance. A multi-center prospective blinded study (DNA-based Transplant Rejection Test, DTRT) investigated the value of donor fraction (DF), defined as the ratio of cfDNA specific to the transplanted organ to total amount of cfDNA present in a blood sample.
(The Society of Thoracic Surgeons) Legendary heart-lung transplant surgeon, researcher, and professor Sir Magdi Habib Yacoub, MD, today was honored with the 2020 Earl Bakken Scientific Achievement Award from The Society of Thoracic Surgeons.
UCLA researchers are part of an international team that reported the use of a stem cell gene therapy to treat nine people with the rare, inherited blood disease known as X-linked chronic granulomatous disease, or X-CGD. Six of those patients are now in remission and have stopped other treatments. Before now, people with X-CGD – which causes recurrent infections, prolonged hospitalizations for treatment, and a shortened lifespan – had to rely on bone marrow donations for a chance at remission.“With this gene therapy, you can use a patient’s own stem cells instead of donor cells for a transplant,&rdqu...
I read with interest the original science study by Leary et al entitled “Endothelin-1, cardiac morphology, and heart failure: the MESA angiogenesis study.1” The authors are to be congratulated for their thoughtful work pursuing the association of endothelin-1 (ET1) with cardiovascular risk in a population free from clinical cardiovascular disease at enrollment. Furt her, their counter-intuitive findings that higher ET1 were associated with higher ejection fraction and reduced risk for heart failure or cardiovascular death are thought-provoking.
We report a comprehensive analysis of stroke subtypes in the ENDURANCE (DT) and ENDURANCE Supplemental (DT2) trials.
AbstractBackgroundWe previously demonstrated high diagnostic accuracy of Rubidium-82 positron emission tomography (PET) myocardial blood flow (MBF) quantification for CAV. The purpose of this study was to validate multiparametric PET detection of CAV by combined rate-pressure-product-corrected myocardial flow reserve (cMFR), stress MBF, and coronary vascular resistance (CVR) assessment.Methods and ResultsDiagnostic CAV cut-offs of cMFR
Publication date: Available online 25 January 2020Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): Miriam Zeillemaker - Hoekstra, Carlijn I. Buis, Vlado Cernak, Koen MEM. ReyntjensAbstractThe combined transplantation of a thoracic organ and the liver is performed in patients with dual-organ failure in whom survival is not expected with single-organ transplantation alone. Although uncommonly performed, the number of combined liver-lung and liver-heart transplants is increasing. Anesthetic management of this complex procedure is challenging. Major blood loss, prolonged operation time, difficult weaning ...
The utilization and duration of left ventricular assist device (LVAD) support has increased steadily over the last decade and recent changes in the UNOS heart allocation system, implemented in October 2018, portend a further increase in the duration of mechanical circulatory support for many patients (1). Though four-year survival rates have improved to 60% following LVAD implantation, the leading cause of death in these patients is neurological injury, specifically ischemic and hemorrhagic stroke (spontaneous subarachnoid hemorrhage or intraparenchymal hemorrhage [IPH]) (2).
Recipients of solid organ transplant (SOT) are at risk of viral infection and development of viral-driven malignancy (EBV-PTLD) due to immunosuppressive medications to prevent organ rejection. Treatments are limited by poor efficacy and organ toxicity, and reduction in immunosuppression to enable the patient's immune system fight the infection risks organ rejection. Allogeneic viral specific T-cells (VST) have been used to treat viral infections after stem cell transplant, and here we evaluated VST for the treatment of CMV, ADV, EBV-PTLD and BK in six SOT (heart, liver, kidney, lung) recipients.
Prior research has suggested that the prevalence and outcomes of pulmonary arterial hypertension (PAH) may vary by race or ethnicity. However, these studies have been limited by small sample size or methodological techniques relying on epidemiologic data. The purpose of this study is to evaluate the relationship between race/ethnicity and survival in a large U.S.-based prospective multicenter registry.
Mechanical circulatory support (MCS) evolved from an engineering dream to clinical reality during the 1980s when increasing numbers of patients were dying on heart transplant wait lists. Following the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial,1 the US Food and Drug Administration (FDA) approved a pulsatile implantable left ventricular assist device (LVAD) for long-term implantation in 2002. When the FDA approved the first US continuous flow (CF) LVAD in 2008, the landscape had changed dramatically.