When Good Intentions Turn Bad: A Need for Course Correction
Years of research of candidates for heart transplantation led to crafting the recent donor heart allocation system in the United States, implemented in October 2018, which was designed to allow more equitable organ allocation of patients awaiting heart transplantation, to reduce mortality in the waiting list and to preserve excellent outcomes post-heart transplant. In this issue of the Journal, Cogswell and colleagues examine key changes in patient characteristics and post transplant outcomes in the period of 3 years before and 5.4 months after the change of the US allocation algorithm.
Approaches to risk assessment in pulmonary arterial hypertension (PAH) include the non-invasive French risk assessment approach (number of low-risk criteria based on the ESC/ERS guidelines) and REVEAL 2.0 risk calculator. The prognostic and predictive value of these methods for morbidity/mortality was evaluated in the predominantly prevalent population of GRIPHON, the largest randomized controlled trial in PAH.
Despite advances in drug development, life expectancy in idiapathic pulmonary arterial hypertension (IPAH) remains unacceptable. Contemporary IPAH characterization is based on criteria that may not adequately capture disease heterogeneity and may be proposed as a possible explanation for why patient's outcome is still unfavorable.
Patients with cardiogenic shock (CS) needing temporary circulatory support (TCS) have poor survival after durable ventricular assist device (dVAD). We aimed to characterize post-dVAD adverse event burden and survival in those requiring pre-operative TCS.
Lung transplantation (LTx) offers a survival benefit for patients with end-stage lung disease. When suitable donors are identified, centers must accept or decline the offer for a matched candidate on their waitlist. The degree to which variability in per-center offer acceptance practices impacts candidate survival is not established. The purpose of this study was to determine the degree of variability in per-center rates of LTX offer acceptance, and to ascertain the associated contribution to observed differences in per-center waitlist mortality.
In this study, we determined whether symptomatic respiratory viral infections in post-lung transplantation induce circulating exosomes that contain lung-associated self-antigens, and to assess whether these exosomes activate immune responses to self-antigens.
Ambrisentan is effective in Group 1 pulmonary arterial hypertension (PAH). Although portopulmonary hypertension (PoPH) is a subset of Group 1 PAH, few clinical trials testing PAH therapies enrolled PoPH patients. We aimed to evaluate the efficacy and safety of ambrisentan in PoPH.
Cytomegalovirus (CMV) infection is the most prevalent viral infection in heart transplant recipients. Current strategies for the prevention of CMV infection after heart transplantation include either universal prophylaxis (ranging from 100 to 200 days) or preemptive therapy1,2. Since the international consensus on CMV prophylaxis and treatment2 lacks definite recommendations on optimal CMV infection prevention and the duration of prophylaxis, these are subject to significant intercenter variability.
In this study, we assessed the efficacy and safety of DOACs compared to warfarin after HTx.
In heart transplantation (HT), while blood type O organs can go to any blood type, non-O organs may not be allocated to adult O recipients. Therefore, O candidates wait longer than non-O, and frequently require bridging with left ventricular assist devices (LVADs). The effects of this discrepancy are rarely investigated in a large registry. The purpose of the present study was to assess the association between candidates ’ blood type and their outcomes after HT listing.
This study provides strong evidence that following a healthy lifestyle can substantially extend the years a person lives disease-free." Commentary on Recent Evidence for Cognitive Decline to Precede Amyloid Aggregation in Alzheimer's Disease https://www.fightaging.org/archives/2020/01/commentary-on-recent-evidence-for-cognitive-decline-to-precede-amyloid-aggregation-in-alzheimers-disease/ I can't say that I think the data presented in the research noted here merits quite the degree of the attention that it has been given in the popular science press. It is interesting, but not compelling if its role...