Micro-RNA Biomarkers of Allograft Rejection in Pediatric Heart Transplantation
Purpose: Historically, endomyocardial biopsy (EMB) has been the standard for surveillance and diagnosis of rejection after heart transplantation. EMB is invasive and distressing for pediatric heart transplant (PHT) recipients. In adults, non-invasive, molecular evaluation of rejection has eliminated the need for many surveillance EMBs by detecting allograft injury suggestive of acute cellular rejection (ACR) or antibody-mediated rejection (AMR). Our previous work identified blood-based microRNAs (miRs) that accurately discriminated ACR and AMR in adults. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , B. Feingold, K. Rose-Felker, A. Mercado, P. Bagchi, M. Zinn, S. West, S. Miller, P. Shah Source Type: research
Predictors of Intraoperative Donor Lung Turndown After Initial Acceptance
Purpose: Turndown of donor lungs at the time of potential recovery wastes transplant team, hospital, and system resources. We investigated predictors of intraoperative turndown (ITD) of donor lung allografts that were initially accepted. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , A.L. Zhou, J.M. Ruck, A. Kalra, A.J. Casillan, J.S. Ha, C.A. Merlo, E.L. Bush Source Type: research
Long Term Outcome of First-Year C1q Positive Donor Specific Antibodies After Heart Transplantation
Purpose: Detection of donor specific antibodies (DSA) after heart transplantation (HTx) has been associated with poor outcome in the long term. DSA have been associated with decreased survival, increased incidence of cardiac allograft vasculopathy (CAV), increase in cardiac dysfunction, and increase in non-fatal major adverse cardiac events (NF-MACE). DSA are heterogeneous and amount of antibody-binding can be detected by the Luminex assay. Functional studies indicate whether the DSA can cause killing by the ability to bind complement. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , J. Patel, M. Kittleson, M. Welton, N. Bhatnagar, A. Kanungo, M. Lee, Z. Wakefield, M. Hamilton, A. Hage, L. Czer, P. Catarino, J. Kobashigawa Source Type: research
Epicardial and Microvascular CAV are Associated with Restrictive Physiology After Heart Transplantation
Purpose: Cardiac allograft vasculopathy (CAV) is a major cause of graft failure following heart transplantation (HT). One criterion for ISHLT CAV3 is restrictive physiology (RP), and recently, modified RP (RA>8 mmHg, PCWP>15 mmHg, CI (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , N. Prasad, J.A. Fried, V.K. Topkara, J. Raikhelkar, E.M. DeFilippis, F. Latif, M. Yuzefpolskaya, P.C. Colombo, G. Sayer, N. Uriel, K. Clerkin Source Type: research
Re-Evaluating Natriuretic Peptides as Biomarkers of Cardiac Allograft Vasculopathy
Purpose: Despite initial evidence supporting the use of elevated B-type natriuretic peptide (BNP) to predict cardiac allograft vasculopathy (CAV), a recent meta-analysis questioned the diagnostic accuracy of BNP and N-terminal-pro brain natriuretic peptide (NT-proBNP) in the detection of CAV following heart transplantation (HTx). To our knowledge, no study has assessed both BNP and NT-proBNP in the prediction of CAV in HTx. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , A. Yadalam, M.E. Gold, P. Patel, J. Waller, A.S. Gillet, A. Panagopoulos, A. Alkhoder, Z. Siddiqui, O. Khawaja, H. Allaqaband, S. Sakr, A. Rahbar, Y. Haroun, H. Hashmi, A. Shamim, K. Ejaz, D. Gupta, W. Book, A.A. Quyyumi Source Type: research
Myocardial Blood Flow Assessment with PET Improves Risk Stratification Among HT Recipients with CAV1
Purpose: Cardiac allograft vasculopathy (CAV) results in impaired blood flow in epicardial vessels and/or coronary microvasculature. ISHLT CAV guidelines stratify disease into 4 groups based on severity of epicardial disease measured by coronary angiography (CA), with mild CAV (CAV 1) encompassing a broad phenotype, from luminal irregularities up to 69% stenosis of a primary vessel. Studies have shown that impaired myocardial blood flow (MBFR ≤ 2, CFR25) is associated with increased mortality risk. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , E.S. Harris, D. Skoll, J. Fried, V.S. Topkara, J. Raikhelkar, E.M. DeFilippis, F. Latif, M. Yuzefpolskaya, P.C. Colombo, G. Sayer, N. Uriel, A.J. Einstein, K.J. Clerkin Source Type: research
Waitlist Mortality for Patients with Cardiac Allograft Vasculopathy Under the 2018 UNOS Donor Heart Allocation System
Purpose: On October 18, 2018 the UNOS donor heart allocation system was redesigned to prioritize patients on the basis of predicted waitlist mortality. Patients listed for re-transplantation due to cardiac allograft vasculopathy (CAV) are assigned to Status 4 unless hemodynamic criteria are met to qualify for a more urgent status. We sought to examine the waitlist outcomes of this unique cohort of patients compared to all other adult heart transplant candidates. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , S.S. Patel, S. Sidhu, A.B. Massie, S. Golob, R. Goldberg, N. Moazami, A. Reyentovich Source Type: research
Engraftment of Alveolar Macrophages from Human LT Recipients into Immunodeficient Mice as a Tool to Study Mechanisms of Lung Allograft Inflammation
Purpose: We previously identified a subset of alveolar macrophages (AMs) with expression of interferon stimulating genes (ISG) associated with acute and chronic lung allograft dysfunction. Here, we show successful engraftment of AMs from human lung transplant (LT) recipients in an immunodeficient NOD scid γc-/- (NSG) mouse model and demonstrate its utility as a tool to study how ISG AMs may contribute to allograft dysfunction. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , Y. Suzuki, A. Duong, J. Oliver, T. Martinu, S. Juvet Source Type: research
Longitudinal Lower Airway Microbial Signatures of Acute Cellular Rejection in Lung Transplantation
Purpose: Dynamic changes in the lower airway microbiome after lung transplantation (LT) have been shown to influence immunologic tone within the allograft, although its overall impact on risk for acute cellular rejection (ACR) remains poorly understood. Our study aimed to evaluate whether temporal changes in certain microbial signatures were associated with the development of ACR. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , K.K. Wong, N.C. Nelson, B.G. Wu, D. Rudym, M.B. Lesko, S. Qayum, T.C. Lewis, S.H. Chang, J.C. Chan, T.C. Geraci, F.A. Tiripicchio, Y. Li, C. Wang, H. Li, J. Schnier, P. Pamar, I.J. Mahoney, T. Malik, F. Darawshy, I. Sulaiman, R. Singh, D.E. Collazo, M. Source Type: research
Dysfunctional Regulatory T Cells Characterize Acute Cellular Rejection in Lung Transplant Recipients
In this study, we report a role of dysfunctional regulatory T cell (Treg) repertoire in the pathogenesis of ACR. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , A. Potter, M.M. Banday, D. Hayes, N.S. Sharma Source Type: research
Blocking Signaling Pathways Like Notch and Hedgehog Reduces Chronic Rejection in a Murine Aortic Transplant Model
Purpose: Cardiac allograft vasculopathy (CAV) remains a primary contributor to chronic rejection following heart transplantation. A combination of effects including immunological and non-immunological factors contributes to the development of CAV. The main objective of this study is to investigate whether LDE225, as a Hedgehog pathway inhibitor, and/or DAPT, as a γ-secretase inhibitor known to disrupt the Notch signaling pathway, can attenuate chronic rejection in a mouse aortic transplant model and act as potential targets to prevent the development of CAV to improve long-term outcomes for heart transplant recipients. (S...
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , C. Gr äbner, A. Kuckhahn, J. Distler, B. Spriewald, M. Ramsperger-Gleixner, O. Dewald, C. Heim Source Type: research
Anti-Reflux Surgery for Prevention of CLAD Onset After Lung Transplantation: The Earlier the Better? A Single-Center Series of 284 Patients
Purpose: GERD is highly prevalent after lung transplantation (LTx), and suspected to favor chronic lung allograft disease (CLAD) development, mainly in its bronchiolitis obliterans syndrome (BOS) phenotype. Preventive effect of antireflux surgery (ARS) on BOS/CLAD onset in patients with GERD still remains debated. We aimed to compare the outcome of GERD patients with or without performed ARS, and those without GERD. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: A. Hamid, A. Vall ée, S. Rong, S. De Miranda, O. Boche, J. Rouillet-Audy, M. Stern, D. Grenet, L. Beaumont, F. Parquin, S. Colin De Verdiere, C. Picard, B. Zuber, J. Devaquet, J. Fessler, M. Le Guen, J. De Wolf, C. Pricopi, M. Glorion, E. Sage, A. Roux, Source Type: research
Impact of Primary Graft Failure: Analysis of the PHTS Database
Purpose: Primary graft failure (PGF) is a leading cause of early morbidity and mortality after heart transplant (HTx). It manifests as allograft dysfunction in the absence of other causes. While the impact of PGF on early mortality in pediatrics has been described, it is unclear if PGF also influences long-term survival and post-HTx complications. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , T. Pidborochynski, J. Kirklin, R. Cantor, H. Zhao, A. Sheybani, J. Lamour, L.G. Hahn, L. Collins, J. Laks, D.H. Freed Source Type: research
How Well Does the Molecular Microscope Diagnostic System (MMDx) Correlate with Traditional Pathologic Biopsy Interpretation in a Pediatric Heart Transplant Population?
Purpose: Histologic evaluation of endomyocardial biopsies (EMB) is the gold-standard for diagnosis of rejection post heart transplant (HT), but the methodology is subject to interobserver variability and sampling error. The molecular microscope diagnostic system (MMDx) analyzes RNA transcripts from EMB tissue to differentiate quiescent allograft tissue from that with rejection/injury. While MMDx results have been described in adult HT cohorts, less is known about its utility in pediatric patients which differ regarding indications for HT, degree of anti-HLA sensitization, and post HT immunosuppression. (Source: The Journal...
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: , T.P. Singh, G. Nava, M. Clark, R. Kobayashi, P. Esteso, C. Carreon, A. Al-Ibraheemi, L.A. Sleeper, K.P. Daly Source Type: research
Correlation of Donor-Derived Cell-Free DNA to Rejection Events in Pediatric Heart Transplant Recipients
Purpose: Acute cellular (ACR) and antibody-mediated (AMR) rejection are risk factors for allograft loss in heart transplant (HT) recipients. Endomyocardial biopsy (EMB), although considered gold standard for rejection surveillance, is invasive and has high interobserver variability. Non-invasive donor-derived cell free DNA (dd-cfDNA) sampling has high negative predictive value for rejection in adults and is increasingly used in pediatrics. This single center study aimed to test the performance of dd-cfDNA in detecting acute rejection in pediatric HT recipients. (Source: The Journal of Heart and Lung Transplantation)
Source: The Journal of Heart and Lung Transplantation - April 1, 2024 Category: Transplant Surgery Authors: S.A. Bravo, L.D. Akabas, A.D. Simonelli, W.A. Zuckerman, M.E. Richmond, Source Type: research
