A Multi-Center, Randomized, Open-Label, Parallel Group Phase IV Trial Investigating the Outcome on Renal Function, Efficacy and Safety of CNI-Reduction or Elimination With Everolimus in De Novo Heart Transplant: Recipients: The MANDELA Study Design

The MANDELA study (NCT00862979) is designed to assess the benefit of either CNI-free or CNI-minimized EVR-based regimen after early conversion from standard treatment in de novo heart transplant recipients (HTxR).There is growing evidence on the beneficial use of everolimus (EVR) in heart transplantation supporting reduction or withdrawal of calcineurin inhibitor (CNI) therapy, mainly to maintain renal function, to avoid malignancies and to reduce progression of cardiac allograft vasculopathy.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research

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Abstract PURPOSE OF REVIEW: The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk. RECENT FINDINGS: Increasing evidence suggests that depression, cognitive function, and other posttr...
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research
Purpose of review The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk. Recent findings Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocia...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: VASCULARIZED COMPOSITE ALLOTRANSPLANTATION: Edited by Linda C. Cendales Source Type: research
CONCLUSION: The Korean urgency classification for LTx is determined by using very limited parameters and may not be a true reflection of urgency. Status 0 patients seem to have poor outcomes compared to the other urgency status patients, despite having the highest priority for donor lungs. Further multi-center and nationwide studies are needed to revise the lung allocation system to reflect true urgency and provide the best benefit of lung transplantation. PMID: 31538435 [PubMed - in process]
Source: Yonsei Medical Journal - Category: Universities & Medical Training Authors: Tags: Yonsei Med J Source Type: research
There has been continuous improvement in survival after heart transplantation (HTx) and lung transplantation (LTx), facilitated by developments regarding surgical procedures and postoperative immunosuppressive regimens.1,2 However, primary graft dysfunction remains a significant source of early and late morbidity and mortality among transplant recipients.1-4 Such conditions include bronchiolitis obliterans syndrome (BOS) in LTx recipients and coronary allograft vasculopathy (CAV) in HTx recipients.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
The foundation of successful strategy in thoracic transplantation is to overcome multiple barriers to donor and recipient compatibility. Once blood group barriers are surmounted, anatomic considerations become a principal guiding consideration. The available allograft may not be of similar size as the recipient's diseased organ (Figure 1). An undersized allograft is associated with an increased risk of primary graft dysfunction (PGD) in both heart1 and lung transplantation,2 making assessment of donor-recipient size match a fundamental issue.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Editorial Source Type: research
Cardiac allograft vasculopathy (CAV) is a major complication limiting long-term survival after heart transplantation (HTx). However, long-term outcome data of HTx recipients with detailed information on angiographic severity are scarce.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
Cardiac allograft vasculopathy (CAV) is a major complication limiting long-term survival after heart transplantation (HTx). However, long-term outcome data of HTx recipients with detailed information on angiographic severity are scarce.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL CLINICAL SCIENCE Source Type: research
This thirty-sixth adult lung and heart –lung transplant report summarizes data from 69,200 adult lung and 4,128 adult heart-lung transplants performed through June 30, 2018 and reported to the International Thoracic Organ Transplant Registry. With each year's report, we now provide more detailed analyses on a particular focus theme imp ortant to patient outcomes. Since 2013, these have been donor and recipient age; retransplantation; early graft failure; indication for transplant; allograft ischemic time; and multiorgan transplantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
ConclusionDLT followed by percutaneous ASD closure is an efficient therapeutic approach in patients with end-stage ASD associated PAH that may offer an alternative option to HLT.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Antibody-mediated rejection continues to hinder long-term survival of solid organ allografts. Natural antibodies (Nabs) with polyreactive and autoreactive properties have recently emerged as potential contributors to antibody-mediated graft rejection. This review discusses Nabs, their functions in health and disease, their significance in rejection following kidney, heart, and lung transplantation, and their implication in serum reactivity to key antigens associated with rejection. Finally, potential effector mechanisms of Nabs in the context of transplantation are explored.
Source: Transplantation - Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research
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