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Muscle Mass and Mortality After Cardiac Transplantation
Conclusions Muscle mass is an independent predictor of mortality and major morbidity after OHT. Further research is needed to determine whether frail OHT patients with low PMA may benefit from muscle-building interventions to improve outcomes.
Source: Transplantation - November 22, 2018 Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research

Prognostic implications of serial outpatient blood pressure measurements in patients with a left ventricular assist device
Elevated blood pressure (BP) has been linked to adverse events during left ventricular assist device support. We aimed to investigate the association between outpatient BP and stroke or suspected pump thrombosis among HeartMate II (HMII) recipients.
Source: The Journal of Heart and Lung Transplantation - November 15, 2018 Category: Transplant Surgery Authors: Alberto Pinsino, Francesco Castagna, Amelia M Zuver, Eugene A Royzman, Mojdeh Nasiri, Eric J St öhr, Barbara Cagliostro, Barry McDonnell, John R Cockcroft, A Reshad Garan, Veli K Topkara, P Christian Schulze, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Tags: Original Clinical Science Source Type: research

Prognostic implications of serial outpatient blood pressure measurements in patients with an axial continuous-flow left ventricular assist device
In this study we investigated the association between outpatient BP and stroke or suspected pump thrombosis among HeartMate II (HMII) recipients.
Source: The Journal of Heart and Lung Transplantation - November 15, 2018 Category: Transplant Surgery Authors: Alberto Pinsino, Francesco Castagna, Amelia M. Zuver, Eugene A. Royzman, Mojdeh Nasiri, Eric J. St öhr, Barbara Cagliostro, Barry McDonnell, John R. Cockcroft, A. Reshad Garan, Veli K. Topkara, P. Christian Schulze, Koji Takeda, Hiroo Takayama, Yoshifumi Tags: ORIGINAL CLINICAL SCIENCE Source Type: research

A Tale of the Twist in the Outflow Graft: An Analysis from the MOMENTUM 3 Trial
Heralded as a significant step forward in the evolution of left ventricular assist systems (LVAS), the HeartMate 3 device (Abbott, Abbott Park, Il, USA) has demonstrated improved outcomes by averting de-novo intra-pump thrombosis leading to pump related malfunction, and in reducing the incidence of stroke events when compared with the axial flow HeartMate II LVAS.1,2,3,4 Moreover, the HeartMate 3 LVAS experience has reduced the vexing incidence of hemocompatibility related adverse outcomes.5,6,7 On the heels of these advances, intriguing reports began to surface of a twist within the outflow graft that caused disruption in...
Source: The Journal of Heart and Lung Transplantation - August 24, 2018 Category: Transplant Surgery Authors: Mandeep R. Mehra, Christopher Salerno, Yoshifumi Naka, Nir Uriel, Joseph C. Cleveland, Douglas Horstmanshof, Daniel J. Goldstein, for the MOMENTUM 3 Investigators Tags: Editorial Source Type: research

Cardiovascular Disease Outcomes Related to Early Stage Renal Impairment After Liver Transplantation
Background In the general population, even mild renal disease is associated with increased cardiovascular (CV) complications. Whether this is true in liver transplant recipients (LTR) is unknown. Methods This was a retrospective cohort study of 671 LTR (2002-2012) from a large urban tertiary care center and 37 322 LTR using Vizient hospitalization data linked to the United Network for Organ Sharing. The 4-variable Modification of Diet in Renal Disease equation estimated glomerular filtration rate (eGFR). Outcomes were 1-year CV complications (death/hospitalization from myocardial infarction, heart failure, atrial fibr...
Source: Transplantation - June 29, 2018 Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research

Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device
AbstractCurrently, we use the Nipro paracorporeal VAD (p-VAD) for initial short-term ventricular support, as a bridge to decision (BTD) or a bridge to candidacy (BTC) treatment, in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 and 2 patients. However, it is possible that compared to patients with primary implantable-VADs (P-iVAD), the bridge-to-bridge (BTB) patients are more likely to develop complications. This retrospective study used data from 24 consecutive BTB patients who were initially implanted with Nipro p-VAD as BTD or BTC treatments between April 2011 and March 2016, and...
Source: Journal of Artificial Organs - June 25, 2018 Category: Transplant Surgery Source Type: research

Evaluation of Neuroimaging Findings of Central Nervous System Complications in Heart Transplant Recipients.
CONCLUSIONS: Posterior reversible leukoencephalopathy syndrome and ischemic stroke were the most common neurologic complications in our heart transplant recipients. The other complications were hemorrhagic stroke, intracranial abscess, and intracranial dissemination of sinusoidal fungal infection. Neurologic complications are common in heart transplant recipients and should be identified promptly for early treatment. For the recognition of these complications, computed tomography should be performed for initial evaluation to rule out edema or hemorrhage. However, in the presence of serious neurologic symptoms that cannot b...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - May 23, 2018 Category: Transplant Surgery Authors: Turnaoglu H, Agildere AM, Kural Rahatli F, Yildirim Donmez F, Ocal R, Sezer T, Can U, Sezgin A, Aslamaci S Tags: Exp Clin Transplant Source Type: research

First-in-Man Use of the MVAD Axial-Flow Pump: Long Term Outcome
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and whe...
Source: The Journal of Heart and Lung Transplantation - April 24, 2018 Category: Transplant Surgery Authors: Marian Urban, Anfrew Woods, Nicola Robinson-Smith, Guy MacGowan, Chandrika Roysam, Stephan Schueler Source Type: research

First-in-man use of the MVAD axial-flow pump: Long-term outcome
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke, and gastrointesinal bleeding are among the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort, and reduced quality of life.
Source: The Journal of Heart and Lung Transplantation - April 24, 2018 Category: Transplant Surgery Authors: Marian Urban, Anfrew Woods, Nicola Robinson-Smith, Guy MacGowan, Chandrika Roysam, Stephan Schueler Tags: Case Anecdotes, Comments and Opinions Source Type: research

First-in-Man Use of the MVAD Axial-Flow Pump: Long Term Outcome
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and whe...
Source: The Journal of Heart and Lung Transplantation - April 24, 2018 Category: Transplant Surgery Authors: Marian Urban, Anfrew Woods, Nicola Robinson-Smith, Guy MacGowan, Chandrika Roysam, Stephan Schueler Source Type: research

A Review of the Use of Direct Oral Anticoagulant Use in Orthotopic Heart Transplantation Recipients
Over 60 years ago, the vitamin K antagonist (VKA) warfarin was approved and remained the only oral anticoagulation agent until recently [1]. Currently, within North America and Europe there are four DOACs available. Dabigatran, first approved in Europe and Canada in 2008, then in the United States of America in 2010, followed by rivaroxaban, apixaban, and most recently edoxaban. The introduction of direct oral anticoagulants (DOACs) has been a major advancement and these agents are the preferred to VKAs for many indications [2 –5], including stroke prevention in nonvalvular atrial fibrillation (NVAF), acute treatment and...
Source: Transplantation Reviews - April 16, 2018 Category: Transplant Surgery Authors: Rosaleen Boswell, Glen J. Pearson Tags: Review article Source Type: research

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in Continuous-Flow Left Ventricular Assist Device Patients
In the general population, increased aortic stiffness (kAo) is associated with risk of cardiovascular events. Continuous-flow left ventricular assist device (CF-LVAD) pts have been reported to have increased kAo. The association between kAo and common adverse events (AEs), including stroke, gastrointestinal bleed (GIB) and pump thrombosis (PT) are unknown in CF-LVAD pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: H. Rosenblum, A. Pinsino, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, A. Gaudig, M.T. Pineda, Y. Naka, H. Takayama, K. Takeda, F. Castagna, J.Z. Willey, B.J. McDonnell, J.R. Cockcroft, E.J. St öhr Source Type: research

Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients
Elevated blood pressure (BP) in pts on left ventricular assist device (LVAD) support is a risk factor for adverse events (AEs) such as stroke and pump thrombosis (PT). Current guidelines recommend a mean arterial pressure (MAP) ≤ 80mmHg. Above-median systolic BP (SBP) at discharge after HeartMate II (HMII) implant has been associated with an increased risk of stroke. We sought to 1) compare the predictive value of outpt MAP and SBP on AEs, 2) examine the association of visit-to-visit variability (VVV) of BP with AEs in H MII pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Pinsino, F. Castagna, J.Z. Willey, A.M. Zuver, M.A. Flannery, B. Cagliostro, J.R. Cockroft, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya Source Type: research

Risk Predictors for Ischemic Stroke in CF-LVAD Patients by Pump Flow Type
Risk of stroke continues to be a major adverse event post-LVAD implantation, limiting wider application and utility of the device. Even with aggressive blood pressure control, patients with LVADs are at higher risk of stroke due to combination of pump-dependent factors including loss of natural pulsatility, anticoagulation, and thrombosis risk from blood-pump interaction. We used a Bayesian Network machine-learning approach to derive comparative risk factors for ischemic stroke in patients with axial versus centrifugal flow pumps at 3 months post LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, S. Bailey, C. Mcilvennan, S. Murali, J. Antaki Source Type: research

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