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High molecular weight kininogen contributes to early mortality and kidney dysfunction in a mouse model of sickle cell disease.
CONCLUSIONS: We found elevated plasma levels of cleaved HK in sickle patients compared to healthy controls, suggesting ongoing HK activation in SCD. We used bone marrow transplantation to generate wild type and sickle cell mice on a HK-deficient background. We found that short-term HK deficiency attenuated thrombin generation and inflammation in sickle mice at steady state, which was independent of bradykinin signaling. Moreover, long-term HK deficiency attenuates kidney injury, reduces chronic inflammation, and ultimately improves of sickle mice. PMID: 32573897 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - June 22, 2020 Category: Hematology Authors: Sparkenbaugh EM, Kasztan M, Henderson MW, Ellsworth P, Davis PR, Wilson KJ, Reeves B, Key NS, Strickland S, McCrae K, Pollock DM, Pawlinski R Tags: J Thromb Haemost Source Type: research

Anticoagulation with direct factor Xa inhibitors in transplant recipients: Results from the DRESDEN NOAC REGISTRY (NCT01588119)
After solid organ or hematopoietic stem cell transplantation (HSCT), the risk of arterial or venous thromboembolism (VTE) is high (1 –7). Oral anticoagulation represents the mainstay for stroke prevention in atrial fibrillation (SPAF) and VTE treatment. The pharmacodynamic and pharmacokinetic profiles of vitamin k antagonists (VKA) represent a challenge especially in the setting of transplantation, also due to the high risk of bleeding (8) and due to complex co-medications of transplant recipients.
Source: Thrombosis Research - April 23, 2020 Category: Hematology Authors: Jan Beyer-Westendorf, Sandra Marten, Christiane Naue, Luise Tittl, Katja Sockel, Jan Moritz Middecke, Martin Bornh äuser Tags: Letter to the Editors-in-Chief Source Type: research

Outcome of patients receiving a continuous flow left ventricular assist device - a retrospective single center study.
Conclusions. Survival rates were good, although one third of patients were bridged with temporary circulatory support. We report a high level of freedom from pump thrombosis, fatal stroke, and driveline infection. PMID: 32292078 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - April 16, 2020 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Increased Mean Platelet Volume is Associated with Decreased Survival in Patients Supported with Impella
Increased mean platelet volume (MPV) has been associated with elevated risk of stroke and myocardial infarction in the general population and stroke/pump thrombosis in Heartmate II recipients. It has been proposed that contact with foreign surfaces and centrifugation promote prothrombotic states with platelet activation and increased MPV. An association between MPV and outcomes of patients treated with percutaneous short-term circulatory devices has not been investigated.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: M. Harutyunyan, K. Doshi, H. Nazeer, E. Joye, O. Saeed, M. Torosoff, U. Jorde, D. Belov Tags: (1029) Source Type: research

Pre-Operative Intracardiac Thrombus is Associated with Increased Risk of Stroke and Death in CF-LVAD Patients
Advanced heart failure predisposes patients to intracardiac thrombus (ICT) formation. There is a paucity of evidence examining the impact of pre-existing left atrial (LA) or left ventricular (LV) thrombi on post-operative outcomes in patients undergoing durable LVAD implantation.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: C.A. Bravo Carillo, J.A. Fried, G.M. Mondellini, A. Javaid, H.S. Lumish, J.Z. Willey, V.K. Topkara, L. Braghieri, Y. Kaku, L. Witer, H. Takayama, K. Takeda, Y. Naka, N. Uriel, M. Yuzefpolskaya, P.C. Colombo Tags: (349) Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a support strategy for advanced heart failure. Complications such as thrombosis and bleeding have been linked to LVAD. We observed that LVAD implantation was followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE) and apoptotic cells. Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: S.B. See, D. Onat, E. Hittesdorf, F. McDougan, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, Y. Naka, H. Takayama, K. Takeda, G.P. Milligan, D. Wencker, S.A. Hall, M. Askar, P. Kimball, G. Wagener, P. Colombo, E. Zorn Tags: (1211) Source Type: research

Inflow Cannula Position as Predictor for Neurological Dysfunction in Patients with HeartMate 3 Left Ventricular Assist Device
This study aimed to investigate pump position, derived from chest X-rays of HM3 patients, in correlation to any neurological dysfunction (ND) and specifically to ischemic stroke (IS) and intracranial hemorrhage (ICH).
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: T. Schl öglhofer, P. Aigner, M. Migas, D. Beitzke, F. Wittmann, J. Riebandt, D. Wiedemann, G. Laufer, F. Moscato, H. Schima, D. Zimpfer Tags: (216) Source Type: research

Left ventricular assist systems and strokes: Statins to the rescue?
The development of durable left ventricular assist systems (LVASs) has been critical in providing an option for management of end-stage heart disease and addressing the increasing gap between demand and supply of donor cardiac allografts for management of end-stage heart disease. The technology also provides an alternative to heart transplantation in many patients. Unfortunately, the long-term use of LVASs has been associated with significant morbidities, the most devastating of which may relate to the thrombogenicity of the artificial devices, leading to ischemic stroke or pump thrombosis.
Source: The Journal of Heart and Lung Transplantation - March 16, 2020 Category: Transplant Surgery Authors: Jignesh K. Patel Tags: EDITORIAL COMMENTARY Source Type: research

Left Ventricular Assist Systems and Strokes- Statins to the Rescue?
The development of durable left ventricular assist systems (LVAS) has been critical in providing an option for management of end-stage heart disease and addressing the increasing gap between demand and supply of donor cardiac allografts for management of end-stage heart disease. The technology also provides an alternative to heart transplantation in many patients. Unfortunately, the long-term use of LVAS has been associated with significant morbidities, the most devastating of which may relate to the thrombogenicity of the artificial devices, leading to ischemic stroke or pump thrombosis.
Source: The Journal of Heart and Lung Transplantation - March 16, 2020 Category: Transplant Surgery Authors: Jignesh Patel Tags: Editorial Source Type: research

Human neural stem cells improve early stage stroke outcome in delayed tissue plasminogen activator-treated aged stroke brains.
CONCLUSIONS: Aged stroke mice that received delayed tPA treatment in combination with hNSC transplantation exhibited reduced stroke pathophysiology in comparison to non-transplanted stroke mice with delayed tPA. This suggests that hNSC transplantation may synergize with already existing stroke therapies to benefit a larger stroke patient population. PMID: 32147438 [PubMed - as supplied by publisher]
Source: Experimental Neurology - March 4, 2020 Category: Neurology Authors: Boese A, Eckert A, Hamblin MH, Lee JP Tags: Exp Neurol Source Type: research

Permanent Implantable Cardiac Support Systems.
CONCLUSION: A VAD system can be implanted as an alternative to cardiac transplan- tation or as a bridging treatment until the patient can be listed for transplantation and receive the transplant. Because of the organ s , only a minority of VAD patients ever receive a transplant. PMID: 31931951 [PubMed - in process]
Source: Deutsches Arzteblatt International - January 16, 2020 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

Bleeding in critical care associated with left ventricular assist devices: pathophysiology, symptoms, and management.
Authors: Leebeek FWG, Muslem R Abstract Chronic heart failure (HF) is a growing health problem, and it is associated with high morbidity and mortality. Left ventricular assist devices (LVADs) are nowadays an important treatment option for patients with end-stage HF not only as a bridging tool to heart transplantation but also, as a permanent therapy for end-stage HF (destination therapy). The use of LVAD is associated with a high risk for bleeding complications and thromboembolic events, including pump thrombosis and ischemic stroke. Bleeding is the most frequent complication, occurring in 30% to 60% of patients, b...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Bloodstream Infections in Continuous Flow Left Ventricular Assist Device Recipients: Diagnostic and Clinical Implications
Bloodstream infection (BSI) is a common complication of left ventricular assist device (LVAD) support and particularly difficult to treat. The presentation is often variable because of altered physiology and augmentation of cardiac output by the device. We studied LVAD recipients at a single institution. Multivariate logistic and Cox (with time-varying parameters) regression were implemented. Of 212 patients, 58% experienced infections. Driveline infection (DLI) affected 31%, with 60% of them having deep-tissue involvement. Sixty-six patients (31%) suffered from 135 BSIs. Systemic inflammatory response syndrome (SIRS) was ...
Source: ASAIO Journal - November 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

First Human Implantation of A Miniaturized Axial Flow Ventricular Assist Device in a Child with End-Stage Heart Failure
Small children with end-stage heart failure who require left ventricular assist device (LVAD) support to heart transplant have limited device options leading to high morbidity and mortality and chronic hospitalization until transplant.1,2 The only FDA-approved durable LVAD for children is a paracorporeal pulsatile device that carries a high stroke risk and lacks portability precluding hospital discharge.1 Temporary paracorporeal continuous flow (CF) devices have also been used off-label for bridge-to-transplant but carry higher mortality, require lengthy paracorporeal cannulas prone to circuit thrombus, and typically requi...
Source: The Journal of Heart and Lung Transplantation - September 10, 2019 Category: Transplant Surgery Authors: Antonio Amodeo, Sergio Filippelli, Gianluigi Perri, Roberta Iacobelli, Rachele Adorisio, Francesca Iodice, Alessandra Rizza, M. Patricia Massicotte, J. Timothy Baldwin, Christopher S.D. Almond Tags: Case Anecdotes, Comments and Opinions Source Type: research

Bridging the Gap to LVAD Recovery and Explantation
Left ventricular assist device (LVAD) implantation continues to occur at an exceedingly high rate due to the donor and supply mismatch when it comes to heart transplantation. LVADs however do not come without risk and have high rates of significant bleeding, stroke, pump thrombosis and infection. Most of the clinical and research efforts thus far have been focused on LVAD insertion with the goal of destination therapy or as a bridge to transplant. The goal of bridge to recovery has often been underestimated despite multiple studies showing reverse remodeling of the myocardium.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Karlee K. Hoffman, Manreet Kanwar Tags: 361 Source Type: research

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