Journal ArticleDOI
Report from a consensus conference on primary graft dysfunction after cardiac transplantation.
Jon A. Kobashigawa,Andreas Zuckermann,Peter S. Macdonald,Pascal Leprince,Fardad Esmailian,Minh B. Luu,Donna Mancini,Jignesh Patel,Rabia R. Razi,Hermann Reichenspurner,Stuart D. Russell,Javier Segovia,N. Smedira,Josef Stehlik,Florian Wagner +14 more
TLDR
A consensus conference was organized to better define, diagnose, and manage primary graft dysfunction (PGD), with the aim of leading to better understanding of PGD and prevention/minimization of its adverse outcomes.Abstract:
Although primary graft dysfunction (PGD) is fairly common early after cardiac transplant, standardized schemes for diagnosis and treatment remain contentious. Most major cardiac transplant centers use different definitions and parameters of cardiac function. Thus, there is difficulty comparing published reports and no agreed protocol for management. A consensus conference was organized to better define, diagnose, and manage PGD. There were 71 participants (transplant cardiologists, surgeons, immunologists and pathologists), with vast clinical and published experience in PGD, representing 42 heart transplant centers worldwide. State-of-the-art PGD presentations occurred with subsequent breakout sessions planned in an attempt to reach consensus on various issues. Graft dysfunction will be classified into primary graft dysfunction (PGD) or secondary graft dysfunction where there is a discernible cause such as hyperacute rejection, pulmonary hypertension, or surgical complications. PGD must be diagnosed within 24 hours of completion of surgery. PGD is divided into PGD-left ventricle and PGD-right ventricle. PGD-left ventricle is categorized into mild, moderate, or severe grades depending on the level of cardiac function and the extent of inotrope and mechanical support required. Agreed risk factors for PGD include donor, recipient, and surgical procedural factors. Recommended management involves minimization of risk factors, gradual increase of inotropes, and use of mechanical circulatory support as needed. Retransplantation may be indicated if risk factors are minimal. With a standardized definition of PGD, there will be more consistent recognition of this phenomenon and treatment modalities will be more comparable. This should lead to better understanding of PGD and prevention/minimization of its adverse outcomes.read more
Citations
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Journal ArticleDOI
Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association.
Marvin A. Konstam,Michael S. Kiernan,Daniel Bernstein,Biykem Bozkurt,Miriam Jacob,Navin K. Kapur,Robb D. Kociol,Eldrin F. Lewis,Mandeep R. Mehra,Francis D. Pagani,Amish N. Raval,Carey Ward +11 more
TL;DR: RHF is a complex syndrome including diverse causes, pathways, and pathological processes and multiple hemodynamic and biochemical markers are associated with worsening RHF and can serve to guide clinical assessment and therapeutic decision making.
Journal ArticleDOI
The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Heart Transplantation Report--2015; Focus Theme: Early Graft Failure
Lars H. Lund,Leah B. Edwards,Anna Y. Kucheryavaya,Christian Benden,Anne I. Dipchand,Samuel B. Goldfarb,Bronwyn Levvey,Bruno Meiser,Joseph W. Rossano,Roger D. Yusen,Josef Stehlik +10 more
TL;DR: Data are submitted to the ISHLT Registry by national and multinational organ/data exchange organizations and individual centers.
Journal ArticleDOI
The promise of organ and tissue preservation to transform medicine
Sebastian Giwa,Jedediah K. Lewis,Luis M. Alvarez,Luis M. Alvarez,Luis M. Alvarez,Robert Langer,Alvin E. Roth,George M. Church,James F. Markmann,David H. Sachs,Anil Chandraker,Anil Chandraker,Jason A. Wertheim,Martine Rothblatt,Edward S. Boyden,Elling Eidbo,W. P. Andrew Lee,Bohdan Pomahac,Gerald Brandacher,David M. Weinstock,Gloria D. Elliott,David R. Nelson,Jason P. Acker,Korkut Uygun,Boris Schmalz,Boris Schmalz,Brad P Weegman,Alessandro Tocchio,Greg M Fahy,Kenneth B. Storey,Boris Rubinsky,John C. Bischof,Janet A.W. Elliott,Teresa K. Woodruff,G. John Morris,Utkan Demirci,Kelvin G. M. Brockbank,Erik J. Woods,Robert N. Ben,John G. Baust,Dayong Gao,Barry Fuller,Yoed Rabin,David C. Kravitz,Michael J. Taylor,Michael J. Taylor,Mehmet Toner +46 more
TL;DR: Developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research.
Journal ArticleDOI
Ferroptotic cell death and TLR4/Trif signaling initiate neutrophil recruitment after heart transplantation
Wenjun Li,Guoshuai Feng,Jason M. Gauthier,Inessa Lokshina,Ryuji Higashikubo,Sarah Evans,Xinping Liu,Adil Hassan,Satona Tanaka,Markus Cicka,Hsi-Min Hsiao,Daniel Ruiz-Pérez,Andrea L. Bredemeyer,Richard W. Gross,Douglas L. Mann,Yulia Y. Tyurina,Andrew E. Gelman,Valerian E. Kagan,Valerian E. Kagan,Andreas Linkermann,Kory J. Lavine,Daniel Kreisel +21 more
TL;DR: It is demonstrated that ferrostatin-1 (Fer-1), a specific inhibitor of ferroptosis, decreases the level of pro-ferroptotic hydroperoxy-arachidonoyl-phosphatidylethanolamine, reduces cardiomyocyte cell death and blocks neutrophil recruitment following heart transplantation.
Journal ArticleDOI
Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors.
Arjun Iyer,Arjun Iyer,Ling Gao,A. Doyle,Padmashree Rao,Jonathan R. Cropper,C. Soto,Andrew Dinale,G. Kumarasinghe,G. Kumarasinghe,Andrew Jabbour,Andrew Jabbour,Mark Hicks,Mark Hicks,Mark Hicks,Paul Jansz,Paul Jansz,Michael P. Feneley,Richard P. Harvey,Richard P. Harvey,Robert M. Graham,Robert M. Graham,Robert M. Graham,Kumud Dhital,Peter S. Macdonald +24 more
TL;DR: Viability studies of human DCD hearts using NEVP are warranted and five of six hearts preserved with NEVP demonstrated favorable lactate profiles during NEVP and all five could be weaned off cardiopulmonary bypass posttransplant.
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