a-porcine-heterotopic-heart-transplantation-protocol-for-delivery

A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft

Cardiac transplantation is the gold standard treatment for end-stage heart failure. However, it remains limited by the number of available donor hearts ...

Duke University

An early report of recipient heart transplantation outcomes under the new U.S. heart allocation system introduced in late 2018 found a lower post-transplant survival rate compared with that of the prior system.

Reassessing Recipient Mortality Under the New Heart Allocation System: An Updated UNOS Registry Analysis.

Commentary: A longer agonal period in lungs donated after circulatory determination of death is a gamble worth taking.

In the era of antiretroviral therapy, HIV-positive patients have reduced mortality from HIV infection and increased morbidity from end-stage heart failure. The number of HIV-positive heart transplantation recipients remains scant. Long-term survival has not been rigorously studied. We compared survival outcomes of heart transplantation in HIV-positive recipients with those of HIV-negative recipients.

Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients.

Lung transplantation primary graft dysfunction (PGD) is common and portends poor outcomes. We examined the association of lung transplant center volume with PGD and the risk of mortality. The United Network for Organ Sharing transplant registry was queried for adult lung transplants from March 2015 to March 2019. Recipients were stratified by the occurrence of grade 3 PGD 72 h post-transplant, defined using modified ISHLT criteria. The adjusted association between volume and PGD as well as post-PGD survival was analyzed. 7322 recipients were included, among whom approximately 21% (n = 1525) experienced grade 3 PGD. After adjustment, increasing annualized lung transplant volume was associated with a decrease in the odds of PGD in a near-linear fashion (OR 0.94 per 10 transplants, 95% CI 0.89-0.99). Furthermore, increasing annualized lung transplant center volume up to approximately 55 transplants per year was associated with improved survival among patients with grade 3 PGD (HR 0.87 per 10 transplants, 95% CI 0.79-0.94). Increasing annual lung transplant center volume is associated with a decreased incidence of grade 3 PGD. Further, increasing volume among low- and medium-volume centers is associated with improved survival of patients who experience PGD.

Center volume and primary graft dysfunction in patients undergoing lung transplantation in the United States - a cohort study.

To determine characteristics, outcomes, and clinical factors associated with death in patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) support.

Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study.

Commentary: Wire-based cannula exchange when time is of the essence.

The recently concluded prospective Portable Organ Care System (OCS) Heart trial to Evaluate the Safety and Effectiveness of The Portable Organ Care System Heart for Preserving and Assessing Expanded Criteria Donor Hearts for Transplantation (EXPAND) demonstrated that the use of ex vivo perfusion for expanded-criteria hearts may be a viable method for increasing the use of donor hearts. We sought to estimate the potential impact of ex vivo expanded-criteria heart perfusion on the donor pool in the United States by using a large national transplant registry. After applying the inclusion criteria of EXPAND, 8637 potentially eligible donors were identified in the U.S. between January 1, 2015, and June 30, 2019, representing a substantial potential increase in the donor pool.

EXPANDing the Donor Pool: Quantifying the Potential Impact of a Portable Organ-Care System for Expanded Criteria Heart Donation.

Advanced heart failure affects more than 250,000 people in the United States alone and is associated with high risk of morbidity and mortality. Cardiac transplantation provides a cure for patients with advanced disease but has historically been limited by donor availability. Recent changes in the allocation system as well as advances in donor selection, procurement and desensitization protocols have served to widen the donor pool and increase the availability of cardiac transplantation for those in need. This review provides an update on recent advances in cardiac transplantation.

Trends in cardiovascular medicine: Update on cardiac transplantation.

We assessed the effect of implementing a protocol-directed strategy to determine when patients can be liberated from venovenous extracorporeal membrane oxygenation on extracorporeal membrane oxygenation duration, time to initiation of first sweep-off trial, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and survival to hospital discharge.

A Daily, Respiratory Therapist Assessment of Readiness to Liberate From Venovenous Extracorporeal Membrane Oxygenation in Patients With Acute Respiratory Distress Syndrome.

Article	Year
Reassessing Recipient Mortality Under the New Heart Allocation System: An Updated UNOS Registry Analysis. JACC. Heart failure\| PubMed ID: 32417413	2020
Commentary: A longer agonal period in lungs donated after circulatory determination of death is a gamble worth taking. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 32713638	2021
Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients. The Annals of thoracic surgery\| PubMed ID: 32946847	2021
Center volume and primary graft dysfunction in patients undergoing lung transplantation in the United States - a cohort study. Transplant international : official journal of the European Society for Organ Transplantation\| PubMed ID: 33145853	2021
Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 34112505	2021
Commentary: Wire-based cannula exchange when time is of the essence. JTCVS techniques\| PubMed ID: 34317764	2020
EXPANDing the Donor Pool: Quantifying the Potential Impact of a Portable Organ-Care System for Expanded Criteria Heart Donation. Journal of cardiac failure\| PubMed ID: 34407451	2021
Trends in cardiovascular medicine: Update on cardiac transplantation. Trends in cardiovascular medicine\| PubMed ID: 34856337	2021
A Daily, Respiratory Therapist Assessment of Readiness to Liberate From Venovenous Extracorporeal Membrane Oxygenation in Patients With Acute Respiratory Distress Syndrome. Critical care explorations\| PubMed ID: 34881366	2021
Commentary: Extracorporeal membrane oxygenation is associated with longstanding functional limitations. The Journal of thoracic and cardiovascular surgery\| PubMed ID: 34922746	2021

Benjamin S. Bryner

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