The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Feb 2008
Case ReportsExtracorporeal membrane oxygenation in pulmonary crisis and primary graft dysfunction.
This report describes the clinical use of an extracorporeal membrane oxygenation system in a 23-year-old woman with severe pulmonary arterial hypertension due to end-stage systemic lupus erythematosus. The system was also used to provide a direct bridge from resuscitation to transplantation after acute onset of pulmonary crisis and maintenance of stable hemodynamics during the bilateral lung transplant, and also to provide optimal oxygenation until the transplanted lung recovered from severe primary graft dysfunction.
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J. Heart Lung Transplant. · Feb 2008
The Papworth experience with the Levitronix CentriMag ventricular assist device.
The Levitronix CentriMag ventricular assist device (VAD) is a centrifugal pump designed for short-term extracorporeal support in cardiogenic shock. The aim of this study is to report our clinical experience with the Levitronix CentriMag for uni- and biventricular support. ⋯ The Levitronix CentriMag system is a reliable and facile temporary circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock.
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J. Heart Lung Transplant. · Feb 2008
Pneumatic paracorporeal ventricular assist device in infants and children: initial Stanford experience.
Mechanical circulatory support with the Berlin Heart EXCOR pediatric ventricular assist device (VAD) has been used successfully in Europe for children with cardiac failure. Eighty-seven devices have been placed in North America through February 2007. We describe our single-center experience in 8 children. ⋯ In selected children, the Berlin Heart VAD can be used as a bridge to transplantation. In contrast to the published European experience, neurologic events occur frequently. Anti-coagulation and platelet inhibition strategies continue to evolve. Device exchange is technically feasible at the bedside and should be considered at the earliest visualization of thrombus formation.
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J. Heart Lung Transplant. · Feb 2008
Comparative StudyOutcomes in patients older than 60 years of age undergoing orthotopic heart transplantation: an analysis of the UNOS database.
Patients 60 years and older have traditionally not been considered candidates for orthotopic heart transplantation (OHT). Recent studies have shown equivalent survival between older and younger patients, leading many to question this traditional ethos. As these studies may lack significant power to draw meaningful conclusions, the United Network for Organ Sharing (UNOS) database provides a unique opportunity to examine the effects of age on OHT. ⋯ The UNOS database has provided a large multi-institutional sample examining OHT in the elderly. Although our analysis shows lower survival in patients >or=60 years of age, the cumulative 5-year survival in these patients of close to 70% is acceptable. OHT should not be restricted based on age, as encouraging long-term results exist.