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. · Oct 2011
Severe acute kidney injury according to the RIFLE (risk, injury, failure, loss, end stage) criteria affects mortality in lung transplantation.
The RIFLE criteria (risk, injury, failure, loss, end stage) are new consensus definitions for acute kidney injury (AKI) associated with increased mortality; however, they have not been applied in lung transplantation (LTx). Using the RIFLE criteria, we examined the effect of AKI on outcomes and cost in LTx. ⋯ This study shows high rates of AKI using the new RIFLE criteria in LTx. RIFLE-F is associated with higher in-hospital and 1-year mortality. Less severe degrees of AKI are not associated with increased mortality. The financial burden associated with AKI is significant.
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J. Heart Lung Transplant. · Oct 2011
Thrombosis and failure of a HeartMate II device in the absence of alarms.
Next-generation left ventricular assist devices such as the HeartMate II (Thoratec Corporation, Pleasanton, CA) have significantly improved patient outcomes. In particular, the incidence of thromboembolic events appears to be significantly reduced. ⋯ The thromboses reported with next-generation devices have generally been partial thromboses associated with significant abnormalities in the system performance data as displayed on the system monitor. We describe a case of complete thrombosis of a HeartMate II axial-flow pump resulting in cardiac arrest but in the absence of alarms or significant aberrations in the performance data.
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J. Heart Lung Transplant. · Oct 2011
Successful use of a pneumatic biventricular assist device as a bridge to transplantation in cardiogenic shock.
Mechanical circulatory support is a highly effective technology to maintain organ perfusion in patients with cardiogenic shock as a bridge to transplantation. Although implantation of a left ventricular assist device alone is often the preferred configuration, patients with biventricular failure and significant end-organ dysfunction often require biventricular assistance. ⋯ Biventricular assist device therapy represents an effective and reliable means of supporting selected Interagency Registry for Mechanically Assisted Circulatory Support profile 1 patients as a bridge to transplantation, with excellent success to transplant rates and post-transplant survival.