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. · Aug 2012
Randomized Controlled Trial Multicenter StudyTacrolimus and cyclosporine have differential effects on the risk of development of bronchiolitis obliterans syndrome: results of a prospective, randomized international trial in lung transplantation.
Chronic lung allograft dysfunction, which manifests as bronchiolitis obliterans syndrome (BOS), is recognized as the primary cause of morbidity and mortality after lung transplantation. In this study we assessed the efficacy and safety of two de novo immunosuppression protocols to prevent BOS. ⋯ Compared with cyclosporine, de novo tacrolimus use was found to be associated with a significantly reduced risk for BOS Grade ≥1 at 3 years despite a similar rate of acute rejection. However, no survival advantage was detected.
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J. Heart Lung Transplant. · Aug 2012
Randomized Controlled Trial Multicenter StudyBaseline NT-proBNP correlates with change in 6-minute walk distance in patients with pulmonary arterial hypertension in the pivotal inhaled treprostinil study TRIUMPH-1.
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a biomarker of disease severity in pulmonary arterial hypertension (PAH). In this study we aimed to determine whether baseline NT-proBNP levels correlate with improvement in 6-minute walk distance (6MWD) in the pivotal randomized, placebo-controlled, double-blind study of the addition of inhaled treprostinil to oral therapy for PAH. ⋯ Greater improvement in 6MWD in actively treated patients with high levels of NT-proBNP enhances understanding of the robustness of clinical response to inhaled treprostinil in more advanced disease.
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J. Heart Lung Transplant. · Aug 2012
Recovery of right heart function with temporary right ventricular assist using a centrifugal pump in patients with severe biventricular failure.
Long-term outcomes of a biventricular assist device (BiVAD) support are worse than those of an isolated left ventricular assist device (LVAD) support. This study evaluated our strategy for right heart failure using a temporary right VAD (RVAD) with an extracorporeal centrifugal pump. ⋯ Our strategy with temporary RVAD for severe acute right heart failure was effective in selecting the patients who could be weaned from RVAD support. Patient survival was improved by avoiding the long-term support with a paracorporeal pulsatile BiVAD.