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. · Apr 1998
Comparative StudyHigher incidence of malignant neoplasms after heart transplantation for treatment of chronic Chagas' heart disease.
Heart transplantation is a new therapeutic procedure to treat heart failure resulting from Chagas' disease. Experimental studies have demonstrated neoplastic effects of benznidazole, which is used for treatment of Trypanosoma cruzi infection. We compared the incidence and characteristics of neoplasia after heart transplantation for treatment of chronic Chagas' disease with those of other diseases. ⋯ We found a higher incidence of malignant neoplasia after heart transplantation for treatment of chronic Chagas' disease. It is likely that the neoplasia is the result of chronic infection with an immunomodulator protozoan, immunosuppression, reactivation of the T. cruzi infection, or the toxicity of therapeutic intervention with benznidazole.
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J. Heart Lung Transplant. · Apr 1998
Morbidity, functional status, and immunosuppressive therapy after heart transplantation: an analysis of the joint International Society for Heart and Lung Transplantation/United Network for Organ Sharing Thoracic Registry.
The morbidity and mortality studies on heart transplantation to date have come from single-center or multicenter studies that often have required collection of data over periods of time greater than a year. Data are now available from the International Society for Heart and Lung Transplantation/United Network for Organ Sharing (ISHLT/UNOS) Thoracic Registry from all centers in the United States performing heart transplantation, which allows analysis of morbidity and mortality rates on an annual basis. ⋯ Clinical data are now available from the ISHLT/UNOS Thoracic Registry on the basis of the initial registration and 1-year follow-up of all patients undergoing heart transplantation in the United States. Analysis of these data from April 1, 1994, through March 31, 1995, demonstrates that the first year after the initial hospitalization for heart transplantation is a period of significant morbidity and frequent rehospitalization but excellent survival. In spite of a high level of functional capacity at 1-year follow-up, only a minority of patients return to work. The ISHLT/UNOS Thoracic Registry can now serve as a valid source of data for future analysis of trends in heart transplantation in the United States.
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J. Heart Lung Transplant. · Mar 1998
Adjunctive use of inhaled nitric oxide during implantation of a left ventricular assist device.
The aim of this study was to evaluate the efficacy of inhaled nitric oxide in the prevention and reversal of pulmonary hypertension during and after left ventricular assist device implantation. ⋯ The administration of inhaled nitric oxide at the time of left ventricular assist device implantation prevents rises in pulmonary vascular resistance that in some patients result in critical reductions in left ventricular assist device flow. We suggest that inhaled nitric oxide is a useful adjunctive treatment that should be routinely available at the time of left ventricular assist device implantation.
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J. Heart Lung Transplant. · Mar 1998
Case ReportsDetection of herpesvirus-like sequences in Kaposi's sarcoma from heart transplant recipients.
Herpesvirus-like DNA sequences have been found in lesions from patients with Kaposi's sarcoma in its several forms, suggesting that this tumor may be caused by a new herpesvirus, referred to as Kaposi's sarcoma-associated herpesvirus or human herpesvirus 8. ⋯ These findings suggest that Kaposi's sarcoma-associated herpesvirus may play a significant role in the pathogenesis of all forms of Kaposi's sarcoma. The development of the tumor in transplant recipients may be related, at least in some cases, to transplantation-associated immunosuppression, rather than to the acquisition of the virus from the donor.
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J. Heart Lung Transplant. · Dec 1997
Case ReportsResolution of cavopulmonary shunt-associated pulmonary arteriovenous malformation after heart transplantation.
A child with heterotaxia, azygous continuation of an interrupted inferior vena cava, single ventricle, and pulmonary atresia underwent the Kawashima modification of the Fontan procedure, which excluded hepatic venous return from the pulmonary blood flow. After the operation, the patient had development of pulmonary arteriovenous malformations, increasing cyanosis, and ventricular dysfunction. He underwent orthotopic heart transplantation at 7 years of age with prompt resolution of the pulmonary arteriovenous malformations.