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. · Jun 2015
Comparative StudyInfluence of age on survival in adult patients on extracorporeal membrane oxygenation before lung transplantation.
Extracorporeal membrane oxygenation (ECMO) is widely accepted as a means of support before lung transplantation (LTx), but limited data exist regarding its impact on long-term survival in association with patient age and covariates that may be influencing clinical outcomes. ⋯ Although ECMO adversely impacted survival in a contemporary cohort of adult lung transplant recipients, the negative effect centered on older patients.
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J. Heart Lung Transplant. · Jun 2015
Comparative StudyVentricular reconditioning and pump explantation in patients supported by continuous-flow left ventricular assist devices.
The potential for myocardial reconditioning and device explantation after long-term continuous-flow left ventricular assist device (LVAD) support presents an opportunity to delay or avoid transplantation in select patients. ⋯ The potential for recovery of native LV function after long-term continuous-flow LVAD support should encourage a more aggressive approach to ventricular reconditioning with the goal of device explantation and a return to medical management, particularly in young patients with dilated cardiomyopathy.
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J. Heart Lung Transplant. · May 2015
Review Meta AnalysisLung transplantation from donation after cardiocirculatory death: a systematic review and meta-analysis.
Lung transplantation (LTx) can extend life expectancy and enhance the quality of life for select patients with end-stage lung disease. In the setting of donor lung shortage and waiting list mortality, the interest in donation after cardiocirculatory death (DCD) is increasing. We performed a systematic review and meta-analysis to compare outcomes between DCD and conventional donation after brain death (DBD). ⋯ Survival after LTx from DCD is comparable to survival after LTx from DBD in observational cohort studies. DCD appears to be a safe and effective method to expand the donor pool.
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J. Heart Lung Transplant. · May 2015
Randomized Controlled TrialDe novo sirolimus with low-dose tacrolimus versus full-dose tacrolimus with mycophenolate mofetil after heart transplantation--8-year results.
Although acute cellular rejection after heart transplantation (HTX) can be controlled by full-dose calcineurin inhibitor (CNI)-based immunosuppressive regimens, cardiac allograft vasculopathy (CAV), nephrotoxicity, and malignancy remain ongoing problems. To evaluate the potential beneficial effects of sirolimus and CNI reduction, we compared de novo low-dose tacrolimus and sirolimus with standard tacrolimus and mycophenolate mofetil (MMF)-based immunosuppression after HTX. ⋯ Reduction of de novo CNI did not result in superior long-term renal function. Low-dose mechanistic target of rapamycin inhibition did not achieve any benefit in CAV prevention compared with full-dose TAC/MMF after HTX.
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J. Heart Lung Transplant. · May 2015
Multicenter StudyWeight loss prior to lung transplantation is associated with improved survival.
Obesity is associated with increased mortality after lung transplantation and is a relative contraindication to transplant. It is unknown whether weight reduction prior to transplantation ameliorates this risk. Our objective was to determine whether weight loss prior to lung transplantation improves survival. ⋯ A reduction in BMI prior to lung transplantation was associated with a reduction in the risk of death and mechanical ventilator days. A greater reduction in BMI was associated with a greater survival benefit.