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. · Sep 2013
Multicenter StudyExperience of extracorporeal membrane oxygenation as a bridge to lung transplantation in France.
Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation (LTx). However, data concerning this approach remain limited. ⋯ Our study confirms that the use of ECMO as a bridge to LTx in France could provide a medium-term survival benefit for LTx recipients with critical conditions. Survival differed by underlying respiratory disease. Larger studies are needed to further define the optimal use of ECMO.
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J. Heart Lung Transplant. · Sep 2013
Multicenter StudyImpact of medication non-adherence on survival after pediatric heart transplantation in the U.S.A.
Medication non-adherence (NA) can result in life-threatening illness in children after solid-organ transplantation. Little is known about the incidence, risk factors and outcomes of NA in large numbers of pediatric heart transplant (HT) recipients. ⋯ Medication NA is an important problem in pediatric HT recipients and is associated with high mortality. Adolescent age, black race, Medicaid insurance and invasive hemodynamic support at transplant were associated with NA, whereas time on the wait list and gender were not. Targeted interventions among at-risk populations may be warranted.
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J. Heart Lung Transplant. · Aug 2013
Changes in body composition after lung transplantation in children.
The evaluation of nutritional status, including body composition measurements, in pediatric patients before and after lung transplant (LTx) can aid in adapting nutrition support and physical rehabilitation programs to meet individual patient needs. The purpose of this retrospective study was to determine the changes in weight, lean body mass (LBM), and body fat (BF) before and after LTx and their association with lung function in pediatric patients. ⋯ Maximum weight and LBM gain occur at 12 months after LTx, with smaller gains noted at 24 months. Clinicians must look beyond height and weight and evaluate LBM and fat mass in pediatric patients after LTx.
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J. Heart Lung Transplant. · Aug 2013
Marked changes in right ventricular contractile pattern after cardiothoracic surgery: implications for post-surgical assessment of right ventricular function.
Longitudinal shortening accounts for the majority of right ventricular (RV) contraction in normal hearts. This finding accounts for the correlation between longitudinal measures of RV contraction such as tricuspid annular plane systolic excursion (TAPSE) and global RV function. We hypothesized that, after cardiac surgery, there are major differences in the RV contractile pattern relative to normal hearts. ⋯ After cardiac surgery, the RV contractile pattern changes, with a relative loss of longitudinal shortening and gain in transverse shortening despite normal global RV function. These findings have major implications for quantitative assessment of RV function after cardiac surgery, suggesting that global measures of RV function assessment may be preferred in this setting and that lower normative ranges should be used when measurement of RV function is performed with longitudinal methods.