Goodnight Moon: The (not so) mystical effect of folklore and superstitions on cardiac transplantation.

Background: The effect of Friday the 13th and Full Moons on cardiac transplantation is unknown. We investigated the impact of these superstitious events on recipient and donor qualities, complications, survival, and volume.

Methods: All adult transplants from 2013-2023 in the United Network for Organ Sharing database were retrospectively reviewed.

Outcomes and quality of life in patients receiving durable left ventricular assist device with biventricular support.

Background: Patients requiring biventricular support (BIVAD) face higher morbidity than those undergoing durable left ventricular assist device (LVAD) implantation alone. The goal of the current study was to evaluate quality of life (QOL) of patients with LVAD therapy in the modern era, stratified by use of biventricular support.

Methods: All patients undergoing LVAD at our center were reviewed between October 2017 and September 2021.

Outcomes and quality of life in patients receiving mitral surgery for asymptomatic disease.

Objectives: We sought to characterize the demographics, outcomes, and quality of life of asymptomatic patients undergoing mitral valve surgery at our center over a 10-year period.

Methods: Adults undergoing mitral surgery were retrospectively reviewed between 2010 and 2019. Patients were included if deemed asymptomatic by review of referring cardiologist and surgeon consultation.

Tricuspid surgery at time of mitral surgery improves survival free from severe tricuspid regurgitation but not quality of life.

Objective: The choice to operate on moderate tricuspid regurgitation (TR) during mitral surgery is challenging owing to limited mid-term data. We assess whether concomitant tricuspid operations improve mid-term quality of life, morbidity, or mortality.

Methods: An institutional database identified mitral surgery recipients with moderate TR at the time of surgery from 2010 to 2019.

Center Volume Predicts Improved Early Outcomes in Multiorgan Heart Transplantation.

Purpose: Center volume is associated with improved survival after isolated heart transplant, but its impact on multiorgan heart transplant (MHT) outcomes is unknown. This study examines the impact of institutional MHT volume on MHT outcomes.

Methods: Adult patients undergoing first time MHT from 2011 to 2021 were identified in the United Network for Organ Sharing database.

Non-inferior outcomes in lower urgency patients transplanted with extended criteria donor hearts.

Background: Recent work has suggested that outcomes among heart transplant patients listed at the lower-urgency (United Network for Organ Sharing Status 4 or 6) status may not be significantly impacted by donor comorbidities. The purpose of this study was to investigate outcomes of extended criteria donors (ECD) in lower versus higher urgency patients undergoing heart transplantation.

Methods: The United Network for Organ Sharing (UNOS) database was queried for all adult patients undergoing heart transplantation from October 18, 2018 through December 31, 2021.

Heart Retransplantation Under the 2018 Adult Heart Allocation Policy.

Background: The purpose of the present study was to characterize the impact of the 2018 adult heart allocation policy change on waiting list and posttransplant outcomes of heart retransplantation in the United States.

Methods: All adults listed for heart retransplantation from May 2015 to June 2022 were identified using the United Network for Organ Sharing database. Patients were stratified into eras (era 1 and era 2) based on the heart allocation change on October 18, 2018.

Decreased survival of simultaneous heart-kidney transplant recipients in the new heart allocation era.

Background: In 2018, the United Network for Organ Sharing (UNOS) modified their heart allocation policy to reduce waitlist mortality. The rates of simultaneous heart-kidney transplant (SHKT) have dramatically increased in recent years, despite increased rates of posttransplant renal failure in the new policy era. This study sought to investigate the impact of the new allocation system on waitlist and posttransplant outcomes of simultaneous heart-kidney transplantation.

Emerging Racial Differences in Heart Transplant Waitlist Outcomes for Patients on Temporary Mechanical Circulatory Support.

Temporary mechanical circulatory support (tMCS) is increasingly used for patients awaiting heart transplantation. Although examples of systemic inequity in cardiac care have been described, biases in tMCS use are not well characterized. This study explores the racial disparities in tMCS use and waitlist outcomes.

Outcomes of COVID-19-Positive Donor Heart Transplantation in the United States.

Background Little is known regarding the impact of donor COVID-19 status on recipient outcomes after heart transplantation. In this study, we characterize outcomes of the first 110 heart transplants from organ donors positive for COVID-19 (COVID-19+) in the United States. Methods and Results Retrospective analysis of the United Network for Organ Sharing database was performed for single-organ adult heart transplants from January 2020 to March 2022.

Comparison of Intraaortic Balloon Pump and Impella 5.5 as Heart Transplant Bridging Strategies.

Background: Temporary mechanical circulatory support is increasingly utilized as a bridge to heart transplantation. The Impella 5.5 (Abiomed) has achieved anecdotal success as a bridge since receiving US Food and Drug Administration approval.

Aortic valve replacement for moderate aortic stenosis during mitral surgery improves survival free from severe stenosis.

Background: Optimal management of moderate aortic stenosis during surgery for another indication is unclear. We assessed the effects of surgical aortic valve replacement for moderate aortic stenosis during mitral surgery.

Methods: An institutional mitral surgery database was queried for patients with preoperative moderate aortic stenosis.

Prosthesis Choice in Dialysis Patients Undergoing Mitral Valve Replacement.

Background: Patients with renal disease on dialysis have significant comorbidity limiting life expectancy; however, these patients may experience accelerated prosthetic valve degeneration. The purpose of this study was to examine the impact of prosthesis choice on outcomes in dialysis patients undergoing mitral valve replacement (MVR) at our high-volume academic center.

Methods: Adults undergoing MVR were retrospectively reviewed between January 2002 and November 2019.

Use of extended criteria donor hearts in combined heart-kidney transplant confers greater risk of mortality.

Background: Extended criteria donors (ECD) hearts have demonstrated acceptable outcomes in select populations. However, their use in patients undergoing simultaneous heart-kidney transplantation (SHKT) has not been explored. This study is assessed the effect of ECD hearts in patients undergoing SHKT vs isolated heart transplants (IHT).

Heart-kidney transplant versus heart transplant in the obese: a propensity-matched analysis.

Objectives: The decision to perform simultaneous heart-kidney transplant (HKT) rather than isolated heart transplant (IHT) for patients with advanced kidney disease is challenging. Limited data exist to guide this decision in obese patients. We sought to compare mortality after HKT and IHT in obese patients with non-dialysis-dependent kidney disease.

Modern outcomes of heart-lung transplantation: assessing the impact of the updated US allocation system.

Objectives: In 2018, the United Network for Organ Sharing modified their heart allocation policy to reduce waitlist mortality and prioritize patients with the greatest acuity. Considering declining rates of combined heart-lung transplantation, this study sought to investigate the impact of the new allocation system on waitlist and post-transplant outcomes of patients listed for combined heart-lung transplantation.

Methods: Adult patients listed for combined heart-lung transplant between 2012 and 2021 were included.

Antithrombotic therapy for durable left ventricular assist devices - current strategies and future directions.

Left ventricular assist devices (LVADs) improve survival and quality of life for patients with advanced heart failure but are associated with high rates of thromboembolic and hemorrhagic complications. Antithrombotic therapy is required following LVAD implantation, though practices vary. Identifying a therapeutic strategy that minimizes the risks of thromboembolic and hemorrhagic complications is critical to optimizing patient outcomes and is an area of active investigation.

Cytosolic Delivery of Small Protein Scaffolds Enables Efficient Inhibition of Ras and Myc.

The ability to deliver small protein scaffolds intracellularly could enable the targeting and inhibition of many therapeutic targets that are not currently amenable to inhibition with small-molecule drugs. Here, we report the engineering of small protein scaffolds with anionic polypeptides (ApPs) to promote electrostatic interactions with positively charged nonviral lipid-based delivery systems. Proteins fused with ApPs are either complexed with off-the-shelf cationic lipids or encapsulated within ionizable lipid nanoparticles for highly efficient cytosolic delivery (up to 90%).