Heart transplant offers are less likely to be accepted on weekends, holidays, and conferences.

Background: The existence of a "weekend effect" in heart transplantation (HTx) is understudied. The present study sought to determine whether the odds of (HTx) offer acceptance differed for adult and pediatric candidates depending upon the day on which the offer occurred.

Methods: United Network for Organ Sharing data were used to identify all HTx offers to adult (listing age ≥18) and pediatric candidates from 2000-2019.

Fulminant Neisseria meningitidis: role for extracorporeal membrane oxygenation.

Invasive meningococcal disease is often associated with complications of septic shock and central nervous system dysfunction. Extracorporeal membrane oxygenation is more commonly being used for respiratory failure and sepsis, but neurologic injury and potential coagulopathy are often considered relative contraindications. We report a successful case of complicated Neisseria meningitidis septic shock with disseminated intravascular coagulopathy requiring extracorporeal support.

The use of extracorporeal membrane oxygenation in severe necrotizing soft tissue infections complicated by septic shock.

Necrotizing soft tissue infections remain a challenging clinical problem. Delays in diagnosis, incomplete débridement of necrotic tissues, and the hemodynamic instability and end-organ failure associated with overwhelming sepsis all contribute to significant mortality. Extracorporeal support is a well-established tool to support profound cardiopulmonary failure.

Long-term mechanical support for complex left ventricular postinfarct pseudoaneurysms.

Left ventricular free wall rupture can be a catastrophic problem. Although small lacerations can be managed with various techniques of primary closure, larger and more complex defects can be difficult to treat. We present and discuss 2 cases of chronic, complex ventricular pseudoaneurysms managed successfully with long-term mechanical support.

Noninvasive assessment of left ventricular assist devices with cardiovascular computed tomography and impact on management.

Background: Left ventricular assist devices (LVADs) provide a bridge to recovery or heart transplantation but require serial assessment. Echocardiographic approaches may be limited by device artifact and acoustic window. Cardiovascular computed tomography (CCT) may provide improved non-invasive imaging of LVADs.

Advances in mechanical circulatory support.

Purpose Of Review: Mechanical circulatory support is expanding the treatment of advanced heart failure. The number of heart transplantations performed worldwide remains fairly static, and medical therapy alone for end stage heart failure continues to have dismal results. This article presents the authors' opinion as to the current status, challenges, and future course of the field of mechanical circulatory support.

Placement of long-term implantable ventricular assist devices without the use of cardiopulmonary bypass.

Background: Implantation of ventricular assist devices for cardiac support is normally performed using cardiopulmonary bypass. Post-operative complications could be minimized by the placement of these devices without the use of cardiopulmonary bypass.

Methods: We hypothesize that left ventricular assist devices (LVADs), in selected patients, can be implanted safely off-pump.

Aging and transplant arteriosclerosis in absence of alloreactivity and immunosuppressive drugs in a rat aortic model: recipient age's contribution.

Background: Almost half of all transplanted vascularized organ grafts will be lost to transplant arteriosclerosis sometime posttransplantation. Organ shortage for primary transplants and retransplants has led to donor-pool expansion to include elderly donors, knowing that aging per se promotes arteriosclerosis. The current understanding that donor age negatively affects organ and/or patient survival outcome is undermined by variables such as the use of immunosuppressive drugs, their toxicity to the graft, degree of donor-recipient histocompatibility, and the resulting chronic rejection.

Intrathymic inoculation of donor bone marrow induces long-term acceptance of lung allografts.

Background: We investigated whether intrathymic inoculation of donor bone marrow at the time of transplantation induced long-term acceptance of lung allografts.

Methods: Four- to-six-week-old August Copenhagen Irish (ACI) and Wistar Furth (WF) rats were used as donors and recipients, respectively. After being inoculated intrathymically with either donor-specific (ACI) or third-party (F344) bone marrow (2.