Publications by authors named "Sun Hi Lee"
Article Synopsis
- - *The study aimed to assess the effectiveness of molecular gene expression analysis (MMDx) in improving the diagnosis of heart transplant rejection, compared to traditional histopathological evaluation.* - *Out of 418 biopsies analyzed, MMDx detected rejection in 22.7% of cases, significantly higher than the 7.7% identified by histology, highlighting the potential of MMDx in finding "biopsy-negative" rejection.* - *MMDx influenced clinical management strategies in 20.4% of cases, particularly leading to changes in antirejection treatment protocols, indicating its significant role in improving patient outcomes post-transplant.*
Article Synopsis
- This study explores the challenges faced by pediatric heart transplant (HT) recipients when transitioning to adult care, focusing on identifying risk factors for poor health outcomes.
- Researchers analyzed data from 72 patients who made this transition between 2011 and 2021, noting key factors such as medication adherence, psychiatric history, and age at transition.
- The findings emphasize the need for structured transition plans tailored to high-risk individuals to improve adherence and outcomes in adult HT care.
Article Synopsis
- Among heart transplant recipients, a small number go on to receive multiple transplants, but the outcomes of these individuals are not well understood.
- A study of patients from the UNOS registry between 1990 and 2020 found that those receiving a third heart transplant had significantly higher rates of one-year and ten-year mortality compared to those who received their first or second transplant.
- The findings suggest that third heart transplants come with greater health risks, especially for older patients and those who experience acute graft failure, indicating a need for better management strategies for this unique group.
Article Synopsis
- Monitoring for graft rejection is essential in post-transplant care, especially in heart transplants, where traditional methods like endomyocardial biopsy (EMB) have limitations, including complications and variability in interpretation.
- Newer noninvasive tools, such as cardiac biomarkers, imaging, gene expression profiling, donor-derived cell-free DNA, and the molecular microscope diagnostic system (MMDx), have emerged as important alternatives for rejection surveillance.
- The paper argues for the use of MMDx to enhance early detection of rejection when results from EMB don't align with other noninvasive screening methods.
Article Synopsis
- A study was conducted to assess the risk factors and consequences of leukopenia (low white blood cell count) in patients following heart transplantation (HT), finding that 36% of recipients experienced this condition within the first 90 days post-transplant.
- The research included 506 adult HT recipients and identified that those who developed leukopenia had lower pre-transplant white blood cell counts, and the episode lasted for a median of 15.5 days.
- Importantly, early leukopenia was linked to an increased one-year mortality risk (6.6% for those with leukopenia vs. 2.1% for those without), indicating the need for further studies to optimize care for at-risk patients.
Article Synopsis
- Letermovir is a new medication for preventing cytomegalovirus (CMV) infections, especially in heart transplant recipients, that avoids the serious side effects linked to traditional treatments.
- In a study of 17 heart transplant patients, most were high-risk for CMV and received letermovir due to issues with another drug (valganciclovir); over half were still on letermovir after 5 months.
- Some patients experienced minor side effects or issues with CMV, highlighting the need for careful monitoring, and more research is needed to confirm letermovir's long-term safety and effectiveness.
Article Synopsis
- An increasing number of heart transplant (HT) recipients are presenting with pretransplant malignancies (PTM), rising from 3.2% in 2000 to 8.2% by 2020.
- PTM recipients experience higher 1-year mortality rates following HT, particularly those with hematologic cancers, but 5-year survival rates are similar for both PTM and non-PTM groups.
- The incidence of new malignancies at 5 years posttransplant is significantly greater in PTM patients, indicating a need for updated clinical guidelines that consider the complexities of this evolving patient population.
Donor-specific antibodies (DSA) are associated with antibody-mediated rejection (AMR) and poor patient survival. In heart transplant, the efficacy of intermittent intravenous immunoglobulin (IVIg) in reducing de novo DSA levels and treating AMR has not been characterized. We retrospectively studied a cohort of 19 patients receiving intermittent IVIg for elevated DSA and examined changes in DSA levels and graft function.
View Article and Find Full Text PDFBackground: One of the goals of the revised 6-tiered US adult heart allocation policy was to improve risk stratification of patients to lower exception status utilization for transplant listing. We sought to define the characteristics and outcomes of waitlisted patients using exception status and to examine region- and center-level differences in utilization of exception status in the new heart allocation system.
Methods: This retrospective cohort analysis of the United Network for Organ Sharing database included adult waitlisted patients for heart transplant between October 18, 2018, and June 30, 2020, in the United States, stratified by use of exception status versus standard criteria.
Article Synopsis
- Light-chain cardiac amyloidosis (AL CA) has a poorer survival prognosis compared to transthyretin cardiac amyloidosis (ATTR CA) after heart transplantation (OHT).
- A study comparing survival rates of 39 CA patients (18 AL and 21 ATTR) and 1023 non-amyloidosis patients showed significantly lower survival rates for AL in the early era of OHT (2001-2007).
- However, in the late era (2008-2018), survival rates for AL and ATTR patients improved and became similar to those of non-amyloidosis patients, indicating diminished differences in post-OHT survival outcomes.
The Mustard procedure is a palliative surgical procedure used to repair complete transposition of the great arteries. Cardiac transplantation remains the only definitive therapy for patients who develop heart failure after a Mustard procedure. However, pulmonary hypertension represents a major hemodynamic contraindication.
View Article and Find Full Text PDFBackground: Alternate waiting list strategies expand listing criteria for patients awaiting heart transplantation (HTx). We retrospectively analyzed clinical events and outcome of patients listed as high-risk recipients for HTx.
Methods And Results: We analyzed 822 adult patients who underwent HTx of whom 111 patients met high-risk criteria.
Background: Systemic amyloidosis complicated by heart failure is associated with high cardiovascular morbidity and mortality. Heart transplantation for patients with systemic amyloidosis is controversial due to recurrence of disease in the transplanted organ or progression of disease in other organs.
Methods: All patients with systemic amyloidosis and heart failure referred for heart transplant evaluation from 1997 to 2004 were included in this retrospective cohort analysis.
Wound-induced expression of the ferulate 5-hydroxylase gene in Camptotheca acuminata.
Biochim Biophys Acta
February 2006
The phenylpropanoid pathway plays important roles in plants following exposure to environmental stresses, such as wounding and pathogen attack, which lead to the production of a variety of compounds, including lignin, flavonoids and phytoalexins. Ferulate 5-hydroxylase (F5H) is a cytochrome P450-dependent monooxygenase that catalyses the hydroxylation of ferulic acid, coniferaldehyde and coniferyl alcohol, leading to sinapic acid and syringyl lignin biosynthesis. We isolated F5H cDNA and genomic DNA from Camptotheca acuminata and investigated the expression pattern of the C.
View Article and Find Full Text PDFThe expression of CSDC9 encoding S-adenosylmethionine decarboxylase (SAMDC) is developmentally and spatially regulated in carnation. To examine the regulation of the SAMDC gene, we analyzed the spatial expression of CSDC9 with a 5'-flanking beta-glucuronidase fusion in transgenic tobacco plants. GUS was strongly expressed in flower, pollen, stem and vein of cotyledons.
View Article and Find Full Text PDFThe regulation of ornithine decarboxylase (ODC) expression was studied in suspension-cultured tobacco (Nicotiana tabacum L.) BY2 cells. ODC activity increased rapidly 3 h after cells re-entered the cell cycle from the stationary phase, corresponding to the G1 phase, and continued to increase in the subsequent S phase, while the ODC transcript level increased only transiently.
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