Effects of Older Donor Age and Cold Ischemic Time on Long-Term Outcomes of Heart Transplantation.

Using older donor hearts in cardiac transplantation may lead to inferior outcomes: older donors have more comorbidities that reduce graft quality, including coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia. Shorter cold ischemic times might overcome the detrimental effect of older donor age. We examined the relationship between donor allograft age and cold ischemic time on the long-term outcomes of heart transplant recipients.

Characterizing Predictors and Severity of Vasoplegia Syndrome After Heart Transplantation.

Background: Vasoplegia is characterized as a severe vasodilatory shock after cardiac surgery, and can be associated with substantial morbidity. Increased systemic inflammation and endothelial dysfunction, often related to prolonged cardiopulmonary bypass times, anesthesia, or mechanical circulatory support have been shown to be associated with the development of vasoplegia. We sought to identify risk factors and the impact of various degrees of vasoplegia after heart transplantation.

Revealing a new mode of sensitization induced by mechanical circulatory support devices: Impact of anti-AT R antibodies.

Background: Increased levels of angiotensin II type 1 receptor (AT R) antibody have been shown to be associated with allograft rejection. This study aims to determine the rate of development of antibody to AT R after mechanical circulatory support device (MCS) implantation, and if the development of strong binding AT R antibodies is associated with survival.

Methods: Eighty-eight patients who had one MCS implantation were accessed based on serum availability.

Prolonged corrected QT interval in the donor heart: Is there a risk?

Background: Assessing the QT interval in donors is important to exclude long QT syndrome as the cause of death. A donor heart with a corrected QT (QT ) >500 milliseconds is often concerning. We sought to evaluate first year outcomes for donors with a QTc interval >500 milliseconds.

Vasoplegia after heart transplantation: outcomes at 1 year.

Objectives: Vasoplegia syndrome is a potentially life-threatening condition that can occur following cardiopulmonary bypass. Heart transplantation is a recognized risk factor for developing this vasodilatory state. The objective of this study was to determine the effects of vasoplegia syndrome on 1-year heart transplant outcomes.

Corticosteroid wean after heart transplantation-Is there a risk for antibody formation?

Background: Corticosteroid withdrawal after heart transplantation is limited to select immune-privileged patients but it is not known whether this predisposes patients to a higher risk for sensitization.

Methods: A total of 178 heart transplant recipients had panel-reactive antibody (PRA) measurements at transplant and every 6 months and were monitored for rejection with protocol endomyocardial biopsies. Corticosteroid withdrawal was initiated at 6 months post-transplant in select patients.

Intermediate outcomes with ex-vivo allograft perfusion for heart transplantation.

Background: The Organ Care System, an ex-vivo heart perfusion platform, represents an alternative to the current standard of cold organ storage that sustains the donor heart in a near-physiologic state. It is unknown whether using the Organ Care System influences 2-year outcomes after heart transplantation. We reviewed our institutional experience to compare 2-year outcomes for patients randomized to the Organ Care System or standard cold storage.