Mediastinal radiation and adverse outcomes after heart transplantation.

Orthotopic heart transplantation (OHT) may represent the only treatment option for patients with end-stage cardiovascular disease due to mediastinal radiation therapy (MRT). The primary aim of this study was to evaluate the safety and efficacy of OHT in this patient population. We conducted a retrospective, single-center cohort study of patients with MRT-associated cardiovascular disease who underwent OHT between January 1987 and September 2008.

Higher rate of comorbidities after cardiac retransplantation contributes to decreased survival.

Background: Cardiac retransplantation is the definitive treatment for allograft failure despite decreased long-term survival in these patients. The cause of the poorer outcomes in cardiac retransplant patients is unclear.

Methods: This study was a retrospective analysis of 859 adult cardiac transplant patients.

Heart transplantation in human immunodeficiency virus-positive patients.

Background: Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of HIV-positive cardiac transplant recipients.

Neurocognitive assessments in advanced heart failure patients receiving continuous-flow left ventricular assist devices.

Background: Neurocognitive (NC) changes in heart failure patients receiving left ventricular assist devices (LVADs) are not well understood. The purpose of this study was to document changes in the cognitive performance of patients with the continuous-flow HeartMate II LVAD as a bridge to transplant (BTT).

Methods: A NC protocol was used to evaluate patient performance at 1, 3 and 6 months after LVAD implantation at 11 centers.