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Introduction: There is no standard protocol for management of organ preservation for orthotopic, life-sustaining cardiac xenotransplantation, particularly for hearts from pediatric sized donors. Standard techniques and solutions successful in human allotransplantation are not viable. We theorized that a solution commonly used in reparative cardiac surgery in human children would suffice by exploiting the advantages inherent to xenotransplantation, namely the ability to reduce organ ischemic times by co-locating the donor and recipient.

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Early Results of an Infant Model of Orthotopic Cardiac Xenotransplantation.

J Heart Lung Transplant

January 2025

Division of Cardiac Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA. Electronic address:

Objective: Genetically engineered porcine hearts may have an application for infants in need of a bridge to cardiac allotransplantation. The current animal model that resulted in 2 human applications has been validated in adult non-human primates only. We sought to create an infant animal model of life sustaining cardiac xenotransplantation to understand limitations specific to this age group.

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Background: Tricuspid regurgitation (TR) is common immediately after orthotopic heart transplantation (OHT), though the expected outcomes of TR over time remain undefined. In this study, we examined the natural trajectory of TR in the first 120 days post-transplantation. We observed the clinical phenotypes of trajectories of TR after OHT, and assessed trajectory correlation with 1-year mortality and degree of right ventricular (RV) dysfunction.

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Transcatheter Caval Implantation for Severe Tricuspid Regurgitation.

Curr Cardiol Rep

January 2025

Department of Cardiovascular Medicine, Heart Vascular & Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, J2-3, Cleveland, OH, 44195, USA.

Purpose Of Review: We describe the evolution of caval valve implantation (CAVI) as a treatment for severe symptomatic tricuspid regurgitation (TR) in the high surgical risk patient.

Recent Findings: Surgical treatment of severe TR is often limited by the high surgical risk of the patients who tend to develop severe secondary TR. Coaptation, annuloplasty, and orthotopic replacement strategies are all limited by annular and leaflet geometry, prior valve repair, and the presence of cardiac implantable device leads.

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Background: Improvement in gene modifications of donor pigs has led to the prevention of early cardiac xenograft rejection and significantly prolonged cardiac xenograft survival in both heterotopic and orthotopic preclinical non-human primate (NHP) models. This progress formed the basis for FDA approval for compassionate use transplants in two patients.

Methods: Based on our earlier report of 9-month survival of seven gene-edited (7-GE) hearts transplanted (life-supporting orthotopic) in baboons, we transplanted 10 gene-edited pig hearts into baboons (n = 4) using non-ischemic continuous perfusion preservation (NICP) and immunosuppression regimen based on co-stimulation blockade by anti-CD40 monoclonal antibody.

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