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The 2024 American Association for Thoracic Surgery expert consensus document: Current standards in donor lung procurement and preservation.
J Thorac Cardiovasc Surg
February 2025
Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure.
View Article and Find Full Text PDFIn the Twilight of Evidence: Is Bypass Surgery Still on the Table for Cardiac Allograft Vasculopathy?
J Clin Med
December 2024
Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland.
Cardiac allograft vasculopathy (CAV) is a major prognosis-limiting factor in patients undergoing orthotopic heart transplantation (HT). Due to the diffuse involvement of the coronary tree, CAV lesions are often not amenable to percutaneous coronary intervention (PCI), leaving coronary artery bypass grafting (CABG) and retransplantation as primary revascularization options. : The latest guidelines from the International Society for Heart and Lung Transplantation (ISHLT) recognize CABG as a viable option but with a downgraded strength of recommendation.
View Article and Find Full Text PDFIncidence and risk factors for rejection after conversion from calcineurin inhibitor to sirolimus-based immunosuppression in orthotopic heart transplant recipients.
J Heart Lung Transplant
December 2024
Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, Minnesota; Deparment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address:
Background: Although recommended in International Society for Heart and Lung Transplantation (ISHLT) guidelines, transition to mammalian targets of rapamycin (mTOR) inhibitors in heart transplant recipients is not routinely performed, in part due to perceived risk of rejection. This study sought to evaluate the incidence and risk factors for biopsy-proven, clinically relevant rejection following conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) immunosuppression.
Methods: A single center retrospective study was conducted of all consecutive adult patients who underwent orthotopic heart transplantation (OHT) and CNI-free SRL conversion from January 1999 to January 2023.
Impact of donor age ≥65 years on graft survival in large lung transplant cohorts.
J Heart Lung Transplant
November 2024
Lung Transplant Service, Alfred Hospital and Monash University, Melbourne, Australia. Electronic address:
Background: Although the demand for allografts continuously surpasses the supply, the majority of lungs offered for transplant are declined based on various factors, including donor age. This in turn sustains the wait-list mortality of patients with end-stage pulmonary disease.
Methods: In this single-center, observational cohort study, we investigated the impact of donor age on graft survival.
Sacubitril/Valsartan in Pediatric Heart Failure (PANORAMA-HF): A Randomized, Multicenter, Double-Blind Trial.
Circulation
November 2024
M3C-Necker, Congenital and Paediatric Cardiology Department, Hospital Necker-Enfants Malades, University of Paris Cité, France (D.B.).
Background: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), is an established treatment for heart failure (HF) with reduced left ventricular ejection fraction. It has not been rigorously compared with angiotensin-converting enzyme inhibitors in children. PANORAMA-HF (Prospective Trial to Assess the Angiotensin Receptor Blocker Neprilysin Inhibitor LCZ696 Versus Angiotensin-Converting Enzyme Inhibitor for the Medical Treatment of Pediatric HF) is a randomized, double-blind trial that evaluated the pharmacokinetics and pharmacodynamics (PK/PD), safety, and efficacy of sacubitril/valsartan versus enalapril in children 1 month to <18 years of age with HF attributable to systemic left ventricular systolic dysfunction (LVSD).
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