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Impact of Heart Transplant Allocation Changes on Waitlist Mortality and Clinical Practice in Pediatric and Adult Patients With Congenital Heart Disease and Cardiomyopathy.

Circulation

January 2025

Division of Cardiology, Children's Hospital of Philadelphia and Department of Pediatrics (L.W., M.J.O., H.A., J.E., K.Y.L., C.W.-W., J.R., J.B.E.), University of Pennsylvania, Philadelphia.

Background: The United Network of Organ Sharing made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. Although recent work has evaluated the impact of the revised allocation systems on mechanical circulatory support practices and waitlist outcomes, there are limited data that focus more specifically on the impact of the allocation changes on patients with congenital heart disease (CHD) or cardiomyopathy and how these relationships might differ in pediatric and adult patients.

Methods: The United Network of Organ Sharing database was queried for pediatric (<18 years of age) and adult (18-50 years of age) patients with a CHD or cardiomyopathy diagnosis listed for HT.

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Fifteen-year experience of direct bridge with venoarterial extracorporeal membrane oxygenation to heart transplantation.

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December 2024

Thoracic and Cardiovascular Surgery Department, Sorbonne Université, APHP, Groupe Hospitalier Pitié-Salpétrière, Institute of Cardiology, Paris, France.

Objective: The study objective was to evaluate outcomes of patients directly bridged with venoarterial extracorporeal membrane oxygenation to heart transplantation.

Methods: A single-center retrospective study was performed on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with an extracorporeal membrane oxygenation to transplantation (extracorporeal membrane oxygenation group, n = 317) were compared with standard cohorts of patients (no extracorporeal membrane oxygenation group, n = 835).

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Objective: There are limited data on the outcome of routine cardiac operations in patients with cardiac amyloidosis. This study studied the impact of amyloidosis on early and late results of cardiac operations.

Methods: This was a retrospective, propensity-matched, case-control study of patients with cardiac amyloidosis undergoing cardiac surgery.

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Objective: Machine learning (ML) may allow for improved discernment of hemodynamics and oxygen delivery compared to standard invasive monitoring. We hypothesized that an ML algorithm could predict impaired delivery of oxygen (IDO) with comparable discrimination to invasive mixed venous oxygen saturation (SvO) measurement.

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Background: The therapeutic management of patients with multivessel disease and severe left ventricular dysfunction is complex and controversial.

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