Outcomes of Heart Transplantation

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425).

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 12478

Special Issue Editors


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Guest Editor
1. Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
2. Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
Interests: orthotopic heart transplant; multi-organ transplant; extracorporeal membrane oxygenation; ventricular assist device; organ preservation

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Guest Editor
Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, PA 19140, USA
Interests: myocardial protection/preservation; pulmonary protection/preservation; cardiac anatomy, structure and function; thoracic transplantation; mechanical circulatory support

Special Issue Information

Dear Colleagues,

This Special Issue of the Journal of Cardiovascular Development and Disease focusses on the outcome of orthotopic heart transplantation. Orthotopic heart transplantation is the gold standard treatment for end-stage heart failure. The median survival was 11.9 years for adult and paediatric heart transplants between 1992 and 2017. The conditional median survival, namely, the estimated time at which 50% of the recipients who survived to at least 1 year died, was 14.2 years.

In this Special Issue, we would like to bring together research on the fields of orthotopic heart transplantation. We invite authors to submit original research articles, case reports/series, technical articles, and reviews covering any aspect of heart transplantation; recipient indication; donor consideration; organ preservation; multi-organ transplant; outcomes; immunosuppression; postoperative management. To evaluate and organise the content of the issue, please let us know the preliminary title of your paper, the type of paper that you plan to submit and any additional information that would help us to determine how your intended contribution would fit into the Special Issue. For reviews, we will need to coordinate to avoid thematic overlaps.

This may also be an opportunity for surgeons, cardiologists, cardiac imagers, clinical fellows, and doctoral and post-doctoral trainees to contribute to a review article and showcase their area of expertise.

Dr. Yasuhiro Shudo
Prof. Dr. Yoshiya Toyoda
Guest Editors

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Keywords

  • orthotopic heart transplant
  • recipient indication
  • donor consideration
  • organ preservation
  • multi-organ transplant
  • outcomes
  • immunosuppression
  • postoperative management

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Published Papers (3 papers)

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Research

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11 pages, 1157 KiB  
Article
Donor-Recipient Weight Match in Pediatric Heart Transplantation: Liberalizing Weight Matching with Caution
by Ming Chen, Li Xu, Wenjing Yu, Xingyu Qian, Zhenqi Rao, Jingrong Tu, Nianguo Dong and Fei Li
J. Cardiovasc. Dev. Dis. 2022, 9(5), 148; https://doi.org/10.3390/jcdd9050148 - 7 May 2022
Cited by 1 | Viewed by 2384
Abstract
(1) Background: To expand the donor pool, greater donor hearts tended to be used in heart transplantation. However, the data about the feasibility of expanding the donor and recipient weight ratios (DRWRs. All donor and recipient weight ratio (DRWR) in this study or [...] Read more.
(1) Background: To expand the donor pool, greater donor hearts tended to be used in heart transplantation. However, the data about the feasibility of expanding the donor and recipient weight ratios (DRWRs. All donor and recipient weight ratio (DRWR) in this study or cited from other articles were converted to the DRWR calculated by ((donor weight-recipient weight)/recipient weight) × 100%.) to >30% was still scant in China’s pediatric heart transplantation (HTx). The potential risk increased along with the further expansion of the appropriate range of DRWR to >30% and its upper limit was still in debate. (2) Methods: Seventy-eight pediatric patients (age < 18 years) undergoing HTx between 2015 and 2020 at our center were divided into two groups based on the DRWR (>30% and ≤30%). Variables were summarized and analyzed via univariate analyses and multivariate analyses. A Kaplan-Meier methodology was used to calculate survival and conditional survival. (3) Results: No significant difference was found in one-year, three-year or five-year survival between the two groups. (4) Conclusions: The expansion of DRWR to >30% was acceptable for China’s pediatric HTx. Notably, continuously liberalizing of the upper DRWR boundary to more than 200% could be used as a stop-loss option but should be applied with caution. Full article
(This article belongs to the Special Issue Outcomes of Heart Transplantation)
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11 pages, 1826 KiB  
Article
Combining Prognostic Nutritional Index and Brain Natriuretic Peptide as a Predicting Tool for Heart Transplantation
by Ziwen Cai, Jingrong Tu, Li Xu, Yao Lin, Bowen Deng, Fei Li, Si Chen and Nianguo Dong
J. Cardiovasc. Dev. Dis. 2022, 9(2), 40; https://doi.org/10.3390/jcdd9020040 - 24 Jan 2022
Cited by 2 | Viewed by 2673
Abstract
Our study aimed to evaluate the potential of prognostic nutritional index (PNI) and Brain natriuretic peptide (BNP) in predicting the prognosis of heart transplantation (HTx). We retrospectively investigated 489 patients undergoing HTx between 2015 and 2020 in our center. The relationship between preoperative [...] Read more.
Our study aimed to evaluate the potential of prognostic nutritional index (PNI) and Brain natriuretic peptide (BNP) in predicting the prognosis of heart transplantation (HTx). We retrospectively investigated 489 patients undergoing HTx between 2015 and 2020 in our center. The relationship between preoperative index and prognosis was analyzed respectively, the optimal cut-off values for preoperative PNI and BNP level were evaluated with receiver operating curve analysis. Uni-variate analysis and multivariate analysis were used to compare baseline data (sex, age, diagnosis, etc.) of groups divided by the level of PNI and BNP. Propensity score matching (PSM) was applied to eliminate bias. We calculated the C-index from the prediction efficiency of PNI and BNP. During the period, 489 recipients undergoing HTx in our center were included according to the inclusion criteria; 383 (78.3%) males and 106 (21.7%) females were included in this study, with a median age of 47.57 years old. The ROC curve showed that the optimal cut-off values of each indicator were verified as 49.345 for PNI, and 4397.500 for BNP. The multivariate analyses indicated that PNI (p = 0.047), BNP (p = 0.024), age (p = 0.0023), and waiting time (p = 0.012) were risk factors for all-cause death after HTx. Propensity score matching generated 116 pairs based on PNI level and 126 pairs based on BNP level, and the results showed that OS (overall survival) was significantly correlated with PNI (n = 232, p = 0.0113) and BNP (n = 252, p = 0.0146). Our study implied that higher PNI and lower BNP level had direct correlation with better survival after HTx. Combining PNI and BNP together would be a potential clinical preoperative instrument to predict the survival of patients after HTx, especially in short-term survival. Full article
(This article belongs to the Special Issue Outcomes of Heart Transplantation)
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Review

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17 pages, 3232 KiB  
Review
Failing Heart Transplants and Rejection—A Cellular Perspective
by Maria Hurskainen, Olli Ainasoja and Karl B. Lemström
J. Cardiovasc. Dev. Dis. 2021, 8(12), 180; https://doi.org/10.3390/jcdd8120180 - 12 Dec 2021
Cited by 5 | Viewed by 6608
Abstract
The median survival of patients with heart transplants is relatively limited, implying one of the most relevant questions in the field—how to expand the lifespan of a heart allograft? Despite optimal transplantation conditions, we do not anticipate a rise in long-term patient survival [...] Read more.
The median survival of patients with heart transplants is relatively limited, implying one of the most relevant questions in the field—how to expand the lifespan of a heart allograft? Despite optimal transplantation conditions, we do not anticipate a rise in long-term patient survival in near future. In order to develop novel strategies for patient monitoring and specific therapies, it is critical to understand the underlying pathological mechanisms at cellular and molecular levels. These events are driven by innate immune response and allorecognition driven inflammation, which controls both tissue damage and repair in a spatiotemporal context. In addition to immune cells, also structural cells of the heart participate in this process. Novel single cell methods have opened new avenues for understanding the dynamics driving the events leading to allograft failure. Here, we review current knowledge on the cellular composition of a normal heart, and cellular mechanisms of ischemia-reperfusion injury (IRI), acute rejection and cardiac allograft vasculopathy (CAV) in the transplanted hearts. We highlight gaps in current knowledge and suggest future directions, in order to improve cellular and molecular understanding of failing heart allografts. Full article
(This article belongs to the Special Issue Outcomes of Heart Transplantation)
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