Transplantation – Heart
RCT: Hypothermic Oxygenated Perfusion Trends Toward Lower Primary Graft Dysfunction in Heart Transplantation – The Lancet
17 Aug, 2024 | 19:38h | UTCStudy Design and Population: This randomized, controlled, open-label, multicenter clinical trial evaluated the safety and efficacy of hypothermic oxygenated machine perfusion (HOPE) compared to static cold storage (SCS) in preserving donor hearts for transplantation. Conducted across 15 transplant centers in eight European countries, the study enrolled 229 adult heart transplant candidates between November 2020 and May 2023. The trial included 204 patients who received a transplant and met the study’s inclusion and exclusion criteria.
Main Findings: The primary composite endpoint, including cardiac-related death, graft dysfunction, and rejection within 30 days post-transplant, occurred in 19% of patients in the HOPE group compared to 30% in the SCS group, reflecting a 44% risk reduction (HR 0.56, 95% CI 0.32–0.99, p=0.059). Notably, primary graft dysfunction was significantly lower in the HOPE group (11% vs. 28%, RR 0.39, 95% CI 0.20–0.73). The incidence of major adverse cardiac transplant events was also reduced with HOPE (18% vs. 32%, RR 0.56, 95% CI 0.34–0.92).
Implications for Practice: HOPE showed a potential clinical benefit by reducing the incidence of primary graft dysfunction and major adverse cardiac events after heart transplantation. Although the primary endpoint was not statistically significant, the observed risk reductions suggest that HOPE could improve outcomes in heart transplantation. Further research is needed to confirm these findings and optimize donor heart preservation strategies.
Study | Left ventricular dysfunction in brain-dead heart donors – incidence, reversibility, and implications
31 Jul, 2023 | 14:09h | UTCLeft Ventricular Dysfunction Associated With Brain Death: Results From the Donor Heart Study – Circulation (free for a limited period)
AHA Statement | Indications, evaluation, and outcomes for dual heart-kidney and heart-liver transplantation
14 Jul, 2023 | 12:51h | UTC
RCT | Noninferior survival rates with hearts donated after circulatory death versus brain death
12 Jun, 2023 | 13:57h | UTCTransplantation Outcomes with Donor Hearts after Circulatory Death – New England Journal of Medicine (link to abstract – $ for full-text)
Video summary: Outcomes with Donor Hearts after Circulatory Death | NEJM
News Release: Multicenter Trial Finds Using Circulatory Death Donors is Safe and Effective for Heart Transplantation – Northwestern Medicine
Commentary: Transplantation Outcomes With Donor Hearts After Circulatory Death – American College of Cardiology
Commentary on Twitter
In a randomized trial, survival at 6 months after transplantation with hearts donated after circulatory death was noninferior to that with hearts donated after brain death. https://t.co/IymsknTqSE#cardiology pic.twitter.com/oYAS10fVJt
— NEJM (@NEJM) June 7, 2023
ISHLT Guideline | Mechanical circulatory support
29 May, 2023 | 10:40h | UTC
ISHLT Guidelines for the care of heart transplant recipients
3 May, 2023 | 15:09h | UTC
Expanding Organ Usage: UK study finds organs from patients with a primary brain tumor are a viable option
27 Mar, 2023 | 13:27h | UTCSummary: A national cohort study in the UK investigated the risk of cancer transmission from deceased donors with primary brain tumors to organ recipients. The study found no cases of brain tumor transmission among 778 transplants from 282 donors with primary brain tumors, including 262 from donors with high-grade tumors. Organ transplant survival was equivalent to that in matched controls, and some organs from donors with high-grade tumors were less likely to be transplanted.
The results suggest that the risk of cancer transmission in transplants from deceased donors with primary brain tumors is lower than previously thought. Furthermore, the study indicated that donors with brain tumors provided good-quality organs with favorable risk markers and excellent transplant outcomes. Some organs from donors with high-grade tumors were underutilized, indicating a possible aversion by transplant clinicians or patients to use these organs.
These findings imply that it may be possible to safely expand organ usage from donors with primary brain tumors without negatively impacting outcomes, potentially benefiting many patients waiting for a transplant. Although this might lead to a slight rise in transplant numbers in the UK, the findings may hold particular significance for nations with stricter guidelines, such as the United States. The study’s findings can help transplant clinicians discuss the risks and benefits of accepting organ offers from such donors.
Review | Temporary mechanical circulatory support: devices, outcomes, and future directions.
14 Jul, 2022 | 12:23h | UTC
Trends in advanced heart failure therapy: update on cardiac transplantation.
4 Jul, 2022 | 12:07h | UTCCardiac xenotransplantation: challenges, evolution, and advances.
20 Jun, 2022 | 00:58h | UTCCommentary: Many Hurdles to Clear Before Cardiac Xenotransplantation Takes Off – TCTMD
Related:
In 1st, US surgeons transplant pig heart into human patient – Associated Press
Results of Two Cases of Pig-to-Human Kidney Xenotransplantation – New England Journal of Medicine (link to abstract – $ for full-text)
After a flurry of firsts, xenotransplantation is suddenly back in the spotlight – STAT
Exploratory RCT suggests Cardiovascular Magnetic Resonance accurately diagnoses cardiac allograft rejection in the first year after transplantation.
6 Jun, 2022 | 10:56h | UTCNews Release: Virtual biopsy set to transform heart transplant care – Victor Chang Cardiac Research Institute
Commentary on Twitter
#OriginalResearch: In this #RCT, #CMR-based surveillance reliably graded cardiac allograft rejection compared to a biopsy-based strategy @vass_vassiliou #AHAJournals https://t.co/0kbpeXUtu1 pic.twitter.com/FwDGdJldHK
— Circulation (@CircAHA) June 2, 2022
Bring it on: Top five antimicrobial stewardship challenges in transplant infectious diseases and practical strategies to address them.
29 Apr, 2022 | 10:51h | UTC
Commentary on Twitter
🆕💥Review Article @ASHE_Journal
Bring it on: Top five antimicrobial stewardship challenges in transplant infectious diseases and practical strategies to address them #IDTwitter #medtwitter #TwitteRx #MedEd https://t.co/ToPLQXtC4r pic.twitter.com/pZQWWb3ZSx— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) April 28, 2022
Under a http://creativecommons.org/licenses/by/4.0/ license
Editorial: Pig-to-human transplants take a leap toward reality.
22 Mar, 2022 | 08:31h | UTCPig-to-human transplants take a leap toward reality – Nature Medicine
Retrospective Cohort Study: Association of donor brain death due to stroke with prognosis after heart transplantation.
17 Mar, 2022 | 08:33h | UTCAssociation of Donor Brain Death Due to Stroke With Prognosis After Heart Transplantation – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries:
Young Stroke Victims’ Hearts Might Not Be as Good for Transplantation – MedPage Today
Commentary on Twitter
🔑 Takeaway: #Stroke as the cause of donor brain death compared to all other causes of brain death was not associated w/ increased mortality or allograft failure in heart transplant recipients. Read more: https://t.co/NynBVsQSqh #cvSurg #cvHCM @MartyTamMD
— American College of Cardiology (@ACCinTouch) March 16, 2022
After a flurry of firsts, xenotransplantation is suddenly back in the spotlight.
25 Jan, 2022 | 09:09h | UTCAfter a flurry of firsts, xenotransplantation is suddenly back in the spotlight – STAT
Related: In 1st, US surgeons transplant pig heart into human patient.
In 1st, US surgeons transplant pig heart into human patient.
11 Jan, 2022 | 02:34h | UTCIn 1st, US surgeons transplant pig heart into human patient – Associated Press
RCT: Maribavir for refractory Cytomegalovirus infections with or without resistance post-transplant.
7 Dec, 2021 | 08:37h | UTC
FDA authorizes additional Covid-19 vaccine dose for certain immunocompromised individuals – Other fully vaccinated individuals do not need an additional vaccine dose right now.
16 Aug, 2021 | 01:22h | UTCCommentaries:
CDC, FDA recommend COVID booster for immune-compromised – CIDRAP
FDA authorizes additional dose of Covid-19 vaccine for the immunocompromised – STAT
Covid booster: US approves third jab for the immunocompromised – BBC
CDC Panel Recommends 3rd Vaccine Dose For Immunocompromised People – NPR
6 Things To Know If You’re Immunocompromised And Considering A 3rd Shot – NPR
CDC recommends third Covid-19 vaccine dose for certain immunocompromised people – CNN
Commentary on Twitter
The Infectious Diseases Society of America (IDSA) supports the @FDA and @CDCgov's decision to authorize a supplemental vaccine dose for immunocompromised patients.
Read our statement: https://t.co/odzzSgIxnY pic.twitter.com/4PZfUwpjhM
— IDSA (@IDSAInfo) August 13, 2021
RCT: third dose of Moderna mRNA vaccine increases immunity in transplant recipients.
12 Aug, 2021 | 09:56h | UTCEditorial: Third Time’s a Charm — Covid-19 Vaccine Hope for Solid-Organ Transplant Recipients
Related:
[Preprint] 3rd AstraZeneca shot gives strong immunity.
Commentaries on Twitter
https://twitter.com/hildabast/status/1425576801850433537
The authors conclude that a third-dose booster of mRNA-1273 vaccine should be considered for transplant recipients. https://t.co/Q3gakSaNjd pic.twitter.com/CMN8f7cq29
— NEJM (@NEJM) August 11, 2021
Donor drug use is not associated with worse recipient survival in heart transplantation – “Increasing use of such donors may help alleviate the chronic donor shortage.”
30 Jul, 2021 | 11:39h | UTCIntoxicated Donors and Heart Transplant Outcomes: Long-Term Safety – Circulation: Heart Failure
Commentary: Donor Drug Use Not Tied to Survival for Heart Transplant Recipients – HealthDay
Related study: National Trends in Heart Donor Usage Rates: Are We Efficiently Transplanting More Hearts? – Circulation: Heart Failure
Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients can improve the immunogenicity of the vaccine.
24 Jun, 2021 | 10:32h | UTC
Case series: Safety and immunogenicity of a third dose of SARS-CoV-2 vaccine in solid organ transplant recipients.
15 Jun, 2021 | 08:59h | UTCCommentaries: For Transplant Recipients, Third Time May Be the Charm for Better COVID Vaccine Protection – Hopkins Medicine AND Extra COVID Vaccine May Help Protect Transplant Patients – Associated Press
Commentary on Twitter
Our report about 3rd vaccine doses in transplant patients is published! "It is encouraging that antibody titers increased after the 3rd dose in 1/3 of patients who had negative antibody titers and in all patients who had low-positive antibody titers"https://t.co/6XElwyIdAa
— Dorry Segev (@Dorry_Segev) June 14, 2021
Cohort study shows inadequate antibody response to mRNA SARS-CoV-2 vaccine among kidney transplant recipients.
6 May, 2021 | 09:01h | UTC
Commentary on Twitter
https://twitter.com/hildabast/status/1390097665451462656
Organ transplant recipients remain vulnerable to Covid-19 even after second vaccine dose.
6 May, 2021 | 09:03h | UTCOriginal Study: Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients – JAMA
Systematic review: Interventions for increasing solid organ donor registration
28 Apr, 2021 | 08:11h | UTCInterventions for increasing solid organ donor registration – Cochrane Library
Summary: Interventions for increasing solid organ donor registration – Cochrane Library