scholarly journals Long-Term Survival in a Young Adult with Total Artificial Heart: A Success Story

2015 ◽  
Vol 3 (1) ◽  
pp. 7-10
Author(s):  
Öztekin Oto ◽  
Tuğra Gençpınar ◽  
Gökmen Akkaya
Keyword(s):  
Young Adult ◽  
Artificial Heart ◽  
Total Artificial Heart ◽  
Success Story ◽  
Term Survival ◽  
Long Term Survival

scholarly journals A heart transplant after total artificial heart support: initial and long-term results

2020 ◽  
Vol 58 (6) ◽  
pp. 1175-1181
Author(s):  
Charles-Henri David ◽  
Philippe Lacoste ◽  
Prakash Nanjaiah ◽  
Philippe Bizouarn ◽  
Thierry Lepoivre ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Artificial Heart ◽  
Survival Rates ◽  
Total Artificial Heart ◽  
Long Term Results ◽  
Term Survival ◽  
Long Term Survival ◽  
Bridge To Transplant ◽  
Biventricular Failure

Abstract OBJECTIVES At our centre, the SynCardia temporary Total Artificial Heart (TAH-t) (SynCardia Systems, LLC, Tucson, AZ, USA) is used to provide long-term support for patients with biventricular failure as a bridge to a transplant. However, a heart transplant (HT) after such support remains challenging. The aim of this retrospective study was to assess the immediate and long-term results following an HT in the cohort of patients who had a TAH-t implant. METHODS A total of 73 patients were implanted with the TAH-t between 1988 and 2019 in our centre. Of these 73 consecutive patients, 50 (68%) received an HT and are included in this retrospective analysis of prospectively collected data. RESULTS In the selected cohort, in-hospital mortality after an HT was 10% (n = 5). The median intensive care unit stay was 33 days (range 5–278). The median hospital stay was 41 days (range 28–650). A partial or total pericardiectomy was performed during the HT procedure in 21 patients (42%) due to a severe pericardial reaction. Long-term survival rates after an HT at 5, 10 and 12 years were 79.1 ± 5.9% (n = 32), 76.5 ± 6.3% (n = 22) and 72.4 ± 7.1% (n = 12), respectively, which was similar to the long-term survival for a primary HT without TAH-t during the same period (n = 686). An HT performed within 3–6 months post-TAH-t implantation appeared to provide the best survival (P = 0.007). Eight (16%) patients required chronic dialysis during the subsequent follow-up period, with 3 patients requiring a kidney transplant. CONCLUSIONS The long-term outcomes with the SynCardia TAH-t as a bridge to transplant in patients with severe biventricular failure are very encouraging. Our review noted that an HT following TAH-t can be technically challenging, especially in the case of a severe pericardial reaction, with potential pitfalls that should be recognized preoperatively.

scholarly journals Long‐term survival among 5‐year survivors of adolescent and young adult cancer

Cancer ◽  
2020 ◽  
Vol 126 (16) ◽  
pp. 3708-3718 ◽  
Author(s):  
Amy M. Berkman ◽  
J. A. Livingston ◽  
Kelly Merriman ◽  
Michelle Hildebrandt ◽  
Jian Wang ◽  
...  
Keyword(s):  
Young Adult ◽  
Adolescent And Young Adult ◽  
Term Survival ◽  
Long Term Survival ◽  
Young Adult Cancer

Young Adult Patients with Post -HCT Relapse of AML May Benefit from Aggressive Salvage and 2nd Cellular Therapy

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5482-5482
Author(s):  
Syed Osman Ahmed ◽  
Amna Gamil ◽  
Muhamad Hitham Almahayni ◽  
Naeem A. Chaudhri ◽  
Fahad Alsharif ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Young Adult ◽  
Cellular Therapy ◽  
Significant Proportion ◽  
Patient Choice ◽  
Adult Patients ◽  
Term Survival ◽  
Long Term Survival

Abstract A Significant Proportion of Young Adult Patients with Post -HCT Relapse Of AML Benefit From Aggressive Salvage And 2nd Cellular Therapy. INTRODUCTION: There is currently no standard of care for patients with AML who relapse following hematopoietic cell transplantation (HCT), and outcomes in these patients are generally poor. Given this fact, there is great variability in practice, and many patients may be palliated in the absence of suitable clinical trials, especially following early relapses. We sought to analyse long-term survival of young adults with AML based on whether or not they received a second cellular therapy (CT) (second transplant or donor lymphocyte infusion [DLI]) following post-HCT relapse. METHODS: We retrospectively analysed data on patients who had received a HCT between 2000 and 2012 and had a post HCT relapse. The patients were stratified by whether or not they had 2nd CT with or without prior chemotherapy. Baseline characteristics and outcomes were compared. RESULTS: Ninety four patients were identified who had relapsed AML following HCT. The median age at transplant for the patients was 27.5 (range 14-58y) years for the whole cohort; 50% were females. Of these, 30 patients received 2nd CT either in the form of DLI (80% for available CT data) or a 2nd HCT. Median in age for both groups was 24 years and there was no significant difference between the 2 groups in good or poor risk cytogenetics. Median time to relapse was significantly lower in the group that did not receive 2nd CT vs the group that did (5.9 vs 18.2 months, p<0.001). For the 64 patients that did not receive 2nd CT, reasons included early relapse (28 cases), presence of GVHD (15 cases), refractory to salvage (8 cases), poor performance (9 cases), and patient choice (4). The OS for patients who did not receive 2nd CT was 4.5 months ± 2.6% vs 36% ± 11% for patients who did receive 2nd CT (Fig.1). Of the 6 patients in the 2nd CT group who relapsed in <6 months, only 1 survived long term (16%). Conclusion: The management of post BMT relapse remains challenging, and a number of factors may preclude intensive therapy post-HCT relapse. However, our experience confirms that a proportion of patients do benefit from long-term survival from a strategy of aggressive salvage followed either by DLI or a second HCT; in addition to disease biology, a treatment bias where early relapses are less likely to be treated aggressively partly explains the difference in outcome in the groups. This strategy should be considered in young fit patients and may lead to long-term survival in a significant proportion of young adults; patients with later relapses beyond 6 months appear to derive a greater benefit. Prospective clinical trials are required incorporating novel therapies in patients who relapse early post HCT. Disclosures No relevant conflicts of interest to declare.

Continuous-flow total artificial heart port-to-port connection technique using dedicated de-airing sleeve

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 861-864
Author(s):  
Jamshid H Karimov ◽  
Shengqiang Gao ◽  
Kiyotaka Fukamachi ◽  
Patrick Grady
Keyword(s):  
Continuous Flow ◽  
Artificial Heart ◽  
Surgical Techniques ◽  
Total Artificial Heart ◽  
Circulatory Support ◽  
Term Survival ◽  
Support Device ◽  
Mechanical Circulatory Support Device

Preventing the introduction of air while a mechanical circulatory support device is being implanted is critical for successful outcomes. A substantial amount of air may be introduced into the circulation during the pump-to-outflow and/or pump-to-inflow port connection, which can be detrimental to optimal pump function and long-term survival. We have developed a novel connecting sleeve that enables an airless connection of the continuous-flow total artificial heart to the conduits. Herein, we describe the device design and surgical techniques evaluated in vivo.

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