heart transplantation
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2022 ◽  
Author(s):  
Rabea Asleh ◽  
Alexandros Briasoulis ◽  
Ilias Doulamis ◽  
Hilmi Alnsasra ◽  
Aspasia Tzani ◽  
...  

Author(s):  
Carlo Mariani ◽  
Antonio Loforte ◽  
Gregorio Gliozzi ◽  
Giulio G. Cavalli ◽  
Luca Botta ◽  
...  

2022 ◽  
Vol 23 (1) ◽  
pp. 1
Author(s):  
Morcos A. Awad ◽  
Aakash Shah ◽  
Bartley P. Griffith

2022 ◽  
Vol 11 (2) ◽  
pp. 322
Author(s):  
Rabea Asleh ◽  
Darko Vucicevic ◽  
Tanya M. Petterson ◽  
Walter K. Kremers ◽  
Naveen L. Pereira ◽  
...  

Mammalian target of rapamycin (mTOR) inhibitors have been shown to reduce proliferation of lymphoid cells; thus, their use for immunosuppression after heart transplantation (HT) may reduce post-transplant lymphoproliferative disorder (PTLD) risk. This study sought to investigate whether the sirolimus (SRL)-based immunosuppression regimen is associated with a decreased risk of PTLD compared with the calcineurin inhibitor (CNI)-based regimen in HT recipients. We retrospectively analyzed 590 patients who received HTs at two large institutions between 1 June 1988 and 31 December 2014. Cox proportional-hazard modeling was used to examine the association between type of primary immunosuppression and PTLD after adjustment for potential confounders, including Epstein–Barr virus (EBV) status, type of induction therapy, and rejection. Conversion from CNI to SRL as primary immunosuppression occurred in 249 patients (42.2%). During a median follow-up of 6.3 years, 30 patients developed PTLD (5.1%). In a univariate analysis, EBV mismatch was strongly associated with increased risk of PTLD (HR 10.0, 95% CI: 3.8–26.6; p < 0.001), and conversion to SRL was found to be protective against development of PTLD (HR 0.19, 95% CI: 0.04–0.80; p = 0.02). In a multivariable model and after adjusting for EBV mismatch, conversion to SRL remained protective against risk of PTLD compared with continued CNI use (HR 0.12, 95% CI: 0.03–0.55; p = 0.006). In conclusion, SRL-based immunosuppression is associated with lower incidence of PTLD after HT. These findings provide evidence of a benefit from conversion to SRL as maintenance therapy for mitigating the risk of PTLD, particularly among patients at high PTLD risk.


2022 ◽  
Author(s):  
Patrick Yerly ◽  
Samuel Rotman ◽  
Julien Regamey ◽  
Vincent Aubert ◽  
Stefania Aur ◽  
...  

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 87
Author(s):  
Khalil Jawad ◽  
Alex Koziarz ◽  
Maja-Theresa Dieterlen ◽  
Jens Garbade ◽  
Christian D. Etz ◽  
...  

Background: Peripartum cardiomyopathy (PPCM) is a rare, life-threatening form of heart disease, frequently associated with gene alterations and, in some cases, presenting with advanced heart failure. Little is known about ventricular assist device (VAD) implantation in severe PPCM cases. We describe long-term follow-up of PPCM patients who were resistant to medical therapy and received mechanical circulatory support or heart transplant. Methods and results: A total of 13 patients were included with mean follow-up of eight years. Mean age of PPCM onset was 33.7 ± 7.7 years. All patients were initially treated with angiotensin-converting enzyme inhibitors and beta-blockers, and four received bromocriptine. Overall, five patients received VADs (three biventricular, two isolated left ventricular) at median 27 days (range: 3 to 150) following childbirth. Two patients developed drive line infection. Due to the short support time, none of those patients had a stroke or VAD thrombosis. In total, five patients underwent heart transplantation, of which four previously had implanted VADs. Median time to transplantation from PPCM onset was 140 days (range: 43 to 776), and time to transplantation from VAD implantation were 7, 40, 132, and 735 days, respectively. All patients survived until most recent follow up, with the exception of one patient who died following unrelated abdominal surgery two years after PPCM recovery. Conclusions: In patients with severe, life-threatening PPCM refractory to medical management, mechanical circulatory support with or without heart transplantation is a safe therapeutic option.


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