Predictors and outcomes of severe primary graft dysfunction in heart transplantation: United States cohort analysis.

Background: This study aims to assess predictors and outcomes of severe primary graft dysfunction (PGD) in a contemporary United States cohort.

Methods: The United Network for Organ Sharing database was retrospectively reviewed for isolated adult heart transplant recipients (September 2023-March 2025). The population was stratified into severe PGD (left or biventricular dysfunction within 24 hours following transplantation that requires mechanical circulatory support [MCS]) and control cohorts (all other recipients).

Long-term outcomes of the international EXPAND trial of Organ Care System (OCS) Lung preservation for lung transplantation.

Background: Portable ex vivo lung perfusion and ventilation with the Organ Care System (OCS) Lung system is a safe, effective method for preserving extended criteria donor (ECD) organs before transplant. Although this technology is increasingly used in the United States, no published data describe its effects on long-term graft function and patient outcomes. This study assessed long-term clinical outcomes after transplantation of ECD lungs that were preserved, recruited, and assessed with the OCS Lung.

Complex Tricuspid and Pulmonic Carcinoid Heart Disease With Timely Surgical Repair.

A 63-year-old man with a history of hypertension, prediabetes, and sleep apnea presented with pedal edema, weight loss, and flushing. Laboratory work revealed elevated B-type natriuretic peptide and normocytic anemia. Echocardiography showed right ventricular enlargement, severe tricuspid valve regurgitation, and thickened tricuspid valve leaflets, raising suspicion for carcinoid heart disease.

Early outcomes of lung transplantation under the composite allocation score system.

Purpose: The Composite Allocation Score was introduced in March 2023 with the goal of improving organ allocation for potential lung transplant recipients. The purpose of this study is to characterize waitlist and post-transplant outcomes for adult lung transplant recipients under the Composite Allocation Score policy.

Methods: We included all adult candidates listed for isolated lung transplantation in the United States from May 2022 to December 2023.

T cell immune senescence is associated with frailty and sarcopenia in lung transplant candidates.

Backgound: Older lung transplant recipients experience increased rates of adverse clinical outcomes, including infection compared with younger patients, potentially related to impaired cell-mediated immunity, frailty, and sarcopenia.

Methods: Patients over age 55 years undergoing evaluation for lung transplantation were evaluated for sarcopenia by cross-sectional area and average attenuation of the pectoralis major muscle on chest computed tomography. Frailty was measured using the Fried Frailty Phenotype.

In-person versus virtual heart transplantation selection committee meetings: Longer-term impact on committee member perceptions and patient selection outcomes.

The COVID-19 pandemic led to changes in heart transplantation, including transitioning from in-person to virtual selection committee meetings. The longer-term impact of this transition on committee perceptions and patient selection outcomes has not been described. An anonymous survey was administered to our institution's selection committee.

Incidence and Risk Factors for Clinically Significant Oropharyngeal Dysphagia After Lung Transplantation.

Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population.

Triple-Organ Transplantation: Dual Heart-Kidney Transplantation After Lung Transplantation.

We present a patient with a history of lung transplantation who subsequently underwent dual heart-kidney transplantation for nonischemic cardiomyopathy and chronic kidney disease, becoming one of the rare cases of triple-organ transplantation. This case underscores the evolving challenges and successes in managing complex transplant recipients.

Practicality and Safety of Electrical Pulmonary Vein Isolation and Left Atrial Appendage Ligation in Lung Transplant Recipients With Pretransplant Atrial Fibrillation.

Background: Lung transplant surgery creates surgical pulmonary vein isolation (PVI) as a routine part of the procedure. However, many patients with pretransplant atrial fibrillation continue to have atrial fibrillation at 1 y. We hypothesized that the addition of electrical PVI and left atrial appendage isolation/ligation (LAL) to the lung transplant procedure restores sinus rhythm at 1 y in patients with pretransplant atrial fibrillation.

Safety and efficacy of delaying lung transplant surgery to a morning start.

Objective: We aimed to evaluate the safety and efficacy of delaying lung transplantation until morning for donors with cross-clamp times occurring after 1:30 am.

Methods: All consented adult lung transplant recipients between March 2018 and May 2022 with donor cross-clamp times between 1:30 am and 5 am were enrolled prospectively in this study. Skin incision for enrolled recipients was delayed until 6:30 am (Night group).

Lung Transplantation from hepatitis C+ donor lungs: Reassuring midterm outcomes.

Background: The development of modern antiviral therapy for hepatitis C virus (HCV) has allowed for the transplantation of HCV nucleic acid amplification testing-positive (NAT+) donor lungs with acceptable short-term outcomes. We sought to evaluate trends and midterm outcomes of lung transplant recipients of HCV NAT+ donor allografts.

Methods: All adults undergoing isolated lung transplantation in the United Network for Organ Sharing database from January 2016 to December 2022 were included in the study.

Characteristics and outcomes of lung transplants performed with ex-situ lung perfusion.

Background: Ex-situ lung perfusion (ESLP) can be used to assess and rehabilitate donor lungs, potentially expanding the donor pool. We examined the characteristics and outcomes of lung transplants performed with ESLP in the United States.

Methods: Retrospective review of the United Network for Organ Sharing registry of primary adult lung transplant recipients from February 28, 2018, to June 30, 2021, was performed, comparing baseline characteristics, in-hospital outcomes, and 1-year survival of ESLP vs no ESLP lung transplants.

Outcomes of heart transplant recipients bridged with percutaneous versus durable left ventricular assist devices.

Background: The new United Network for Organ Sharing (UNOS) heart allocation policy prioritizes temporary percutaneous over durable left ventricular assist devices (LVAD) as bridge to transplant. We sought to examine 1-year outcomes of heart transplant recipients bridged with Impella versus durable LVADs.

Methods: All primary adult orthotopic heart transplant recipients registered in UNOS between January 2016 and June 2021 were analyzed.

Sarcopenia Predicts Outcomes After Lung Transplantation in Older Lung Transplant Candidates.

Background: As lung transplantation (LT) expands to older recipients, objective approaches to evaluate the aging are needed to optimize posttransplantation outcomes. Frailty assessment and sarcopenia have shown promise as tools for predicting clinical outcomes.

Methods: Patients older than 55 years undergoing evaluation for LT were enrolled in an institutional review board-approved study.

The Impact of Transitioning From In-Person to Virtual Heart Transplantation Selection Committee Meetings: Observational Study.

Background: Heart transplant selection committee meetings have transitioned from in-person to remote video meetings during the COVID-19 pandemic, but how this impacts committee members and patient outcomes is unknown.

Objective: The aim of this study is to determine the perceived impact of remote video transplant selection meetings on usability and patient care and to measure patient selection outcomes during the transition period from in-person to virtual meetings.

Methods: A 35-item anonymous survey was developed and distributed electronically to the heart transplant selection committee.

Benefits of both physical assessment and electronic health record review to assess frailty prior to heart transplant.

Introduction: Frailty status affects outcomes after heart transplantation, but the optimal way to assess frailty prior to transplant remains unknown.

Methods: This single-center, observational study assessed 44 heart transplant candidates for frailty using three methods. The Short Physical Performance Battery (SPPB) and Fried Frailty Phenotype (FFP) were used as two physical assessments of frailty.

Venoarterial Versus Venovenous Extracorporeal Membrane Oxygenation As Bridge to Lung Transplantation.

Background: Venovenous (VV) extracorporeal membrane oxygenation (ECMO) has been used as a bridge to lung transplantation with acceptable outcomes. We hypothesized that venoarterial (VA) ECMO, as part of a multidisciplinary ECMO program, yields similar outcomes as VV ECMO as a bridge in lung transplantation.

Methods: Records of all patients who had undergone ECMO with the intention to bridge to lung transplantation at University of California, Los Angeles, from January 1, 2012, to March 31, 2020, were reviewed.

The allograft injury marker CXCL9 determines prognosis of anti-HLA antibodies after lung transplantation.

Despite the common detection of non-donor specific anti-HLA antibodies (non-DSAs) after lung transplantation, their clinical significance remains unclear. In this retrospective single-center cohort study of 325 lung transplant recipients, we evaluated the association between donor-specific HLA antibodies (DSAs) and non-DSAs with subsequent CLAD development. DSAs were detected in 30% of recipients and were associated with increased CLAD risk, with higher HRs for both de novo and high MFI (>5000) DSAs.