Publications by authors named "Gavin Hickey"
Center Experience is Associated with Greater Survival following Donation after Circulatory Death Heart Transplantation.
J Heart Lung Transplant
August 2025
Background: Higher center volume has been associated with improved outcomes in solid organ transplantation. However, the impact of center experience on donation after circulatory death (DCD) heart transplantation outcomes remains unclear. This study evaluates the association between cumulative DCD center experience and DCD posttransplant survival.
View Article and Find Full Text PDFObjective: To describe the outcomes of patients receiving axillary (Ax) IABP and compare with those receiving Femoral (Fem) IABP for heart failure related cardiogenic shock (HF-CS).
Background: IABPs are traditionally placed via the femoral artery. Single center studies have shown the utility of axillary placement to promote ambulation.
Background: This study evaluates clinical trends and mid-term waitlist and posttransplant outcomes following the 2018 heart allocation policy change.
Methods: The United Network for Organ Sharing registry was queried to analyze adult waitlisted and transplanted patients undergoing isolated heart transplantation. Two analyses were conducted: (1) waitlist and (2) posttransplant outcomes.
Background: Intra-aortic balloon pump (IABP) insertion has not been shown to improve mortality rates in acute myocardial infarction-related cardiogenic shock (AMI-CS) but is increasingly used in heart failure-related cardiogenic shock (HF-CS).
Objective: We sought to compare IABP-related outcomes in patients with HF-CS and AMI-CS.
Methods: The Cardiogenic Shock Working Group registry was queried for patients with CS receiving femoral IABPs as the first temporary mechanical circulatory support (tMCS) device.
Direct Cardiac Mechanisms of the Sodium Glucose Co-Transporter 2 Inhibitor Class.
J Cardiovasc Pharmacol Ther
April 2025
BackgroundSodium-glucose co-transporter 2 (SGLT2) inhibitors have demonstrated significant cardiovascular benefits in clinical trial. While their role in reducing heart failure hospitalizations and cardiovascular mortality is well established, the precise mechanisms underlying their direct cardiac effects remain unclear. This literature review aims to synthesize current knowledge on the molecular and physiological pathways by which SGLT2 inhibitors may exert effects on cardiac tissue, independent of glycemic control.
View Article and Find Full Text PDFBackground: Temporary mechanical circulatory support (tMCS) for cardiogenic shock (CS) is increasing despite knowledge gaps and variations in management practices. This document was created to provide clinicians with guidance regarding initiation, escalation, and de-escalation of tMCS in patients with CS.
Methods: An interdisciplinary, international expert panel using a structured literature appraisal and modified Delphi method derived consensus statements regarding triggers for prompt patient assessment and initiating tMCS in CS, assessing adequacy of support, readiness for tMCS weaning, and next steps in nonrecovery.
Background: Outcomes associated with worsening renal function (WRF) in cardiogenic shock (CS) remain poorly understood.
Objectives: To study the incidence of WRF in heart failure-CS (HF-CS) and acute myocardial infarction CS (AMI-CS), examine its association with in-hospital mortality (IHM) rates, define the trajectory of renal function in CS, and identify independent predictors of WRF in HF-CS vs AMI-CS.
Methods: Patients in the Cardiogenic Shock Working Group registry (CSWG) from 2021-2024 were analyzed; those with baseline end-stage renal disease were excluded.
With encouraging early experience, ex vivo machine perfusion (MP) systems are increasingly employed in heart transplantation. In this study, utilizing a national registry database, 2 separate analyses were performed to evaluate the effects of MP on graft preservation time (total n = 22,794; n = 308 with MP) and donor age (total n = 22,581; n = 95 with MP) in donation after brain death (DBD) heart transplantation. The cohort was stratified based on total preservation time (<4 and ≥4 hours) and donor age (<45 and ≥45 years).
View Article and Find Full Text PDFDurable left ventricular assist device in donation after circulatory death heart transplantation.
J Heart Lung Transplant
July 2025
Background: This study evaluates outcomes following donation after circulatory death (DCD) heart transplantation in recipients with a durable left ventricular assist device (LVAD).
Methods: The UNOS registry was queried to analyze adult recipients of isolated DCD heart transplantation between 1/1/2019-3/31/2023. The recipients were stratified by durable LVAD use as a bridge to transplantation.
Background: This study evaluates the effects of nighttime procurement and transplantation on outcomes following heart transplantation.
Methods: The UNOS registry was queried to analyze adult recipients who underwent isolated orthotopic heart transplantation between January 1, 2010, and September 30, 2022. The cohort was stratified into daytime (4 am-8 pm) and nighttime (8 pm-4 am) transplant groups.
Article Synopsis
- The UNOS 2018 heart allocation policy prioritizes patients on temporary mechanical circulatory support (tMCS) due to their high risk of mortality while waiting for a heart transplant.
- A study analyzed 27,343 adults on the waitlist and found a significant increase in tMCS use from 7.4% to 22.4% after the policy change.
- Results showed that patients on tMCS had lower waitlist mortality, higher chances of receiving a transplant, and similar one-year mortality rates after transplantation compared to previous trends.
Article Synopsis
- - The study investigates how donor cardiopulmonary resuscitation (CPR) status affects the outcomes of heart transplants from donors after circulatory death (DCD).
- - An analysis of 683 adult DCD heart transplant recipients showed that those who received donor hearts from CPR donors had similar 1-year survival rates (around 92%) as those from non-CPR donors.
- - Results indicate that using DCD hearts from donors who underwent CPR can help increase the availability of donor organs without harming initial post-transplant survival rates.
Background: This study evaluates the impact of the agonal phase and related hemodynamic measures on post-transplant outcomes and heart utilization in donation after circulatory death (DCD) heart transplantation.
Methods: United Network for Organ Sharing registry was queried to analyze adult recipients who underwent isolated DCD heart transplantation between January 1, 2019 and September 30, 2023. The recipients were stratified into 2 groups based on donor agonal period: <30 and ≥30 minutes.
Background: This study evaluates the effects of pre-transplant transpulmonary gradient (TPG) and donor right ventricular mass (RVM) on outcomes following heart transplantation.
Methods: UNOS registry was queried to analyze adult recipients who underwent primary isolated heart transplantation from 1/1/2010 to 12/31/2018. The recipients were dichotomized into 2 groups based on their TPG at the time of transplantation, < 12 and ≥ 12 mmHg.
Article Synopsis
- Cardiogenic shock (CS) is a serious condition that can lead to severe complications, and this study looked at how changes in hemodynamic (blood flow-related) measurements correlate with patient outcomes in those suffering from heart failure or heart attack.
- Researchers analyzed data from over 2,200 patients to compare the hemodynamic profiles at the start and end of hospitalization, finding that mortality rates were higher in patients with acute myocardial infarction compared to those with heart failure.
- The study revealed that improvements in various hemodynamic and metabolic factors during hospitalization, such as lower blood pressure and better cardiac output, were linked to increased survival rates in both groups of patients.
Mid-term Waitlist and Posttransplant Outcomes With Hepatitis C-positive Donor Hearts.
Transplantation
April 2025
Background: This study evaluates the clinical trends and impact of hepatitis C virus-positive (HCV+) donors on waitlist and posttransplant outcomes after heart transplantation.
Methods: The United Network for Organ Sharing registry was queried to identify adult waitlisted and transplanted patients from January 1, 2015, to December 31, 2022. In the waitlist analysis, the candidates were stratified into 2 cohorts based on whether they were willing to accept HCV+ donor offers.
Serial Shock Severity Assessment Within 72 Hours After Diagnosis: A Cardiogenic Shock Working Group Report.
J Am Coll Cardiol
August 2024
Article Synopsis
- The CSWG-SCAI staging system helps assess the severity of cardiogenic shock (CS) in patients, but there’s limited data on how these stages change over time and affect outcomes.
- This study analyzed data from 3,268 patients with acute myocardial infarction-related CS and heart failure-related CS to see how their SCAI stages changed over 72 hours.
- Findings showed that most patients’ stages changed within the first 24 hours, particularly those in stage B who had a high risk of worsening, indicating that early detection and ongoing evaluation are crucial for improving patient outcomes.
Background: This study evaluates the interaction of donor and recipient age with outcomes following heart transplantation under the 2018 heart allocation system.
Methods: The United Network for Organ Sharing registry was queried to analyze adult primary isolated orthotopic heart transplant recipients and associated donors from August 18, 2018, to June 30, 2021. Both recipient and donor cohorts were grouped according to age: <65 and ≥65 y for recipients and <50 and ≥50 y for donors.
Article Synopsis
- * The study, called PROACTIVE-HF, assessed the safety and effectiveness of this monitoring method in 456 patients with chronic heart failure across various centers in the US and Europe.
- * Results showed a 6-month event rate of 0.15 hospitalizations or deaths per patient, far below the goal of 0.43, with a very high safety rate for the device.
Prior studies assessing the effects of Impella 5.5 support duration on posttransplant outcomes have been limited to single-center case reports and series. This study evaluates the impact of Impella 5.
View Article and Find Full Text PDFBackground: This study evaluates the clinical trends, risk factors, and impact of waitlist blood transfusion on outcomes following isolated heart transplantation.
Methods: The UNOS registry was queried to identify adult recipients from January 1, 2014, to June 30, 2022. The recipients were stratified into two groups depending on whether they received a blood transfusion while on the waitlist.