Center Experience is Associated with Greater Survival following Donation after Circulatory Death Heart Transplantation.

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.

Mid-Term Reassessment of Waitlist and Posttransplant Outcomes Under the 2018 Heart Allocation System: Improved All-Cause Survival.

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.

A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation.

The advent of direct-acting antiviral agents (DAA) allows for the utilization of hepatitis C (HCV) viremic donors to uninfected recipients. Sofosbuvir/velpatasvir (SOF/VEL) is a pangenotypic DAA without clinically significant interactions with immunosuppressants, but its concomitant use with amiodarone may cause serious bradycardia. In an open-label study of 20 heart and lung transplant recipients of organs from HCV viremic donors, who received SOF/VEL for 12 weeks starting on post-operative day one, the concomitant use of amiodarone and SOF/VEL resulted in bradycardic episodes and commonly occurred in the presence of beta-blocking medications.

Effects of ex vivo machine perfusion on preservation time and donor age in donation after brain death heart transplantation.

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).

Durable left ventricular assist device in donation after circulatory death heart transplantation.

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.

Effects of Nighttime Procurement and Transplantation on Outcomes Following Heart 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.

Aspirin and Hemocompatibility After LVAD Implantation in Patients With Atherosclerotic Vascular Disease: A Secondary Analysis From the ARIES-HM3 Randomized Clinical Trial.

Importance: The Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure (ARIES-HM3) study demonstrated that aspirin may be safely eliminated from the antithrombotic regimen after HeartMate 3 (HM3 [Abbott Cardiovascular]) left ventricular assist device (LVAD) implantation. This prespecified analysis explored whether conditions requiring aspirin (prior percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], stroke, or peripheral vascular disease [PVD]) would influence outcomes differentially with aspirin avoidance.

Objective: To analyze aspirin avoidance on hemocompatibility-related adverse events (HRAEs) at 1 year after implant in patients with a history of CABG, PCI, stroke, or PVD.

Association of agonal phase duration with heart utilization and post-transplant outcomes in donation after circulatory death heart transplantation.

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.

Medication optimization clinic decreases hospitalizations and mortality for patients with heart failure with reduced ejection fraction.

Study Objective: To evaluate the impact of a medication optimization clinic (MOC) on GDMT and outcomes for patients with HFrEF versus usual care.

Design: Retrospective evaluation of a multi-site MOC was conducted.

Setting: Large health system with academic and community hospitals.

Right Ventricular Mass Oversizing Is Associated With Improved Post-transplant Survival in Heart Transplant Recipients With Elevated Transpulmonary Gradient.

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.

Mid-term Waitlist and Posttransplant Outcomes With Hepatitis C-positive Donor Hearts.

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.

Donor and Recipient Age Influence Outcomes Following Orthotopic Heart Transplantation in the 2018 US Heart Allocation System.

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.

Evolving Trends and Impact of Waitlist Transfusion on Recipient Outcomes Following Heart Transplantation.

Background: 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.

An ISHLT consensus statement on strategies to prevent and manage hemocompatibility related adverse events in patients with a durable, continuous-flow ventricular assist device.

Life expectancy of patients with a durable, continuous-flow left ventricular assist device (CF-LVAD) continues to increase. Despite significant improvements in the delivery of care for patients with these devices, hemocompatability-related adverse events (HRAEs) are still a concern and contribute to significant morbility and mortality when they occur. As such, dissemination of current best evidence and practices is of critical importance.

Impact of post-transplant stroke and subsequent functional independence on outcomes following heart transplantation under the 2018 United States heart allocation system.

Background: This study evaluates the clinical trends, risk factors, and effects of post-transplant stroke and subsequent functional independence on outcomes following orthotopic heart transplantation under the 2018 heart allocation system.

Methods: The United Network for Organ Sharing registry was queried to identify adult recipients from October 18, 2018 to December 31, 2021. The cohort was stratified into 2 groups with and without post-transplant stroke.

Association of pre-left ventricular assist device defibrillator shocks for ventricular arrhythmia with clinical outcomes after left ventricular assist device implantation.

Background: Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks.

Objectives: The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy.

Donation after circulatory death improves probability of heart transplantation in waitlisted candidates and results in post-transplant outcomes similar to those achieved with brain-dead donors.

Objective: To quantitate the impact of heart donation after circulatory death (DCD) donor utilization on both waitlist and post-transplant outcomes in the United States.

Methods: The United Network for Organ Sharing database was queried to identify all adult waitlisted and transplanted candidates between October 18, 2018, and December 31, 2022. Waitlisted candidates were stratified according to whether they had been approved for donation after brain death (DBD) offers only or also approved for DCD offers.

Reduction of HLA donor specific antibodies in heart transplant patients treated with proteasome inhibitors for antibody mediated rejection.

In this project, we describe proteasome inhibitor (PI) treatment of antibody-mediated rejection (AMR) in heart transplantation (HTX). From January 2018 to September 2021, 10 patients were treated with PI for AMR: carfilzomib (CFZ) n = 8; bortezomib (BTZ) n = 2. Patients received 1-3 cycles of PI.

Improved waitlist and comparable post-transplant outcomes in simultaneous heart-kidney transplantation under the 2018 heart allocation system.

Objective: This study aimed to investigate the clinical trends and the impact of the 2018 heart allocation policy change on both waitlist and post-transplant outcomes in simultaneous heart-kidney transplantation in the United States.

Methods: The United Network for Organ Sharing registry was queried to compare adult patients before and after the allocation policy change. This study included 2 separate analyses evaluating the waitlist and post-transplant outcomes.

Association of Angiopoetin-2 and TNF-α With Bleeding During Left Ventricular Assist Device Support: Analysis From the PREVENT Biorepository.

The purpose of this study was to describe the changes in plasma levels of angiogenic and inflammatory biomarkers, specifically Ang-2 and TNF-α, in patients receiving HeartMate II (HMII) left ventricular assist device (LVAD) and correlate them with nonsurgical bleeding. It has been shown that angiopoietin-2 (Ang-2) and tissue necrosis factor-α (TNF-α) may be linked to bleeding in LVAD patients. This study utilized biobanked samples prospectively collected from the PREVENT study, a prospective, multicenter, single-arm, nonrandomized study of patients implanted with HMII.