Safe Practices: Partial Coverage of Left Ventricular Assist Device Reduces Bleeding Risk during Explant-Heart Transplant without Causing Obstruction.

Left ventricular assist device (LVAD) explantation is technically challenging during heart transplantation (HT) and is associated with intraoperative and postoperative blood loss. This single institution study examined the effects of partial polytetrafluoroethylene (PTFE) protective coverage during HeartMate 3 implant on perioperative blood loss during the explant-HT. We found that partial PTFE coverage of the outflow graft and chassis during HeartMate 3 implant is significantly associated with reduced intraoperative and postoperative transfusion requirements, and postoperative chest tube output.

Donor Heart Preservation at 10°C After Thoracoabdominal Normothermic Regional Perfusion Lowers Rates of Severe Primary Graft Dysfunction and Improves Recipient Transplant Outcomes.

This study compares a novel static cold storage (SCS) method using 10°C preservation to conventional ice following thoracoabdominal normothermic regional perfusion (TA-NRP) in donation after circulatory death (DCD) heart transplantation. We retrospectively analyzed adult recipients at a single center from October 2020 to October 2024, excluding congenital and multi-organ transplants. A total of 147 recipients met inclusion criteria (Ice = 96; 10°C = 51).

10-minute Asystolic Warm Ischemic Time (AWIT) Predicts Mortality and Severe Primary Graft Dysfunction in Donation After Circulatory Death Hearts Recovered With Thoracoabdominal Normothermic Regional Perfusion.

Objectives: Donor warm ischemic time (WIT) during donation after circulatory death (DCD) has been linked to adverse outcomes in non-cardiac transplants, but its impact on heart transplant recipients remains unclear. This study evaluated the association between prolonged WIT and outcomes in adult recipients of thoracoabdominal normothermic regional perfusion (NRP)-recovered cardiac allografts.

Methods: We retrospectively reviewed adult heart transplant recipients who received NRP-recovered DCD allografts at a single center between October 2020 and February 2025.

Rapid Recovery of Donor Hearts for Transplantation after Circulatory Death.

We report a method for the recovery of hearts for transplantation from deceased donors after circulatory death that obviates the need for thoracoabdominal normothermic regional perfusion or ex situ perfusion systems. After death, the aorta is clamped and a flush circuit is established to perform a controlled, extended, ultraoxygenated flush of the donor heart at a mean aortic-root pressure of 80 mm Hg. In the first three reported cases in which this method was used, the hearts were transplanted successfully with normal biventricular function, no evidence of acute cellular or antibody-mediated rejection, and excellent early postoperative outcomes.

A foregone conclusion? The association between early hospital course and late outcomes in modern era heart transplant.

Objectives: The revised US donor heart allocation policy allows for transplantation in more critically ill patients with heart failure. This study examines the association between index hospitalization and 1-year functional outcomes in the modern era.

Methods: All adult, single-organ heart transplant recipients at a single institution from October 2018 to January 2023 were retrospectively reviewed.

Two hundred cases of cardiac donation after circulatory death utilizing normothermic regional perfusion: The 4-year Vanderbilt experience.

Objectives: Studies evaluating normothermic regional perfusion (NRP) for donation after circulatory death (DCD) heart recovery involve low volume centers or multi-center studies with wide variation in practice/technique. We sought to provide a single high-volume center's experience encompassing our program's evolution of NRP over time.

Methods: Adult DCD heart transplant patients who received cardiac allografts recovered using only thoracoabdominal NRP were retrospectively reviewed from October 2020 to November 2024.

Normothermic regional perfusion in donation after circulatory death compared with brain dead donors: Single-center cardiac allograft outcomes.

Objective: We sought to provide a single-center analysis of our normothermic regional perfusion (NRP)-recovered donation after circulatory death (DCD) heart transplant outcomes compared with a historical control group of donors of donation after brain death (DBD). We hypothesized that postoperative short-term outcomes and long-term survival trends are comparable in DCD-NRP and DBD cardiac allografts.

Methods: All adult heart-only transplants performed at our institution between January 2020 and June 2024 were retrospectively reviewed.

The effect of warm ischemic intervals on primary graft dysfunction in normothermic regional perfusion for donation after circulatory death heart transplant.

Objectives: To clarify the association between warm ischemic time during donation after circulatory death (DCD) and severe primary graft dysfunction (PGD) after heart transplant.

Methods: DCD heart transplants using normothermic regional perfusion, excluding congenital etiology or multiorgan transplant, at a single institution from January 2020 to December 2024 were reviewed. Donation withdrawal ischemic time (DWIT), functional warm ischemic time, defined by oxygen saturation <80% (FWIT O), systolic blood pressure <80 mm Hg or <50 mm Hg, and asystolic warm ischemic time were examined.

Lithotripsy-Facilitated or Conventional Percutaneous Mitral Balloon Valvuloplasty for Calcific Mitral Valve Disease: A Systematic Review.

Background: The efficacy of percutaneous mitral balloon valvuloplasty (PMBV) for mitral stenosis (MS) secondary to mitral annular calcification (MAC) is poorly understood. The purpose of this systematic review was to consolidate existing data on conventional and lithotripsy-facilitated PMBV in patients with calcific mitral valve disease, to better understand procedural outcomes.

Methods: We performed a systematic search of the literature published in PubMed and Scopus databases through May 2024.

Direct Procurement and Perfusion Using Hypothermic Oxygenated Perfusion for DCD Cardiac Allografts in North America.

Background: Donation after circulatory death (DCD) is a viable avenue for recovery of cardiac allografts for transplantation. Previous methods have utilized direct procurement and perfusion (DPP) using commercially available normothermic perfusion systems or in situ normothermic regional perfusion. A novel portable hypothermic oxygenated perfusion device (HOPE) (XVIVO Perfusion) has been developed and is in clinical trials for preservation of cardiac allografts.

Save a trip: Clinical outcomes of cardiac allografts recovered by local surgeons compared to recipient center surgeons.

Background: Local surgeon recovery of donor livers and kidneys is common and well-studied. This practice is rare and poorly studied in cardiac transplantation. We examined clinical outcomes of cardiac allografts recovered by local surgeons vs.

Ten hour donor heart ischemic time with 10ºC static storage.

Utilization of 10ºC static storage safely extended both ischemic time and travel radius in heart transplantation. A 57-year-old man with ischemic cardiomyopathy, a left ventricular assist device (LVAD), and end-stage renal disease was listed for combined heart-kidney transplant. The donor hospital in Anchorage, AK, was located approximately 2,700 nautical miles and 8 hours from the recipient center.

Patient-specific Predictors of Haemolysis with Percutaneous Ventricular Assist Devices.

Introduction: Percutaneous ventricular assist devices (pVADs) are increasingly used in cardiogenic shock but are associated with complications including haemolysis. The aim of this study was to investigate patient characteristics associated with haemolysis in cardiogenic shock patient population.

Methods: Consecutive patients were identified using Current Procedural Terminology (CPT) codes for pVAD insertion.

Out of the ice age: Preservation of cardiac allografts with a reusable 10 °C cooler.

Objective: Static cold storage with ice has been the mainstay of cardiac donor preservation. Early preclinical data suggest that allograft preservation at 10 °C may be beneficial. We tested this hypothesis by using a static 10 °C storage device to preserve and transport cardiac allografts.

Impella RP Flex: Rescue for the Failing Right Ventricle After Heart Transplantation-Case Report.

Right ventricular (RV) dysfunction (RVD) after orthotopic heart transplantation (OHT) is a common cause of morbidity and mortality. Impella RP Flex was recently approved for RV support as a temporary mechanical circulatory device. We present the first case of its use in managing RVD in a patient after OHT.

Deactivation of LVAD support for myocardial recovery-surgical perspectives.

Left ventricular assist devices (LVADs) are excellent therapies for advanced heart failure patients either bridged to transplant or for lifetime use. LVADs also allow for reverse remodeling of the failing heart that is often associated with functional improvement. Indeed, growing enthusiasm exists to better understand this population of patients, whereby the LVAD is used as an adjunct to mediate myocardial recovery.

Thoraco-abdominal normothermic regional perfusion for thoracic transplantation in the United States: current state and future directions.

Purpose Of Review: To provide an update regarding the state of thoracoabdominal normothermic regional perfusion (taNRP) when used for thoracic organ recovery.

Recent Findings: taNRP is growing in its utilization for thoracic organ recovery from donation after circulatory death donors, partly because of its cost effectiveness. taNRP has been shown to yield cardiac allograft recipient outcomes similar to those of brain-dead donors.

Contemporary utilization of the axillary artery in cardiac surgery.

Introduction: The axillary artery is a reliable inflow vessel when addressing pathology of the aortic root and aortic arch that may preclude standard central cannulation strategies. This narrative review examines the use of the axillary artery in cardiac surgery. Anatomy, indications for use, cannulation strategies, and potential complications will be discussed.

Successful Lung Transplantation for Severe Post-COVID-19 Pulmonary Fibrosis.

Lung transplantation has been well described for patients with coronavirus disease 2019 (COVID-19) in the acute setting, but less so for the resulting pulmonary sequelae. This report describes a case of lung transplantation for post-COVID-19 pulmonary fibrosis. A 52-year-old woman contracted COVID-19 in July 2020 and mounted a partial recovery, but she went on to have declining function over the ensuing 3 months, with development of fibrocystic lung changes.

High-quality results of cytoreductive surgery and heated intraperitoneal chemotherapy perfusion for carcinomatosis at a low volume institution.

Background And Objectives: Maximal cytoreductive surgery (CS) with heated intraperitoneal chemotherapy perfusion (HIPEC) for peritoneal carcinomatosis can improve oncologic outcomes, but is associated with significant morbidity. Whether low-volume experience with CS/HIPEC results in acceptable outcomes is unknown.

Methods: A retrospective review of all patients undergoing CS/HIPEC by a single surgeon.