The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Nov 2010
Multicenter StudyConstruct validity of the definition of primary graft dysfunction after lung transplantation.
This study tested the discriminant validity of International Society for Heart and Lung Transplantation (ISHLT) primary graft dysfunction (PGD) grades with lung injury biomarker profiles and survival. ⋯ The ISHLT grading system has good discriminant validity, based on plasma markers of lung injury and mortality. Grade 3 PGD was associated with the most severely altered plasma biomarker profile and the worst outcomes, regardless of the time point of grading. PGD grade at 48 and 72 hours discriminated mortality better than PGD grade at 24 hours.
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J. Heart Lung Transplant. · Jun 2010
Multicenter Study Comparative StudyPost-operative heparin may not be required for transitioning patients with a HeartMate II left ventricular assist system to long-term warfarin therapy.
Anti-coagulation with heparin is often used after left ventricular assist device implantation as a transition to long-term warfarin therapy. We retrospectively evaluated the effects of heparin use on thromboembolic and bleeding complications after implantation of the HeartMate II left ventricular assist device (LVAD). ⋯ In patients receiving the HeartMate II LVAD who were directly transitioned to warfarin and aspirin therapy without intravenous heparin there was no short-term increase in risk of thrombotic or thromboembolic events, and bleeding requiring transfusion was significantly reduced. Additional long-term follow-up is needed to evaluate possible late effects.
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J. Heart Lung Transplant. · Dec 2009
Multicenter Study Comparative StudyOutcomes of children with restrictive cardiomyopathy listed for heart transplant: a multi-institutional study.
Restrictive cardiomyopathy (RCM) in children often has a progressive nature, with a high risk of clinical deterioration and death. Heart transplantation (HTx) is a widely accepted therapy that offers long-term survival, but criteria for and outcomes after listing have not been well defined. ⋯ Children with RCM awaiting HTx have a generally low waitlist mortality and reasonable overall survival. Children requiring mechanical support and infants had a significantly higher risk of death while waiting. Further study is warranted to identify factors important in determining the optimal timing of listing in children with RCM before the need for inotropic or mechanical support.
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J. Heart Lung Transplant. · Dec 2009
Multicenter Study Comparative StudyOutcome of pediatric patients with dilated cardiomyopathy listed for transplant: a multi-institutional study.
The course of dilated cardiomyopathy (DCM) leading to heart failure in children varies; survival with conventional treatment is 64% at 5 years. Heart transplantation (HTx) enables improved survival; however, outcomes from listing for transplant are not well described. This study reports survival of patients with DCM from listing with the availability of mechanical bridge to transplant. ⋯ Transplantation for DCM in the pediatric population offers enhanced survival compared with the natural history. Overall waitlist mortality for DCM is low, with the exception of patients on ECMO, mechanically ventilated, or with arrhythmias. DCM patients fared well after transplant, making HTx a key therapeutic intervention.
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J. Heart Lung Transplant. · Dec 2009
Multicenter Study Comparative StudyEra effect on post-transplant survival adjusted for baseline risk factors in pediatric heart transplant recipients.
Post-transplant survival in pediatric heart transplant (HT) recipients has improved for recent era recipients. However, the era effect has not been assessed after adjusting for baseline risk factors in HT recipients. ⋯ Despite the worse baseline risk profile of pediatric HT recipients in recent years, their risk-adjusted survival during the first 5 years after transplant has improved. The entire era effect appears to be due to improved survival during the first 6 months post-transplant.