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. · Jun 2005
Randomized Controlled Trial Comparative Study Clinical TrialNitric oxide versus prostaglandin E1 for reduction of pulmonary hypertension in heart transplant candidates.
We sought to directly compare the effects of prostaglandin E1 (PGE1) and nitric oxide (NO) in testing for pulmonary hypertension reversibility in heart transplant candidates. ⋯ The effects of PGE1 and NO on pulmonary hypertension are comparable, with PGE1 having more systemic hypotensive effects. Due to variability of patient responses, we recommend multiple rather than single-agent pharmacologic testing for the reversibility of pulmonary hypertension.
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J. Heart Lung Transplant. · May 2001
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialTacrolimus versus cyclosporine after lung transplantation: a prospective, open, randomized two-center trial comparing two different immunosuppressive protocols.
The need for better immunosuppressive protocols after lung transplantation led us to investigate tacrolimus (Tac) in combination with mycophenolate mofetil (MMF) and steroids or cyclosporine (CsA) in combination with MMF and steroids in a prospective, open, randomized trial after lung transplantation. ⋯ The combination of Tac and MMF seems to have slightly higher immunosuppressive potential compared with CsA and MMF. The effectiveness of Tac as a rescue agent is not paralleled with undue signs of overimmunosuppression.
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J. Heart Lung Transplant. · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of felodipine on left ventricular hypertrophy and systolic function in orthotopic heart transplant recipients: possible interaction with cyclosporine medication.
Concentric left ventricular (LV) hypertrophy develops early in orthotopic heart transplant (OHT) recipients. To compare the effects of a calcium channel blocker, felodipine, versus diuretics on LV hypertrophy and LV systolic function repeated magnetic resonance imaging studies were performed in OHT recipients. Cyclosporine levels and neurohormones were also measured to explore potential interactions with treatment. ⋯ In OHT recipients during diuretic treatment, progression of LV hypertrophy occurs in relation to cyclosporine plasma levels and is accompanied by impairment of systolic contractile function. Felodipine induces regression of LV hypertrophy, while systolic contractile function is preserved. During felodipine treatment, regression of LV hypertrophy is unrelated to cyclosporine levels. Thus, felodipine seems to attenuate the hypertrophic effect of cyclosporine on transplanted hearts.
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J. Heart Lung Transplant. · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialBridging to heart transplantation: prostaglandin E1 versus prostacyclin versus dobutamine.
Prostaglandin E1 (PGE1) and prostacyclin have potent pulmonary and systemic vasodilating properties. This prospective, randomized trial compared PGE1 vs prostacyclin vs. low-dose dobutamine in patients with low-output heart failure awaiting heart transplantation (HTx) who were refractory to oral treatment. ⋯ The findings from this prospective open pilot trial suggest that continuous PGE1 infusions at individualized dosages can be useful in certain patients as a pharmacologic bridging procedure with reduced risk to develop worsening heart failure before HTx compared to prostacyclin and dobutamine. Further comparative studies are warranted to investigate the effects of PGE1 among other bridging agents.
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J. Heart Lung Transplant. · Mar 1994
Randomized Controlled Trial Comparative Study Clinical TrialExercise, education, and quality of life in lung transplant candidates.
In addition to improved functional ability, patients who complete rehabilitation programs typically have positive psychologic changes, including increased motivation and an enhanced quality of life. Potentially, patients with end-stage lung disease awaiting a lung transplant can have similar benefits. However, no studies were identified that examined the impact of an exercise program on quality of life in patients awaiting lung transplantation. ⋯ Findings suggest that patients awaiting lung transplantation perceived improved quality of well-being and increased walk distance after participation in a health maintenance program. Education plus exercise conferred no benefits beyond those achieved by education alone. However, the number of subjects studied was small and duration of follow-up was limited.