October 7, 2013

Lung transplantation after lung volume reduction surgery


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This retrospective cohort study aimed to describe a single centre’s experience with bilateral lung transplantations in patients with previous lung volume reduction surgery. Five-year survival was not different between the cohorts, although the incidence of both post-operative bleeding requiring re-exploration and renal dysfunction requiring dialysis were higher in the lung volume reduction group. Post-transplant peak […]

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October 7, 2013

Single-lung transplantation can be performed with acceptable outcomes using selected donors with heavy smoking history


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A shortage of organ donors can prompts centres to use suboptimal donors. This review of the UNOS database determined that adult single-lung transplantations performed with lungs from heavy smoking donors (>20 pack years) have worse outcomes when compared to transplants from standard donors, including longer length of stay and lower peak FEV1 after transplant. Higher […]

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October 6, 2013

The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Official Adult Heart Transplant Report—2013; Focus Theme: Age


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The 30th adult heart transplant ISHLT report is based on data submitted on 110,486 heart transplants in recipients of all ages (including 99,008 adults) by 407 centers worldwide since 1982 through June 30, 2012, with follow-up until June 30, 2012.

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October 6, 2013

Ten Year Experience with Extended Criteria Cardiac Transplantation


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Given the limitation of donor hearts, extended criteria cardiac transplantation (ECCT) strategies have been formally adopted at a number of transplant centers. The premise of ECCT is to match patients who fall outside traditional listing criteria (such as age 65 or older or significant co-morbidities including significant renal insufficiency, peripheral arterial disease including carotid artery […]

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September 26, 2013

Acute Cellular and Antibody-Mediated Rejection of the Pancreas Allograft: Incidence, Risk Factors and Outcomes

Antibody-mediated pancreas transplant rejection is a relatively recently recognized entity. In this retrospective study, the rate of antibody-mediated rejection post-pancreas transplant was similar to that of acute cellular rejection. Class I DSA were more predictive of antibody-mediated rejection than class II DSA. Antibody-mediated rejection should be considered in all patients with pancreas graft dysfunction post-transplant.

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September 26, 2013

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial


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Non-adherence is a well-recognized cause of poor outcomes post-transplant, but effective interventions to address this problem have been rare. In this randomized controlled trial, patients who were at least one year post-transplant and developed an adherence contract with a pharmacist had better medication adherence, as measured by prescription refills. The rate of hospitalizations was also […]

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September 26, 2013

Complement-Binding Anti-HLA Antibodies and Kidney-Allograft Survival


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The ability to detect anti-HLA antibodies is very sensitive and specific, but it is not clear if all antibodies are the same. Specifically, some antibodies may bind and activate complement better than others. In this retrospective study, the presence of antibodies that could fix C1q and initiate the complement cascade was associated with higher rates […]

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September 10, 2013

Should Eligibility for Heart Transplantation Be a Requirement for Left Ventricular Assist Device Use? Recommendations Based on a Systematic Review


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This Canadian group has generated the first systematic review of the clinical and economic effects of continuous-flow LVADs in Bridge to Transplant (BTT) and Destination Therapy (DT) patients. They conclude that evidence is sufficient to support LVAD use, regardless of transplantation eligibility status, as long as patients are carefully selected and program infrastructure and budget […]

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September 9, 2013

Is it time for a cardiac allocation score? First results from the Eurotransplant pilot study on a survival benefit based heart allocation


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The Eurotransplant group demonstrated mortality on the waitlist could be predicted for non-VAD critically ill (high urgency or urgent request) patients using the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM). The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score was successful for predicting mortality post transplant in non-VAD patients. […]

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September 8, 2013

The urgent priority for transplantation is to trim the waiting list


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This thought provoking editorial by Dr. Lynne Warner Stevenson provides commentary on ineffective waitlist strategies and the need for change.

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