Pub Date : 2025-11-07DOI: 10.1016/j.healun.2025.09.018
Gregor Poglajen MD, PhD
{"title":"Letermovir prophylaxis and cytomegalovirus immune monitoring: Toward a win–win strategy in heart transplantation","authors":"Gregor Poglajen MD, PhD","doi":"10.1016/j.healun.2025.09.018","DOIUrl":"10.1016/j.healun.2025.09.018","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 309-310"},"PeriodicalIF":6.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-24DOI: 10.1016/j.healun.2025.06.008
Alexander M Bernhardt, Vanessa Blumer, Christophe Vandenbriele, Benedikt Schrage, Kanika Mody, Federico Pappalardo, Scott Silvestry, Mark Anderson, Jacob Abraham, Ann Gage, Daniel Goldstein, Michael Grant, Ilija Klipa, Thomas Schlöglhofer, Sern Lim, Jacob Moller, Bernd Panholzer, Ezequiel Molina, Julia Riebandt, Nir Uriel, Anthony Carnicelli, Evgenij Potapov, Manreet Kanwar
The Impella 5.5 (Abiomed, USA) is a catheter-based micro-axial flow pump that has emerged as a vital tool in managing patients with cardiogenic shock (CS). Delivering up to 5.5 L/min of flow, it enables full left ventricular (LV) support with beneficial hemodynamic and metabolic effects. Its unique advantages include high-flow, antegrade circulatory support with the potential for prolonged usage, making it suitable for bridging to recovery or heart replacement therapies. This manuscript provides a comprehensive, structured guide for the clinical management of patients supported with the Impella 5.5. It outlines best practices for patient selection, surgical implantation techniques-most commonly via the axillary artery-perioperative management, anticoagulation strategies, and postoperative monitoring. Special emphasis is placed on complication management, including bleeding, hemolysis, right ventricular dysfunction, stroke, aortic valve injury, and vascular complications. Technologies like SmartAssist and Impella Connect are highlighted for their utility in real-time device monitoring and remote management. The manuscript also discusses a three-phase framework for recovery: hemodynamic stabilization, initiation of guideline-directed medical therapy (GDMT), and structured weaning protocols. Considerations for transitioning patients to heart transplantation or durable LVADs, as well as explant techniques, are detailed. The importance of multidisciplinary coordination-including a mechanical circulatory support (MCS) coordinator-is emphasized to ensure optimal patient outcomes. By synthesizing available evidence and institutional experience, this guide aims to standardize Impella 5.5 management, reduce complications, and improve outcomes in critically ill patients with advanced heart failure or CS.
{"title":"Clinical management of the Impella 5.5 pump.","authors":"Alexander M Bernhardt, Vanessa Blumer, Christophe Vandenbriele, Benedikt Schrage, Kanika Mody, Federico Pappalardo, Scott Silvestry, Mark Anderson, Jacob Abraham, Ann Gage, Daniel Goldstein, Michael Grant, Ilija Klipa, Thomas Schlöglhofer, Sern Lim, Jacob Moller, Bernd Panholzer, Ezequiel Molina, Julia Riebandt, Nir Uriel, Anthony Carnicelli, Evgenij Potapov, Manreet Kanwar","doi":"10.1016/j.healun.2025.06.008","DOIUrl":"10.1016/j.healun.2025.06.008","url":null,"abstract":"<p><p>The Impella 5.5 (Abiomed, USA) is a catheter-based micro-axial flow pump that has emerged as a vital tool in managing patients with cardiogenic shock (CS). Delivering up to 5.5 L/min of flow, it enables full left ventricular (LV) support with beneficial hemodynamic and metabolic effects. Its unique advantages include high-flow, antegrade circulatory support with the potential for prolonged usage, making it suitable for bridging to recovery or heart replacement therapies. This manuscript provides a comprehensive, structured guide for the clinical management of patients supported with the Impella 5.5. It outlines best practices for patient selection, surgical implantation techniques-most commonly via the axillary artery-perioperative management, anticoagulation strategies, and postoperative monitoring. Special emphasis is placed on complication management, including bleeding, hemolysis, right ventricular dysfunction, stroke, aortic valve injury, and vascular complications. Technologies like SmartAssist and Impella Connect are highlighted for their utility in real-time device monitoring and remote management. The manuscript also discusses a three-phase framework for recovery: hemodynamic stabilization, initiation of guideline-directed medical therapy (GDMT), and structured weaning protocols. Considerations for transitioning patients to heart transplantation or durable LVADs, as well as explant techniques, are detailed. The importance of multidisciplinary coordination-including a mechanical circulatory support (MCS) coordinator-is emphasized to ensure optimal patient outcomes. By synthesizing available evidence and institutional experience, this guide aims to standardize Impella 5.5 management, reduce complications, and improve outcomes in critically ill patients with advanced heart failure or CS.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":"1688-1702"},"PeriodicalIF":6.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-26DOI: 10.1016/j.healun.2025.10.026
Ye In Christopher Kwon BA , Daniel Tang MD , Leora Yarboro MD , Vigneshwar Kasirajan MD , Zubair A. Hashmi MD
{"title":"Step towards device transparency and reporting for better outcomes in heart transplantation using ex-vivo machine perfusion","authors":"Ye In Christopher Kwon BA , Daniel Tang MD , Leora Yarboro MD , Vigneshwar Kasirajan MD , Zubair A. Hashmi MD","doi":"10.1016/j.healun.2025.10.026","DOIUrl":"10.1016/j.healun.2025.10.026","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 236-238"},"PeriodicalIF":6.0,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145381118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1016/j.healun.2025.10.019
Khodr Tello MD , Marion Delcroix MD , Christine Pausch PhD , Doerte Huscher PhD , David Pittrow MD , H. Ardeschir Ghofrani MD , Roberto Badagliacca MD , Anton Vonk-Noordegraaf MD , Grzegorz Kopec MD , Michael Halank MD , Ralf Ewert MD , Hans Klose MD , Ekkehard Grünig MD , Andris Skride MD , Silvia Ulrich MD , Stefan Stadler MD , Laura Scelsi MD , Elena Pfeuffer-Jovic MD , Marius M. Hoeper MD , Karen M. Olsson MD
Parenteral prostacyclin analogues (PPA) are recommended for pulmonary arterial hypertension (PAH) patients at intermediate-high or high risk, yet supporting evidence remains limited. We retrospectively analyzed pretreated patients with idiopathic/heritable/drug-associated PAH (I/H/D-PAH), connective tissue disease-associated PAH (CTD-PAH), or congenital heart disease-associated PAH (CHD-PAH) from the COMPERA registry who received add-on PPA therapy. Among 495 patients, all pretreated with ≥1 PAH medication, add-on PPA treatment was associated with improvements in 6-minute walk distance, WHO functional class, and NT-proBNP across groups. However, mortality was high: Kaplan-Meier survival estimates at 5 years were 59% in I/H/D-PAH, 59% in CHD-PAH, and 31% in CTD-PAH. Independent predictors of mortality included older age, male sex, CTD, CHD, and intermediate-high or high risk at time of PPA initiation. These findings indicate short-term clinical improvements but high subsequent mortality with add-on PPA therapy in patients with PAH, particularly in those with CTD-PAH, underscoring the need for more effective therapies.
{"title":"Add-on therapy with parenteral prostacyclin analogues in patients with pulmonary arterial hypertension: Insights from the COMPERA registry","authors":"Khodr Tello MD , Marion Delcroix MD , Christine Pausch PhD , Doerte Huscher PhD , David Pittrow MD , H. Ardeschir Ghofrani MD , Roberto Badagliacca MD , Anton Vonk-Noordegraaf MD , Grzegorz Kopec MD , Michael Halank MD , Ralf Ewert MD , Hans Klose MD , Ekkehard Grünig MD , Andris Skride MD , Silvia Ulrich MD , Stefan Stadler MD , Laura Scelsi MD , Elena Pfeuffer-Jovic MD , Marius M. Hoeper MD , Karen M. Olsson MD","doi":"10.1016/j.healun.2025.10.019","DOIUrl":"10.1016/j.healun.2025.10.019","url":null,"abstract":"<div><div>Parenteral prostacyclin analogues (PPA) are recommended for pulmonary arterial hypertension (PAH) patients at intermediate-high or high risk, yet supporting evidence remains limited. We retrospectively analyzed pretreated patients with idiopathic/heritable/drug-associated PAH (I/H/D-PAH), connective tissue disease-associated PAH (CTD-PAH), or congenital heart disease-associated PAH (CHD-PAH) from the COMPERA registry who received add-on PPA therapy. Among 495 patients, all pretreated with ≥1 PAH medication, add-on PPA treatment was associated with improvements in 6-minute walk distance, WHO functional class, and NT-proBNP across groups. However, mortality was high: Kaplan-Meier survival estimates at 5 years were 59% in I/H/D-PAH, 59% in CHD-PAH, and 31% in CTD-PAH. Independent predictors of mortality included older age, male sex, CTD, CHD, and intermediate-high or high risk at time of PPA initiation. These findings indicate short-term clinical improvements but high subsequent mortality with add-on PPA therapy in patients with PAH, particularly in those with CTD-PAH, underscoring the need for more effective therapies.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 284-288"},"PeriodicalIF":6.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.healun.2025.06.016
Carlos E. Zari-Hidalgo MD
{"title":"Clarification on Ischemia–Reperfusion Injury Pathophysiology","authors":"Carlos E. Zari-Hidalgo MD","doi":"10.1016/j.healun.2025.06.016","DOIUrl":"10.1016/j.healun.2025.06.016","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page 1848"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.healun.2025.06.031
Abby McCaig , Mingyao Liu MD
{"title":"Endothelial glycocalyx and human ex vivo lung perfusion: Potential biomarkers and therapeutic targets for lung transplantation","authors":"Abby McCaig , Mingyao Liu MD","doi":"10.1016/j.healun.2025.06.031","DOIUrl":"10.1016/j.healun.2025.06.031","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1843-1844"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.healun.2025.06.015
B.C.J. van Dijk , D. Bos , R.A. de Boer , R.P.J. Budde , O.C. Manintveld
{"title":"Letter to the Editor: Can the grading of mild cardiac allograft vasculopathy be further refined? An angiographic and physiologic assessment of heart transplant recipients with ISHLT CAV 1","authors":"B.C.J. van Dijk , D. Bos , R.A. de Boer , R.P.J. Budde , O.C. Manintveld","doi":"10.1016/j.healun.2025.06.015","DOIUrl":"10.1016/j.healun.2025.06.015","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Pages 1845-1846"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.healun.2025.06.024
Nikil Prasad MD , Kevin J. Clerkin MD, MSc
{"title":"Author Response: Can the grading of mild cardiac allograft vasculopathy be further refined? An angiographic and physiologic assessment of heart transplant recipients with ISHLT CAV 1","authors":"Nikil Prasad MD , Kevin J. Clerkin MD, MSc","doi":"10.1016/j.healun.2025.06.024","DOIUrl":"10.1016/j.healun.2025.06.024","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page 1847"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/j.healun.2025.07.008
Yasbanoo Moayedi MD , Amit Alam MD , Manreet Kanwar MD
{"title":"Response letter to the editor","authors":"Yasbanoo Moayedi MD , Amit Alam MD , Manreet Kanwar MD","doi":"10.1016/j.healun.2025.07.008","DOIUrl":"10.1016/j.healun.2025.07.008","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page 1849"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-22DOI: 10.1016/S1053-2498(25)02299-5
{"title":"Information for Readers","authors":"","doi":"10.1016/S1053-2498(25)02299-5","DOIUrl":"10.1016/S1053-2498(25)02299-5","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 11","pages":"Page A2"},"PeriodicalIF":6.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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