Pub Date : 2025-11-13DOI: 10.1016/j.healun.2025.10.020
Ioannis Dimarakis MD, PhD , Bassel Al-Alao MBBS , Charlene Tennyson MBBS , Mackenzie Adcox MD , David Edwards , Travis Bourland , Brent Beatty , Alexis Voitik , Bethany Sissom , Mackenzy Keller , Chris Figland , Jessica Gimelli , Peter Wong , Tony Li , Trang Bodtke , April Stempien-Otero MD , Richard K. Cheng MD , Jay D. Pal MD, PhD
Background
Donation after circulatory death (DCD) heart transplantation commonly relies on normothermic regional perfusion or ex vivo reanimation, both of which can be resource-intensive and operationally complex. To simplify procurement and mitigate logistical constraints, a direct procurement strategy employing oxygenated cold blood perfusion without reanimation was introduced. This study describes the early outcomes associated with this simplified technique.
Methods
A streamlined direct procurement protocol was implemented in five DCD heart donors. Hearts were recovered without the use of normothermic regional perfusion and were instead flushed with oxygenated cold blood perfusion followed by a standard preservation solution. Transplantation was performed using conventional implantation methods. Postoperative graft function, rejection events, and early clinical outcomes were assessed during short-term follow-up.
Results
All five transplant procedures were successfully completed. Recipients exhibited normal postoperative graft function with no evidence of rejection during the short-term follow-up period. The simplified procurement method proved feasible, operationally efficient, and less resource-dependent than existing reanimation-based techniques. Early results indicate that this approach may represent a cost-effective alternative for DCD heart recovery and may contribute to expanding the DCD donor pool.
{"title":"Donation after circulatory determination of death heart transplantation using simplified direct procurement: Expanding access","authors":"Ioannis Dimarakis MD, PhD , Bassel Al-Alao MBBS , Charlene Tennyson MBBS , Mackenzie Adcox MD , David Edwards , Travis Bourland , Brent Beatty , Alexis Voitik , Bethany Sissom , Mackenzy Keller , Chris Figland , Jessica Gimelli , Peter Wong , Tony Li , Trang Bodtke , April Stempien-Otero MD , Richard K. Cheng MD , Jay D. Pal MD, PhD","doi":"10.1016/j.healun.2025.10.020","DOIUrl":"10.1016/j.healun.2025.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Donation after circulatory death (DCD) heart transplantation commonly relies on normothermic regional perfusion or ex vivo reanimation, both of which can be resource-intensive and operationally complex. To simplify procurement and mitigate logistical constraints, a direct procurement strategy employing oxygenated cold blood perfusion without reanimation was introduced. This study describes the early outcomes associated with this simplified technique.</div></div><div><h3>Methods</h3><div>A streamlined direct procurement protocol was implemented in five DCD heart donors. Hearts were recovered without the use of normothermic regional perfusion and were instead flushed with oxygenated cold blood perfusion followed by a standard preservation solution. Transplantation was performed using conventional implantation methods. Postoperative graft function, rejection events, and early clinical outcomes were assessed during short-term follow-up.</div></div><div><h3>Results</h3><div>All five transplant procedures were successfully completed. Recipients exhibited normal postoperative graft function with no evidence of rejection during the short-term follow-up period. The simplified procurement method proved feasible, operationally efficient, and less resource-dependent than existing reanimation-based techniques. Early results indicate that this approach may represent a cost-effective alternative for DCD heart recovery and may contribute to expanding the DCD donor pool.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 199-203"},"PeriodicalIF":6.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525111","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 : 2025-11-13DOI: 10.1016/j.healun.2025.10.011
Anthony P. Carnicelli MD , Shashank S. Sinha MD, MSc , Song Li MD , Borui Li MA , Michele Esposito MD , Rachna Kataria MD , Arthur R. Garan MD , Van-Khue Ton MD, PhD , Kevin John MD , Elric Zweck MD , Jaime Hernandez-Montfort MD , Jacob Abraham MD , Daniel Burkhoff MD, PhD , Manreet K. Kanwar MD , Navin K. Kapur MD , On Behalf of the Cardiogenic Shock Working Group Academic Consortium
{"title":"Author’s response to Moeller et al.","authors":"Anthony P. Carnicelli MD , Shashank S. Sinha MD, MSc , Song Li MD , Borui Li MA , Michele Esposito MD , Rachna Kataria MD , Arthur R. Garan MD , Van-Khue Ton MD, PhD , Kevin John MD , Elric Zweck MD , Jaime Hernandez-Montfort MD , Jacob Abraham MD , Daniel Burkhoff MD, PhD , Manreet K. Kanwar MD , Navin K. Kapur MD , On Behalf of the Cardiogenic Shock Working Group Academic Consortium","doi":"10.1016/j.healun.2025.10.011","DOIUrl":"10.1016/j.healun.2025.10.011","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 313-314"},"PeriodicalIF":6.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525121","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 : 2025-11-13DOI: 10.1016/j.healun.2025.10.025
Maria Francesca Scuppa MD , Guillaume Coutance MD, PhD
{"title":"Not for the faint of heart—and yet: Donation after circulatory death simultaneous heart-kidney transplantation delivers","authors":"Maria Francesca Scuppa MD , Guillaume Coutance MD, PhD","doi":"10.1016/j.healun.2025.10.025","DOIUrl":"10.1016/j.healun.2025.10.025","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 212-214"},"PeriodicalIF":6.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525112","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 : 2025-11-13DOI: 10.1016/j.healun.2025.10.021
Jiho Han MD , Mikail Siddiki MD , Sara Kalantari MD , Mark N. Belkin MD , Jonathan Grinstein MD
Background
The purpose of the study is to assess a novel hemodynamic parameter, right ventricular myocardial performance score (RV-MPS), as a marker for right ventricular function and prognosis for advanced heart failure patients.
Methods
A total of 800 pressure-volume loop in silico simulations were performed at various hemodynamic conditions. RV-MPS was calculated as (3 × pulmonary artery pulsatility index [PAPI] × right ventricular cardiac power output [RV-CPO]) / 2. For the validation cohort, a total of 223 patients with advanced heart failure who underwent invasive hemodynamic testing from January 2013 to December 2019 were included. Advanced hemodynamic parameters, including RV-CPO, PAPI, and RV-MPS were calculated.
Results
In the simulation cohort, the median RV-CPO was (median 0.22, IQR: [0.08, 0.33] watts), RV coupling ratio was (median 1.3, IQR: [0.87, 1.85], and PAPI (median 2.2, IQR: [1.2, 3.5]), and the median RV-MPS was 0.74 (IQR: 0.19, 1.60). Simulations showed increases in RV EES and RV mechanical efficiency was associated with increase in RV-MPS for all conditions of stressed blood volume and arterial resistance. In the validation cohort, RV-MPS (OR: 0.64, 95% CI: [0.43, 0.97], p = 0.037), baseline creatinine (OR: 0.71, 95% CI: [0.51, 0.97], p = 0.32), and PCWP (OR: 1.05, 95% CI: [1.01, 1.10], p = 0.011) were independent predictors of composite outcome of death and need for heart replacement therapy at 1-year. Prior to left ventricular assist device implantation (n = 33), patients with RV-MPS <0.5 had significantly increased incidence of RV failure compared to patients with preserved RV-MPS ≥0.5 (66.7% vs. 16.7%, p = 0.003).
Conclusions
RV-MPS is a reliable estimator of RV function on in silico simulations. RV-MPS was an independent predictor of death or need for heart replacement therapy and may have a role in prognostication of advanced heart failure patients.
{"title":"Advanced hemodynamics for right ventricular failure: Evaluating the use of the myocardial performance score","authors":"Jiho Han MD , Mikail Siddiki MD , Sara Kalantari MD , Mark N. Belkin MD , Jonathan Grinstein MD","doi":"10.1016/j.healun.2025.10.021","DOIUrl":"10.1016/j.healun.2025.10.021","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of the study is to assess a novel hemodynamic parameter, right ventricular myocardial performance score (RV-MPS), as a marker for right ventricular function and prognosis for advanced heart failure patients.</div></div><div><h3>Methods</h3><div>A total of 800 pressure-volume loop <em>in silico</em> simulations were performed at various hemodynamic conditions. RV-MPS was calculated as (3 × pulmonary artery pulsatility index [PAPI] × right ventricular cardiac power output [RV-CPO]) / 2. For the validation cohort, a total of 223 patients with advanced heart failure who underwent invasive hemodynamic testing from January 2013 to December 2019 were included. Advanced hemodynamic parameters, including RV-CPO, PAPI, and RV-MPS were calculated.</div></div><div><h3>Results</h3><div>In the simulation cohort, the median RV-CPO was (median 0.22, IQR: [0.08, 0.33] watts), RV coupling ratio was (median 1.3, IQR: [0.87, 1.85], and PAPI (median 2.2, IQR: [1.2, 3.5]), and the median RV-MPS was 0.74 (IQR: 0.19, 1.60). Simulations showed increases in RV E<sub>ES</sub> and RV mechanical efficiency was associated with increase in RV-MPS for all conditions of stressed blood volume and arterial resistance. In the validation cohort, RV-MPS (OR: 0.64, 95% CI: [0.43, 0.97], <em>p</em> = 0.037), baseline creatinine (OR: 0.71, 95% CI: [0.51, 0.97], <em>p</em> = 0.32), and PCWP (OR: 1.05, 95% CI: [1.01, 1.10], <em>p</em> = 0.011) were independent predictors of composite outcome of death and need for heart replacement therapy at 1-year. Prior to left ventricular assist device implantation (n = 33), patients with RV-MPS <0.5 had significantly increased incidence of RV failure compared to patients with preserved RV-MPS ≥0.5 (66.7% vs. 16.7%, <em>p</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>RV-MPS is a reliable estimator of RV function on <em>in silico</em> simulations. RV-MPS was an independent predictor of death or need for heart replacement therapy and may have a role in prognostication of advanced heart failure patients.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 378-385"},"PeriodicalIF":6.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525115","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 : 2025-11-12DOI: 10.1016/j.healun.2025.10.023
Satona Tanaka , Daisuke Nakajima , Hiroshi Date
{"title":"Comments and opinions regarding “International Society for Heart and Lung Transplantation Consensus Statement on the Referral and Selection of Pediatric Lung Transplant Candidates”: Expanding role of living-donor lobar lung transplantation in pediatric patients","authors":"Satona Tanaka , Daisuke Nakajima , Hiroshi Date","doi":"10.1016/j.healun.2025.10.023","DOIUrl":"10.1016/j.healun.2025.10.023","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 315-316"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145509656","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 : 2025-11-12DOI: 10.1016/j.healun.2025.10.033
Kelly M. Pennington MD , Sahar A. Saddoughi MD, PhD
{"title":"I can breathe again, and the best is yet to come—understanding quality of life after lung transplantation","authors":"Kelly M. Pennington MD , Sahar A. Saddoughi MD, PhD","doi":"10.1016/j.healun.2025.10.033","DOIUrl":"10.1016/j.healun.2025.10.033","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 440-441"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516249","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 : 2025-11-12DOI: 10.1016/j.healun.2025.10.015
Norihisa Shigemura MD, PhD , Chadi A. Hage MD
{"title":"Beyond the incision: Integrating mechanical circulatory support and less-invasive approaches in lung transplantation","authors":"Norihisa Shigemura MD, PhD , Chadi A. Hage MD","doi":"10.1016/j.healun.2025.10.015","DOIUrl":"10.1016/j.healun.2025.10.015","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 251-252"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516282","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 : 2025-11-12DOI: 10.1016/j.healun.2025.11.006
Susanna Mak MD, PhD
{"title":"“Advanced hemodynamics”—moving the field forward","authors":"Susanna Mak MD, PhD","doi":"10.1016/j.healun.2025.11.006","DOIUrl":"10.1016/j.healun.2025.11.006","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 386-387"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515886","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 : 2025-11-12DOI: 10.1016/j.healun.2025.10.018
John M. Trahanas, Aaron M. Williams
{"title":"Follow the lead of the Valiant − heart transplantation after prolonged donor ischemia time","authors":"John M. Trahanas, Aaron M. Williams","doi":"10.1016/j.healun.2025.10.018","DOIUrl":"10.1016/j.healun.2025.10.018","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 182-183"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516248","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 : 2025-11-12DOI: 10.1016/j.healun.2025.10.030
Isabel C. Balachandran MD , Ruth O. Adekunle MD, MSCR
{"title":"A New Frontier of HIV Organ Policy Equity − Expanding the transplant donor pool","authors":"Isabel C. Balachandran MD , Ruth O. Adekunle MD, MSCR","doi":"10.1016/j.healun.2025.10.030","DOIUrl":"10.1016/j.healun.2025.10.030","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 3","pages":"Pages 473-474"},"PeriodicalIF":6.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516247","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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