Pub Date : 2026-02-01Epub Date: 2025-11-07DOI: 10.1016/j.healun.2025.10.009
Jennifer K.L. Chow MD, MS, David R. Snydman MD
{"title":"Response to “Letermovir prophylaxis and CMV immune monitoring: Toward a win–win strategy in heart transplantation”","authors":"Jennifer K.L. Chow MD, MS, David R. Snydman MD","doi":"10.1016/j.healun.2025.10.009","DOIUrl":"10.1016/j.healun.2025.10.009","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Page 311"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458987","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 : 2026-02-01Epub Date: 2025-12-16DOI: 10.1016/j.healun.2025.09.017
John R. Greenland MD, PhD , Michael Perch MD , Kieran Halloran MD, MSc , Deborah J. Levine MD , Eric D. Morrell MD, MA , Anna Reed MBChB , Ciara M. Shaver MD, PhD , Jonathan P. Singer MD, MS , Stuart C. Sweet MD, PhD , Robin Vos MD, PhD , Shambhu Aryal MD, FCCP , Nicholas Avdimiretz MD, FRCPC , Fay Burrows BPharm , Daniel Calabrese MD , Fiorella Calabrese MD , Silvia Campos PhD , Michael Combs MD, MS , Marc de Perrot MD, MSc, FRCSC , Göran Dellgren MD, PhD , Joshua M. Diamond MD, MS , Jamie L. Todd MD, MHS
Clinical trials in lung transplantation have been hindered by a lack of clarity on the formulation and significance of endpoints for evaluating therapeutic efficacy. To address this challenge, a multidisciplinary working group from the International Society for Heart and Lung Transplantation developed consensus recommendations on endpoints beyond mortality. These endpoints include primary graft dysfunction (PGD), chronic lung allograft dysfunction (CLAD), acute cellular rejection (ACR), antibody-mediated rejection (AMR), immunosuppression-related complications, patient-reported outcomes (PROs), and pediatric-specific considerations. For each endpoint, a subgroup reviewed measurement best practices, assessed links to clinical benefit, and evaluated the evidence supporting their utility in clinical trial settings. Consensus was established through a Delphi process involving three rounds of voting. This document provides practical guidance for operationalizing these endpoints and outlines their optimal use in clinical trials. By standardizing trial design, these recommendations aim to accelerate the development of urgently needed therapies to improve lung transplantation outcomes.
{"title":"Considerations for Endpoints in Lung Transplant Clinical Trials: An ISHLT Consensus Statement","authors":"John R. Greenland MD, PhD , Michael Perch MD , Kieran Halloran MD, MSc , Deborah J. Levine MD , Eric D. Morrell MD, MA , Anna Reed MBChB , Ciara M. Shaver MD, PhD , Jonathan P. Singer MD, MS , Stuart C. Sweet MD, PhD , Robin Vos MD, PhD , Shambhu Aryal MD, FCCP , Nicholas Avdimiretz MD, FRCPC , Fay Burrows BPharm , Daniel Calabrese MD , Fiorella Calabrese MD , Silvia Campos PhD , Michael Combs MD, MS , Marc de Perrot MD, MSc, FRCSC , Göran Dellgren MD, PhD , Joshua M. Diamond MD, MS , Jamie L. Todd MD, MHS","doi":"10.1016/j.healun.2025.09.017","DOIUrl":"10.1016/j.healun.2025.09.017","url":null,"abstract":"<div><div>Clinical trials in lung transplantation have been hindered by a lack of clarity on the formulation and significance of endpoints for evaluating therapeutic efficacy. To address this challenge, a multidisciplinary working group from the International Society for Heart and Lung Transplantation developed consensus recommendations on endpoints beyond mortality. These endpoints include primary graft dysfunction (PGD), chronic lung allograft dysfunction (CLAD), acute cellular rejection (ACR), antibody-mediated rejection (AMR), immunosuppression-related complications, patient-reported outcomes (PROs), and pediatric-specific considerations. For each endpoint, a subgroup reviewed measurement best practices, assessed links to clinical benefit, and evaluated the evidence supporting their utility in clinical trial settings. Consensus was established through a Delphi process involving three rounds of voting. This document provides practical guidance for operationalizing these endpoints and outlines their optimal use in clinical trials. By standardizing trial design, these recommendations aim to accelerate the development of urgently needed therapies to improve lung transplantation outcomes.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages e104-e128"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762271","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 : 2026-02-01Epub Date: 2025-10-09DOI: 10.1016/j.healun.2025.09.022
Naoki Tadokoro MD, PhD , Sho Takemoto MD , Mansoo Cho MS , Taylor Nordan MD , Michael M. Givertz MD , Tanujit Dey PhD , Mandeep R. Mehra MD, MSc , Akinobu Itoh MD PhD
Introduction
Simultaneous heart–kidney transplantation (SHKT) has become an effective option for patients with end-stage heart and kidney failure; however, the shortage of donors remains a significant challenge. Since 2019, hearts donated after circulatory death (DCD) have been approved and increasingly used, but their safety in the context of SHKT has not been thoroughly studied.
Methods
We conducted a retrospective cohort study using the United Network for Organ Sharing (UNOS) database from January 2019 to December 2024, identifying 1761 adults who were primary SHKT recipients. To adjust for baseline differences, we performed propensity score matching (2:1 nearest neighbor), resulting in 298 donation after brain death (DBD) and 149 DCD recipients. The endpoints assessed included 2-year overall survival, delayed graft function (DGF), and kidney graft survival.
Results
After matching, both heart and kidney out-of-body times remained significantly longer in the DCD group compared to the DBD group (p < 0.001). DGF was more common in the DCD group (36% vs 26%, p = 0.023). Two-year survival rates were 83.6% in the DCD group and 82.3% in the DBD group (p = 0.88). Robust Cox models showed no association between donor type and two-year mortality (Hazard Ratio: 0.78, 95% Confidence Interval: 0.43-1.44, p = 0.5) or kidney graft failure (HR: 0.61, 95% CI: 0.16-2.26, p = 0.5).
Conclusion
SHKT using DCD donor organs shows similar 2-year survival and graft outcomes compared to those using DBD donors, supporting the safe and effective use of DCD organs to expand the donor pool.
同步心肾移植（SHKT）已成为终末期心脏和肾衰竭患者的有效选择；然而，捐助者短缺仍然是一个重大挑战。自2019年以来，循环死亡（DCD）后捐赠的心脏已被批准并越来越多地使用，但其在SHKT背景下的安全性尚未得到彻底研究。方法：2019年1月至2024年12月，我们使用UNOS数据库进行了一项回顾性队列研究，确定了1761名原发性SHKT接受者。为了调整基线差异，我们进行了倾向评分匹配（2:1最近邻），导致298名脑死亡（DBD）后捐赠和149名DCD接受者。评估的终点包括2年总生存期、延迟移植功能（DGF）和肾移植生存期。结果匹配后，DCD组心脏和肾脏离体时间明显长于DBD组（p < 0.001）。DGF在DCD组中更为常见（36% vs. 26%, p = 0.023）。DCD组2年生存率为83.6%，DBD组为82.3% （p = 0.88）。稳健的Cox模型显示供体类型与两年死亡率（风险比：0.78,95%可信区间：0.43-1.44,p = 0.5）或肾移植衰竭（风险比：0.61,95% CI: 0.16-2.26, p = 0.5）之间无关联。结论使用DCD供体器官的shkt与使用DBD供体器官的shkt相比具有相似的2年生存率和移植结果，支持安全有效地使用DCD器官来扩大供体池。
{"title":"Outcomes of simultaneous heart–kidney transplantation using donation after circulatory death donors: A propensity-matched analysis from the UNOS registry","authors":"Naoki Tadokoro MD, PhD , Sho Takemoto MD , Mansoo Cho MS , Taylor Nordan MD , Michael M. Givertz MD , Tanujit Dey PhD , Mandeep R. Mehra MD, MSc , Akinobu Itoh MD PhD","doi":"10.1016/j.healun.2025.09.022","DOIUrl":"10.1016/j.healun.2025.09.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Simultaneous heart–kidney transplantation (SHKT) has become an effective option for patients with end-stage heart and kidney failure; however, the shortage of donors remains a significant challenge. Since 2019, hearts donated after circulatory death (DCD) have been approved and increasingly used, but their safety in the context of SHKT has not been thoroughly studied.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the United Network for Organ Sharing (UNOS) database from January 2019 to December 2024, identifying 1761 adults who were primary SHKT recipients. To adjust for baseline differences, we performed propensity score matching (2:1 nearest neighbor), resulting in 298 donation after brain death (DBD) and 149 DCD recipients. The endpoints assessed included 2-year overall survival, delayed graft function (DGF), and kidney graft survival.</div></div><div><h3>Results</h3><div>After matching, both heart and kidney out-of-body times remained significantly longer in the DCD group compared to the DBD group (<em>p</em> < 0.001). DGF was more common in the DCD group (36% vs 26%, <em>p</em> = 0.023). Two-year survival rates were 83.6% in the DCD group and 82.3% in the DBD group (<em>p</em> = 0.88). Robust Cox models showed no association between donor type and two-year mortality (Hazard Ratio: 0.78, 95% Confidence Interval: 0.43-1.44, <em>p</em> = 0.5) or kidney graft failure (HR: 0.61, 95% CI: 0.16-2.26, <em>p</em> = 0.5).</div></div><div><h3>Conclusion</h3><div>SHKT using DCD donor organs shows similar 2-year survival and graft outcomes compared to those using DBD donors, supporting the safe and effective use of DCD organs to expand the donor pool.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 204-211"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254817","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 : 2026-02-01Epub Date: 2026-01-16DOI: 10.1016/S1053-2498(25)02502-1
{"title":"Information for Readers","authors":"","doi":"10.1016/S1053-2498(25)02502-1","DOIUrl":"10.1016/S1053-2498(25)02502-1","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Page A2"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982002","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 : 2026-02-01Epub Date: 2025-10-02DOI: 10.1016/j.healun.2025.09.023
Darae Kim , Kyu-Sun Lee , Yang Hyun Cho , Hae-Young Lee , Myoung Soo Kim , Hyungseop Kim , Dong-Ju Choi , Sang Eun Lee , Seok-Min Kang , Soo Yong Lee , Hyun-Jai Cho , Jin-Oh Choi , on behalf of KOTRY study group
Background
Extracorporeal membrane oxygenation (ECMO) is prioritized in Korea’s heart transplant (HTx) allocation system to reduce waitlist mortality, but post-transplant outcomes remain a concern. We compared post-transplant outcomes among HTx recipients bridged with ECMO, left ventricular assist device (LVAD), or without mechanical circulatory support (non-MCS).
Methods
We retrospectively analyzed 1021 adult HTx recipients enrolled in the Korean Organ Transplant Registry (2014-2023). Patients were categorized according to bridging strategy at transplantation (ECMO n = 357, LVAD n = 137, non-MCS n = 527). Outcomes included primary graft dysfunction (PGD), in-hospital mortality, any treated rejection, coronary allograft vasculopathy, infection requiring hospitalization, and post-transplant mortality.
Results
ECMO bridging was associated with significantly higher risks of severe PGD (adjusted HR 3.68 vs non-MCS; 2.23 vs LVAD). In-hospital mortality was highest in ECMO recipients (17.9%) compared with LVAD-bridged (4.4%) and non-MCS recipients (4.4%) (P < 0.001). Kaplan-Meier analysis demonstrated significantly lower survival in the ECMO group at 90 days (83.2% vs 94.8% vs 95.0%) and 1 year (77.5% vs 89.0% vs 92.5%) (log-rank p < 0.0001). However, in 6-month landmark analyses, survival was similar across groups. Among ECMO recipients, those who died within 6 months had a markedly higher prevalence of pre-transplant dialysis (66.7% vs 34.7%, p < 0.001). The incidence of treated rejection and CAV did not differ significantly among the three groups.
Conclusions
Direct ECMO bridging is associated with worse early post-transplant outcomes, primarily driven by severe PGD and early mortality, underscoring the need for careful candidate selection. LVAD bridging provided outcomes comparable to non-MCS and may offer a bridge-to-candidacy strategy for selected ECMO patients.
体外膜氧合（ECMO）在韩国心脏移植（HTx）分配系统中被优先考虑，以减少等待名单死亡率，但移植后的结果仍然令人担忧。我们比较了HTx受体在ECMO、左心室辅助装置（LVAD）或无机械循环支持（non-MCS）的桥接下的移植后结果。方法回顾性分析韩国器官移植登记处（2014-2023）登记的1021名成人HTx受者。根据移植时桥接策略对患者进行分类（ECMO n=357, LVAD n=137，非mcs n=527）。结果包括原发性移植物功能障碍（PGD）、住院死亡率、任何治疗后的排斥反应、冠状动脉移植血管病变、需要住院治疗的感染和移植后死亡率。结果secmo桥接与严重PGD的风险显著升高相关（调整后的HR为3.68 vs非mcs； 2.23 vs LVAD）。ECMO受者的住院死亡率最高（17.9%），高于lvad桥接（4.4%）和非mcs受者（4.4%）（p<0.001）。Kaplan-Meier分析显示，ECMO组90天生存率（83.2% vs. 94.8% vs. 95.0%）和1年生存率（77.5% vs. 89.0% vs. 92.5%）显著降低（log-rank p<0.0001）。然而，在6个月的里程碑分析中，各组的生存率相似。在ECMO受者中，6个月内死亡的患者移植前透析的患病率明显更高（66.7% vs. 34.7%, p<0.001）。治疗后的排斥反应和CAV的发生率在三组之间没有显著差异。结论：直接ECMO桥接与较差的移植后早期预后相关，主要是由严重的PGD和早期死亡率驱动的，强调了谨慎选择候选者的必要性。LVAD桥接提供了与非mcs相当的结果，并可能为选定的ECMO患者提供候选策略的桥梁。
{"title":"Post-transplant outcomes by bridging strategy: A nationwide multicenter study of heart transplant recipients in Korea","authors":"Darae Kim , Kyu-Sun Lee , Yang Hyun Cho , Hae-Young Lee , Myoung Soo Kim , Hyungseop Kim , Dong-Ju Choi , Sang Eun Lee , Seok-Min Kang , Soo Yong Lee , Hyun-Jai Cho , Jin-Oh Choi , on behalf of KOTRY study group","doi":"10.1016/j.healun.2025.09.023","DOIUrl":"10.1016/j.healun.2025.09.023","url":null,"abstract":"<div><h3>Background</h3><div>Extracorporeal membrane oxygenation (ECMO) is prioritized in Korea’s heart transplant (HTx) allocation system to reduce waitlist mortality, but post-transplant outcomes remain a concern. We compared post-transplant outcomes among HTx recipients bridged with ECMO, left ventricular assist device (LVAD), or without mechanical circulatory support (non-MCS).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1021 adult HTx recipients enrolled in the Korean Organ Transplant Registry (2014-2023). Patients were categorized according to bridging strategy at transplantation (ECMO <em>n</em> = 357, LVAD <em>n</em> = 137, non-MCS <em>n</em> = 527). Outcomes included primary graft dysfunction (PGD), in-hospital mortality, any treated rejection, coronary allograft vasculopathy, infection requiring hospitalization, and post-transplant mortality.</div></div><div><h3>Results</h3><div>ECMO bridging was associated with significantly higher risks of severe PGD (adjusted HR 3.68 vs non-MCS; 2.23 vs LVAD). In-hospital mortality was highest in ECMO recipients (17.9%) compared with LVAD-bridged (4.4%) and non-MCS recipients (4.4%) (<em>P</em> < 0.001). Kaplan-Meier analysis demonstrated significantly lower survival in the ECMO group at 90 days (83.2% vs 94.8% vs 95.0%) and 1 year (77.5% vs 89.0% vs 92.5%) (log-rank <em>p</em> < 0.0001). However, in 6-month landmark analyses, survival was similar across groups. Among ECMO recipients, those who died within 6 months had a markedly higher prevalence of pre-transplant dialysis (66.7% vs 34.7%, <em>p</em> < 0.001). The incidence of treated rejection and CAV did not differ significantly among the three groups.</div></div><div><h3>Conclusions</h3><div>Direct ECMO bridging is associated with worse early post-transplant outcomes, primarily driven by severe PGD and early mortality, underscoring the need for careful candidate selection. LVAD bridging provided outcomes comparable to non-MCS and may offer a bridge-to-candidacy strategy for selected ECMO patients.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 227-235"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226653","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub Date: 2026-01-16DOI: 10.1016/j.healun.2025.09.016
John R. Greenland MD, PhD , Michael Perch MD , Kieran Halloran MD, MSc , Deborah J. Levine MD , Eric D. Morrell MD, MA , Anna Reed MBChB , Ciara M. Shaver MD, PhD , Jonathan P. Singer MD, MS , Stuart C. Sweet MD, PhD , Robin Vos MD, PhD , Shambhu Aryal MD, FCCP , Nicholas Avdimiretz MD, FRCPC , Fay Burrows Bpharm , Daniel Calabrese MD , Fiorella Calabrese MD , Silvia Campos PhD , Michael Combs MD, MS , Marc de Perrot MD, MSc, FRCSC , Göran Dellgren MD, PhD , Joshua M. Diamond MD, MS , Jamie L. Todd MD, MHS
{"title":"Considerations for Endpoints in Lung Transplant Clinical Trials: Perspective on the ISHLT Consensus Statement","authors":"John R. Greenland MD, PhD , Michael Perch MD , Kieran Halloran MD, MSc , Deborah J. Levine MD , Eric D. Morrell MD, MA , Anna Reed MBChB , Ciara M. Shaver MD, PhD , Jonathan P. Singer MD, MS , Stuart C. Sweet MD, PhD , Robin Vos MD, PhD , Shambhu Aryal MD, FCCP , Nicholas Avdimiretz MD, FRCPC , Fay Burrows Bpharm , Daniel Calabrese MD , Fiorella Calabrese MD , Silvia Campos PhD , Michael Combs MD, MS , Marc de Perrot MD, MSc, FRCSC , Göran Dellgren MD, PhD , Joshua M. Diamond MD, MS , Jamie L. Todd MD, MHS","doi":"10.1016/j.healun.2025.09.016","DOIUrl":"10.1016/j.healun.2025.09.016","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 168-171"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982004","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 : 2026-02-01Epub Date: 2026-01-16DOI: 10.1016/j.healun.2025.09.007
Jacob E. Møller , Norman Mangner , Vasileios Panoulas , Christian Hassager
{"title":"Letter to Carnicelli et al. outcomes with Impella CP in acute myocardial infarction vs heart failure cardiogenic shock","authors":"Jacob E. Møller , Norman Mangner , Vasileios Panoulas , Christian Hassager","doi":"10.1016/j.healun.2025.09.007","DOIUrl":"10.1016/j.healun.2025.09.007","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Page 312"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981960","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 : 2026-02-01Epub Date: 2025-10-09DOI: 10.1016/j.healun.2025.09.026
Andrei M. Darie , Atsuo Doi , Bronwyn J. Levvey , Helen Shingles , Shaun Yo , Trevor Williams , Gregory I. Snell
Introduction
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary vascular disease amenable to multimodal therapy. Pulmonary endarterectomy (PEA) is the cornerstone of CTEPH treatment for operable patients. However, a significant proportion of patients present with inoperable disease or residual postoperative pulmonary hypertension. Lung transplantation (LTx) remains a lifesaving therapy for patients with end-stage right heart failure due to CTEPH.
Methods
In this case series we describe six cases of CTEPH undergoing LTx at the Alfred Hospital. Half of the patients included in this case series underwent PEA prior to LTx.
Results
The most frequent finding on explant histology was arterial muscular hypertrophy due to thrombotic arteriopathy. We present the pre-transplant hemodynamic features and discuss the long-term outcomes post-LTx and the surgical challenges that can arise in the context of prior cardiothoracic surgery.
Conclusions
LTx is a definitive, although rarely utilized therapy, underlining the growing expertise and advancements in specific multimodal therapy for CTEPH.
{"title":"Lung transplantation for chronic thromboembolic pulmonary hypertension—a case series","authors":"Andrei M. Darie , Atsuo Doi , Bronwyn J. Levvey , Helen Shingles , Shaun Yo , Trevor Williams , Gregory I. Snell","doi":"10.1016/j.healun.2025.09.026","DOIUrl":"10.1016/j.healun.2025.09.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary vascular disease amenable to multimodal therapy. Pulmonary endarterectomy (PEA) is the cornerstone of CTEPH treatment for operable patients. However, a significant proportion of patients present with inoperable disease or residual postoperative pulmonary hypertension. Lung transplantation (LTx) remains a lifesaving therapy for patients with end-stage right heart failure due to CTEPH.</div></div><div><h3>Methods</h3><div>In this case series we describe six cases of CTEPH undergoing LTx at the Alfred Hospital. Half of the patients included in this case series underwent PEA prior to LTx.</div></div><div><h3>Results</h3><div>The most frequent finding on explant histology was arterial muscular hypertrophy due to thrombotic arteriopathy. We present the pre-transplant hemodynamic features and discuss the long-term outcomes post-LTx and the surgical challenges that can arise in the context of prior cardiothoracic surgery.</div></div><div><h3>Conclusions</h3><div>LTx is a definitive, although rarely utilized therapy, underlining the growing expertise and advancements in specific multimodal therapy for CTEPH.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"45 2","pages":"Pages 253-259"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254815","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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