CytoSorb Hemoadsorption of Apixaban During Cardio-Pulmonary Bypass for Heart Transplantation

This case study reports on the successful intraoperative removal of apixaban using a CytoSorb hemoadsorption device during emergency heart transplantation. The 61-year-old patient, previously on apixaban, underwent cardiopulmonary bypass (CPB), during which the device significantly reduced anticoagulant levels without complications. The results suggest CytoSorb may offer a viable method to manage DOACs in urgent cardiac surgery settings.

March 29, 2025

Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

This study evaluates the impact of extracorporeal life support (ECLS) as a bridge to lung transplantation (BTT) for patients with idiopathic pulmonary arterial hypertension (iPAH). A comparison between two cohorts (1997–2005 and 2006–2010) shows that ECLS significantly reduced waiting list mortality (from 22% to 0%) while slightly increasing ICU stay. The findings suggest that aggressive ECLS management can improve survival rates for iPAH patients awaiting lung transplants.

March 19, 2025

Outcomes of Donation After Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion

This study examines outcomes of donation after circulatory death (DCD) heart transplantation using thoracoabdominal normothermic regional perfusion (TA-NRP). A retrospective analysis of 32 recipients between 2020-2023 found 100% one-year survival, low rejection rates, and acceptable primary graft dysfunction (PGD) and cardiac allograft vasculopathy (CAV) rates. No significant differences were observed between co-localized and distant donor transplants. TA-NRP proves to be a viable method for DCD heart transplantation.

March 19, 2025

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

This expert consensus document from the American Association for Thoracic Surgery outlines standardized best practices for donor lung procurement and preservation. It highlights significant variability in existing techniques and emphasizes the role of ex vivo lung perfusion (EVLP), cold storage, and normothermic regional perfusion. The document provides 34 evidence-based recommendations aimed at improving organ utilization and lung transplant outcomes.

February 6, 2025

The Superiority of Veno-Arterial Over Veno-Venous Extracorporeal Membrane Oxygenation for Operative Support of Lung Transplantation

This study compares the effectiveness of veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) in lung transplantation. Analyzing 62 patients over eight years, results show that V-A ECMO provides superior pulmonary circulatory unloading and improved survival outcomes. Patients on V-A ECMO had lower pulmonary artery pressure, better oxygenation, and reduced pulmonary edema compared to V-V ECMO. Findings suggest V-A ECMO should be the preferred choice when clinically appropriate.

January 23, 2025

Clinical Outcomes of Cardiac Transplantation in Heart Failure Patients with Previous Mechanical Cardiocirculatory Support

This study evaluates the long-term outcomes of heart failure patients undergoing cardiac transplantation with prior left ventricular assist device (LVAD) use as a bridge-to-transplant (BTT) compared to direct-to-transplant (DTT). The findings indicate similar survival rates at 1 and 7 years post-transplant in both groups. Although LVADs increase surgical complexity and incidence of cerebrovascular events, they do not negatively affect overall outcomes, supporting their viability in advanced heart failure care.

January 18, 2025

Enhancing Lung Transplantation with ECMO: A Comprehensive Review of Mechanisms, Outcomes, and Future Considerations

Lung transplantation (LTx) is a transformative solution for patients with end-stage lung disease, but it comes with significant challenges, including limited donor availability and severe post-operative complications. This review focuses on the role of Extracorporeal Membrane Oxygenation (ECMO) in overcoming these hurdles and improving patient outcomes across all phases of the transplant process.

ECMO, initially developed for cardiac surgery, has become an essential tool in lung transplantation, particularly for its ability to provide cardiopulmonary support. Its applications span the preoperative, intraoperative, and postoperative stages, making it integral to modern LTx practices.

December 22, 2024

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.

December 21, 2024

The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation Among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis

This systematic review analyzes prolonged mechanical ventilation (PMV) post-cardiac surgery, finding an incidence rate of 20%. PMV, defined as ventilation lasting ≥24 hours, is linked to in-hospital mortality (odds ratio: 14.13). Key risk factors include advanced age, female sex, ejection fraction <50%, and body mass index >28 kg/m². PMV also correlates with conditions like chronic renal failure and prolonged cardiopulmonary bypass time. These insights highlight the need for targeted prevention and management strategies.

December 20, 2024

Intraoperative Extracorporeal Support for Lung Transplant: A Systematic Review and Network Meta-Analysis

This systematic review and network meta-analysis investigates the comparative effectiveness of veno-arterial extracorporeal membrane oxygenation (V-A ECMO), cardiopulmonary bypass (CPB), and OffPump strategies for lung transplantation (LT). Based on 27 observational studies with 6113 patients, the study finds that OffPump approaches outperform both ECMO and CPB in all major outcomes, including reduced ICU stay, mechanical ventilation duration, and mortality. Among extracorporeal supports, V-A ECMO showed better performance than CPB. Factors such as age, gender, and BMI significantly influenced postoperative outcomes.

December 20, 2024

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Category: Transplantation

CytoSorb Hemoadsorption of Apixaban During Cardio-Pulmonary Bypass for Heart Transplantation

Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

Outcomes of Donation After Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

The Superiority of Veno-Arterial Over Veno-Venous Extracorporeal Membrane Oxygenation for Operative Support of Lung Transplantation

Clinical Outcomes of Cardiac Transplantation in Heart Failure Patients with Previous Mechanical Cardiocirculatory Support

Enhancing Lung Transplantation with ECMO: A Comprehensive Review of Mechanisms, Outcomes, and Future Considerations

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation Among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis

Intraoperative Extracorporeal Support for Lung Transplant: A Systematic Review and Network Meta-Analysis

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