Elevated Oxygen Extraction During Heart Transplantation Is Associated With Increased Morbidity and Mortality: Implications for Goal-Directed Perfusion

April 12, 2026 No Comments

This single-center retrospective study of 381 adult heart transplants found that prolonged oxygen extraction ratio, or O2ER, above 0.20 during cardiopulmonary bypass was linked to higher post-transplant morbidity and early mortality. O2ER outperformed low indexed oxygen delivery alone in predicting risk, especially around reperfusion, suggesting that perfusion strategies should focus on matching oxygen delivery to metabolic demand rather than relying only on fixed delivery thresholds.

Heart-Liver-Kidney Transplantation for AL Amyloidosis Using Normothermic Recovery and Storage From a Donor Following Circulatory Death: Short-Term Outcome in a First-in-World Experience

April 8, 2026 No Comments

This case report describes the first known heart-liver-kidney transplant for AL amyloidosis using organs recovered from a donation-after-circulatory-death donor with thoracoabdominal normothermic regional perfusion. A 40-year-old man with terminal multiorgan AL amyloidosis underwent sequential heart, liver, and kidney transplantation and remained free of graft dysfunction or rejection at 8 months, highlighting a new path to expand complex transplant access.

Global Bridge to Heart Transplant With Prolonged Impella 5.5 Support

Impact of Prolonged Impella 5.5 Support on Post-Transplant Outcomes: An Institutional Study

March 26, 2026 No Comments

This institutional retrospective study evaluated 72 patients bridged to heart transplant with the Impella 5.5 and compared outcomes for support durations of 14 days or less versus more than 14 days. Prolonged support did not worsen 1-year survival, graft rejection, length of stay, or major complications. Although rehospitalization within a year was common, overall survival was excellent, supporting extended Impella 5.5 use as a safe bridge-to-transplant strategy.

Outcomes of Heart Failure Hospitalizations at Urban Teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States

February 26, 2026 No Comments

This nationwide propensity-matched study of 7.5 million U.S. heart failure hospitalizations (2016–2022) found that urban teaching hospitals had higher inpatient mortality, complication rates, length of stay, costs, and palliative care consultations compared with urban non-teaching hospitals. Despite worse in-hospital outcomes, 30- and 90-day readmission rates were similar. Findings likely reflect referral bias and greater illness severity at teaching centers rather than differences in care quality.

Expanding the Donor Pool: Rethinking Time to Death in DCD Liver Transplantation

Donor Time to Death and DCD Liver Transplant Outcomes: Challenging the Dogma That Shorter Is Better

February 23, 2026 No Comments

This large UNOS registry study of 8,489 DCD liver transplants (2010–2024) found that shorter donor time to death (TTD) was associated with worse graft survival, while prolonged TTD did not negatively impact outcomes—even without normothermic regional perfusion (NRP). Despite this, liver utilization declined sharply after 15 minutes of TTD. Simulation modeling showed that avoiding TTD-based decline could increase utilization by 17%, potentially adding hundreds of safe transplants.

Elective Use of Intraoperative Extracorporeal Membrane Oxygenation in Patients With Pulmonary Fibrosis Reduces Primary Graft Dysfunction After Bilateral Lung Transplantation

February 23, 2026 No Comments

This single-center retrospective study evaluated 422 pulmonary fibrosis patients undergoing bilateral lung transplantation between 2012 and 2025. After adopting a more liberal elective intraoperative veno-arterial ECMO strategy in 2020, the incidence of severe primary graft dysfunction (PGD grade 3 at 72 hours) significantly decreased. Elective ECMO use was associated with shorter ventilation times, reduced dialysis rates, and a trend toward improved one-year graft survival without increasing major vascular complications.

Heart Transplantation Graft Survival Following Donation After Circulatory Death via Thoracoabdominal Normothermic Regional Perfusion

February 18, 2026 No Comments

This national cohort study analyzed adult heart transplants in the United States from 2020–2024 to compare graft survival among donation after circulatory death (DCD) using thoracoabdominal normothermic regional perfusion (TA-NRP), DCD with direct procurement and perfusion (DPP), and donation after brain death (DBD). Two-year graft and patient survival were comparable across groups, supporting broader use of TA-NRP in heart transplantation.

Machine Learning for In-hospital Mortality Prediction in Critically Ill Patients With Acute Heart Failure: A Retrospective Analysis Based on the MIMIC-IV Database

April 3, 2025 No Comments

This study developed machine learning (ML) models to predict in-hospital mortality among ICU patients with acute heart failure (AHF) using data from the MIMIC-IV database. Among five tested algorithms, XGBoost showed the highest predictive accuracy (AUC: 0.82) and outperformed traditional clinical scoring systems. The model incorporated 18 clinical variables from the first 24 hours of ICU admission to aid early intervention strategies.

CytoSorb Filter During Kidney Normothermic

Protocol for a Single-Centre Randomised Pilot Study to Assess the Safety and Feasibility of Adding a CytoSorb Filter During Kidney Normothermic Machine Perfusion to Remove Inflammatory and Immune Mediators Prior to Kidney Transplantation

April 3, 2025 No Comments

This pilot study assesses the safety and feasibility of using a CytoSorb filter during kidney normothermic machine perfusion (NMP) before transplantation. The goal is to reduce inflammation-related damage by filtering immune mediators. Twenty patients will be randomized to receive kidneys preserved with or without the filter. Outcomes include immune gene expression, delayed graft function, and kidney performance at intervals post-transplant.

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

March 29, 2025 No Comments

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.