International Perfusion Association

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IPA

Category: Transplantation

LVAD

Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score

This study evaluates the mortality risk associated with infections in patients with left ventricular assist devices (LVAD). It highlights the development of a clinical risk prediction score based on factors like diabetes, type of Staphylococcus aureus infection, and treatment approaches including surgical debridement and flap reconstruction. Results indicate varying survival rates based on risk scores, suggesting that tailored surgical interventions may improve outcomes for patients with LVAD infections.

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April 23, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

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April 22, 2024
Transplant Heart

Novel Portable Hypothermic Machine Perfusion Preservation Device Enhances Cardiac Viability of Donated Human Hearts

This study investigates a novel portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE®, designed to extend preservation times for donated human hearts. Utilizing hearts from 11 brain-dead donors, the research compared the efficacy of preservation across different durations (4, 6, and 8 hours) against standard static cold storage (SCS). Findings indicate that the VP.S ENCORE® significantly maintains cardiac viability and function, matching levels observed in healthy hearts, particularly in 6-hour perfusion scenarios which showed improved ventricular relaxation and reduced inflammation marker expression.

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April 18, 2024
ECMO Nexk

Alternative Venous Access Sites for Dual-Lumen Extracorporeal Membrane Oxygenation Cannulation

This multicenter case series examines the safety and feasibility of using alternative venous access sites for dual-lumen cannulas in veno-venous (VV) extracorporeal membrane oxygenation (ECMO) when the right internal jugular vein (RIJV) is inaccessible. Data from three high-volume ECMO centers were analyzed, involving 20 patients who required alternative access due to inaccessible RIJV. The study found no procedural complications with alternative sites, which included the left internal jugular, subclavian, and femoral veins. The outcomes were promising with half of the patients successfully bridged to lung transplantation or recovery, highlighting the viability of these alternative sites for critical ECMO support.

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April 11, 2024
TP Perfusion

Beating Heart Transplant Procedures Using Organs From Donors With Circulatory Death

This study evaluates the safety and efficacy of the beating heart method for heart transplantation using donors deceased after circulatory death (DCD). Conducted on 10 male patients with end-stage heart failure, it found 100% survival without the need for postoperative extracorporeal membrane oxygenation (ECMO). This method, which potentially reduces ischemia reperfusion injury, suggests a promising approach to DCD heart transplantation that may lower the incidence of primary graft dysfunction. The findings are significant for institutions considering the use of DCD donors for heart transplants.

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March 12, 2024
Lung Transplat

Intraoperative Extracorporeal Support during Lung Transplantation: Not Just for the High-Risk Patient

In lung transplantation, the use of intraoperative mechanical support, particularly cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), has evolved over time due to their respective advantages and disadvantages. While CPB was traditionally preferred for its full hemodynamic support, it poses risks like systemic inflammation and coagulopathy; ECMO, on the other hand, offers many benefits of CPB with fewer risks, leading to better outcomes such as reduced primary graft dysfunction and overall improved survival, suggesting its potential as a standard protocol in lung transplants.

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January 19, 2024
Heart Transplantation

Donor Heart Preservation: Current Knowledge and the New Era of Machine Perfusion

Heart transplantation traditionally employs static cold storage for donor preservation, but this method carries a risk of early graft dysfunction due to ischemic and reperfusion injury. Emerging preservation techniques, such as hypothermic or normothermic machine perfusion, offer the promise of improved graft protection, the ability to repair organs, and the evaluation of graft function prior to transplantation, potentially expanding the donor pool with the aid of new pharmacological treatments.

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January 17, 2024
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