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Mandeep R Mehra, MD MBBS FACC FACP

mandeep mehraThe August issue of the JHLT follows on the heels of release of our 2011 Impact Factor Rankings which have increased dramatically. Our Impact Factor is now 4.33 and places the JHLT 1st among all solid organ specific transplant journals, 3rd among all Transplantation Journals, and 6th among all respiratory system journals. In the very competitive landscape of cardiovascular journals, the JHLT moved from 34 to a ranking of 22 out of 117 journals.


In this issue of the journal, the JHLT once again focuses on cutting edge issues related to ABO incompatible heart transplants, outcomes in specific situations after transplantation such as those with a remote cancer history and chemotherapy related heart failure. We also feature an important international randomized control trial in lung transplantation that demonstrates a decrease in BOS in the setting of different calcineurin inhibitors. Pulmonary hypertension and response to therapy is highlighted in a sub-study from the TRIUMPH trial. Finally, we see the impact of modification of currently available risk scores to determine disease prognosis in advanced heart failure and guide decision making.

♦  Pushing the boundaries: The current status of ABO-incompatible cardiac transplantation (Irving et al.)
Newer research is now focusing on longer term outcomes of ABOi transplants - in particular the development of graft accommodation or tolerance. This review assesses the current status of ABO-incompatible cardiac transplantation both in infants and in sensitized and older patients. Read more...

♦  Tacrolimus and cyclosporine have differential effects on the risk of development of bronchiolitis obliterans syndrome: Results of a prospective, randomized international trial in lung transplantation (Treede et al.)
In a multicenter, prospective, randomized (1:1) open-label superiority investigation of de novo tacrolimus vs cyclosporine after lung transplantation (stratified at entry for cystic fibrosis) these investigators evaluated the incidence of BOS 3 years after transplant (intention-to-treat analysis). Compared with cyclosporine, de novo tacrolimus use was found to be associated with a significantly reduced risk for BOS Grade ≥1 at 3 years despite a similar rate of acute rejection. However, no survival advantage was detected. Read more...

♦  Characteristics and survival of patients with chemotherapy-induced cardiomyopathy undergoing heart transplantation (Oliveira et al.)
In an investigation from the International Society of Heart and Lung Transplantation Registry patients with chemotherapy-induced cardiomyopathy (CCMP) selected for heart transplantation were younger, had less comorbidity, and were more likely to require biventricular mechanical support pre-transplant than other non-ischemic cardiomyopathy. Despite the higher incidence of malignancy and infection in CCMP patients who have received a heart transplant, their survival was comparable to those with a pre-transplant diagnosis of other cardiomyopathies. Read more...

♦  Baseline NT-proBNP correlates with change in 6-minute walk distance in patients with pulmonary arterial hypertension in the pivotal inhaled treprostinil study TRIUMPH-1 (Frantz et al.)
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a biomarker of disease severity in pulmonary arterial hypertension (PAH). In this study baseline NT-proBNP levels and improvement in 6-minute walk distance (6MWD) in the pivotal randomized, placebo-controlled, double-blind study of the addition of inhaled treprostinil to oral therapy for PAH, was assessed. Greater improvement in 6MWD in actively treated patients with high levels of NT-proBNP noted helps to enhance understanding of the robustness of clinical response to inhaled treprostinil in more advanced disease. Read more...

♦  Prognostic impact of the addition of peak oxygen consumption to the Seattle Heart Failure Model in a transplant referral population (Levy et al.)
In this study the addition of peak oxygen consumption (VO2 was found to add prognostic information across the spectrum of the SHFM, but changes in decision regarding transplant listing occurred mainly in moderate-risk patients. Read more...

Disclosure Statement: Dr. Mehra has consultant relationships with the following companies: St. Jude's Inc, Johnson & Johnson, Medtronic, and Abbott Vascular.