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TATTLING LINKS

~ ISHLT Members in the News ~



FROM THE CZECH REPUBLIC:


Jan Pirk, MD
Institute of Clinical and Experimental Medicine (IKEM), Prague

Center performed the first heart transplant in Prague in 1984
links imageThe Institute of Clinical and Experimental Medicine (IKEM) in Prague has performed 938 heart transplants since January 1984, when the first successful operation was carried out in the country, the cardiology center's head doctor, Jan Pirk, told journalists today. The latest heart transplant was performed last night, he said. In total, 778 men and 160 women have received a new heart at IKEM in the past 30 years. Seventeen of the patients were children, the youngest of them five years of age when he was operated on, Pirk said. More than 90 percent of the patients lived at least 12 months after the heart transplant, three-fourths of the patients lived more than five years, and roughly 60 percent survived more than 10 years. Patients wait one year on average for a new heart. Read full article →


FROM SAUDI ARABIA:


Waleed Saleh, MD
King Faisal Specialist Hospital, Riyadh

Saudi hospital becomes lung transplant leader
links imageKing Faisal Specialist Hospital and Research Center (KFSHRC) has become the regional leader in lung transplants with the use of innovative new techniques, local media reported. Qasim bin Othman Al-Qasabi, executive supervisor of the KFSHRC, said the hospital's use of the new technique is part of its strategic plan to remain the region's leader in this type of surgery. Surgeons performed 17 lung transplants in 2013, with a success rate comparable to well known international hospitals, including 15 two-lung, and two one-lung operations, he said. He said this was an increase of 20 percent from 2012, when doctors completed 14 operations. He said the hospital's surgeons also perform heart, liver, kidney, stem cell and bone transplants. Walid Saleh, a thoracic surgery consultant and surgical director of the lung transplant program at the KFSHRC, said the technique has recently allowed doctors to replace both lungs of a 17-year-old Saudi teenager. Read full article →


FROM SWITZERLAND:


Markus J. Wilhelm, MD
University Hospital Zurich

Heart transplantation continues to be "gold standard" treatment for end-stage heart failure
Heart transplantation continues to be the "gold standard" treatment for end-stage heart failure, and a large number of patients now live 20 years or more after surgery, according to a study in the February 2014 issue of The Annals of Thoracic Surgery. Hector Rodriguez Cetina Biefer, MD and Markus J. Wilhelm, MD, from the University Hospital Zurich in Switzerland, led a research team that examined long-term outcomes in 133 patients from their institution who underwent heart transplantation from 1985 to 1991. Among those patients, 74 (55.6%) survived at least 20 years post-transplantation. The average age at transplant for the 20-year survivors was 43.6 years. Major causes of death in non-survivors were graft rejection (21%), malignancy (21%), cardiac allograft vasculopathy (an accelerated form of coronary artery disease; 14.5%), and infections (14.5%). "A remarkable number of patients survived 20 years or more following heart transplantation, confirming the procedure as the 'gold standard' for end-stage heart failure, at least for the time being," said Dr. Wilhelm. Read full article →


FROM THE UNITED KINGDOM:


Prof. Magdi Yacoub, MD
Imperial College London Heart Science Centre, Harefield, Middlesex

Heart transplant patient Steve Syer of Hucclecote, Gloucestershire reaches 30-year milestone
links imageWhen engineer Steve Syer was given a new heart he was told it might give him another year of life - and if he survived for five years it would be a miracle. That was in 1984 and next month Mr Syer, 71, from Brockworth, near Gloucester, will celebrate 30 years of being fighting fit thanks to the transplant. His life-saving operation was the 87th to be performed by world famous surgeon Sir Magdi Yacoub at Harefield Hospital, Hillingdon, and Mr Syer is now one of the longest surviving patients in the country. Thirty years ago he was just hours from death when the heart of a 25-year-old road crash victim became available for transplant. Although he still has to take daily medication to prevent rejection of his donor heart Mr Syer has had few medical problems since the big op and has led an amazingly active and fulfilling life. Read full article →


This just in:

links image Watch the Conversation with Sir Magdi Yacoub, interviewed by Josef Stehlik, MD and recorded on January 18, 2013, as part of the ISHLT History Project.



FROM THE UNITED STATES:


Andrew C. Kao, MD
St. Luke's Mid-America Heart Institute, Kansas City, Missouri

Woman who has had two heart transplants gives birth
links imageA metro woman had received two heart transplants, yet she says nothing compares to her latest gift. Mindy Corbin now has a healthy baby girl. In 1998, a virus destroyed Corbin's heart for which she received a heart transplant, but then needed another one in 2005. All along, doctors told her that the risk was too high for her to ever have children. The medicines transplant patients take to prevent rejection can cause severe birth defects, but you can't just stop the meds during pregnancy. "It is not worthwhile losing the organ, having a child, and then having a mother die. That would be the ultimate tragedy," said Dr. Andrew Kao of St. Luke's Mid-America Heart Institute. Read full article →


Cesar A Keller, MD
Mayo Clinic Transplant Center, Jacksonville, Florida

Music therapy helping patients with lung problems
links imagePlaying a musical instrument can be fun, but for people with lung problems it can also offer a health benefit. One man convinced his doctor to make his favorite pastime a form of therapy. "I knew I could not just ignore what he was saying because this guy knows what he's talking about," said Dr. Cesar Keller, Professor of Medicine Medical Director, Lung Transplant Program, Mayo Clinic Florida. Dr. Keller says playing the harmonica can strengthen a patient's diaphragm, but unlike standard rehab exercises, it's fun, so patients are more likely to stick with it. "If you can keep your respiratory muscles and your diaphragm as strong as possible, the disease will be better," Dr. Keller said. Dr. Keller says the harmonica isn't a replacement for standard pulmonary therapy, but adding the instrument to the mix could be beneficial. Read full article →


Lee R. Goldberg, MD, MPH
University of Pennsylvania, Philadelphia, PA

Maureen Maguire: Strong Relationships. Strong Heart.
links imageAbout 10 years ago, Maureen was forced to slow down because of heart failure. "This last year was the worst," she says. "The things I could two years ago, I could no longer do—walk around the block, play with the dogs, clean, shop or cook." She was in and out of the hospital, until finally, last February, she was informed by Dr. Lee Goldberg that they had found a donor match. She was getting a new heart on that day. "I was shocked. I needed to think about it," she remembers. "Even though I had heard about it for 30 years, the thought of actually having a transplant that day was overwhelming." Read full article →


Richard C. Daly, MD
Mayo Clinic/St. Mary's Hospital, Rochester, Minnesota

From the heart: Watercolors prove therapeutic for psychiatrist awaiting heart transplant ... and those around him
links imageSteve Turchan dealt with his brush with death by picking up a brush. Some of the Neenah psychiatrist's favorite watercolor paintings were created over the more than five months he spent waiting for a heart in the cardiac intensive care unit at Mayo Clinic in Rochester, Minn. "I told my wife ... I will do this transplant for them and for you," Turchan said. "I was pretty much going to sign myself as a DNR - do not resuscitate. I said I need the right attitude if I'm going in. I'm going into this fighting. And if I do it, I'm going to do it right. I had a plan of how to attack this. I was going in and surviving." Turchan, 52, who calls himself lucky, received a new heart on Thanksgiving Day, the handiwork done by Mayo cardiothoracic surgeon Dr. Richard Daly. Read full article →


Keshava Rajagopal, MD, PhD
University of Maryland, Baltimore, MD
Michael Eberlein, MD, PhD
University of Iowa, Iowa City, IA

Two-sizes-too-small 'Grinch' effect hampers heart transplantation success
Current protocols for matching donor hearts to recipients foster sex mismatching and heart size disparities, according to a first-of-its kind analysis by physicians at the University of Maryland School of Medicine. Matching by donor heart size may provide better outcomes for recipients, who already face a scarcity of resources as they await a transplant. ... According to study co-author Keshava Rajagopal, M.D., Ph.D., a University of Maryland heart and lung transplant surgeon, the research emphasizes the peril of undersizing. "Undersizing a donor heart is very dangerous. It's like putting a motorcycle engine into a truck," says Dr. Rajagopal, assistant professor of surgery at the University of Maryland School of Medicine. ... This research complements prior work on lung sizing in transplantation done by Dr. Reed in collaboration with the study's senior author, Michael Eberlein, M.D., Ph.D., a transplant pulmonologist and assistant professor of medicine at the University of Iowa Roy J. and Lucille A. Carver College of Medicine. Dr. Eberlein notes that lung transplant candidates in the United States are listed for acceptable donor height ranges, with body height used as a surrogate for lung size. A series of studies conducted by Drs. Eberlein and Reed have shown that the body height standard for lungs has shortcomings similar to the body weight standard for hearts. "This thoracic transplantation research tells us there are better ways to manage the organ size-matching process," says Dr. Eberlein. Read full article →


Stephanie Moore, MD
Massachusetts General Hospital, Boston, MA

Why a Woman's Heart Won't Work in A Man's Body
Men who get undersized female hearts are more likely to die within a year of having a heart transplant, according to data gathered by the United Network for Organ Sharing (UNOS). In a first-of-its-kind study, physicians at the University of Maryland's School of Medicine analyzed 31,634 donor-recipient heart transplant pairs using the UNOS transplant registry. ... The problem is not that women's hearts won't work in men. It's that a smaller heart won't work well in a larger body. "It's far more important to size properly - regardless of sex," said Stephanie Moore, MD, a cardiologist at the Massachusetts General Hospital (MGH) Cardiac Transplant Program in Boston Read full article →


Valluvan Jeevanandam, MD
University of Chicago Medical Center, Chicago, Illinois

Why a Woman's Heart Is a Bad Fit for a Man
Using equations that incorporate height, weight, age, and sex to predict heart mass may better allocate donor hearts to transplant recipients than considering body mass alone, a retrospective study suggested. ... Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery at the University of Chicago, said that the equations used in the study could be incorporated easily into the UNOS allocation scheme, but said, "In my opinion, the size doesn't really matter as much as the heart function. What you want to do is be able to deliver a cardiac output to the recipient that's sufficient for their circulation." Read full article →


David O Taylor, MD
Cleveland Clinic, Cleveland, Ohio
Michael A. Acker, MD
University of Pennsylvania, Philadelphia, PA

When It Comes to Heart Transplants, Size May Matter Most
The "Grinch" effect may be curbing survival rates in some heart transplant patients who receive hearts that are too small for their bodies, a new study suggests. ... Historically, cardiac surgeons have tried to match heart failure patients with donors who weigh about the same—weight is one of the key criteria, said Dr. David Taylor, a professor of medicine at the Cleveland Clinic Lerner College of Medicine. ... Dr. Michael Acker, chief of cardiac surgery at the University of Pennsylvania Health System, said he and colleagues look at dozens of factors when seeking a donor for a particular patient. Read full article →


Mary N. Walsh, MD, FACC
St. Vincent Hospital, Indianapolis, IN

Transplant recipients of undersized hearts at greater risk for mortality
Transplant recipients who received undersized hearts or hearts from the opposite sex had an increased risk for mortality at 1 year, according to findings from a new study. ... "The decision that we make at the time of donor-recipient matching is a complex one. It involves blood type, body size and other factors that are specific to each patient. This study will help us make a more informed decision at the time of transplant, in particular in helping to determine if the size of the donor heart is adequate for the recipient. As was stated in the study, undersizing a heart is fraught with difficulties after transplant. What the study has shown us is that compared with simply considering the patient's weight, using a refined method to assess the size of the heart makes us better able to match the donor and the recipient," says Mary Norine Walsh, MD, FACC. Read full article →


Marc G. Schecter, MD and David Morales, MD
Cincinnati Children's Hospital, Cincinnati, Ohio

Cincinnati Children's to launch rare transplant program
A lung transplant program that could prolong the lives of critically ill babies weighing as little as 11 pounds has been started by Cincinnati Children's Hospital Medical Center. Dr. Marc Schecter, who recently joined Cincinnati Children's and has participated in more than 90 pediatric lung transplants, is medical director of the program. The surgical director is Dr. David Morales, who has been involved in more than 50 pediatric lung transplants. About eight people have been hired so far, including a doctor, advanced practice nurse, dietician, social worker and a care manager. A hospital spokesman said he was unsure of the total cost to begin the program. Read full article →


Katsuhide Maeda, MD and David Rosenthal, MD
Stanford University, Stanford, California

2013: A Record-Setting Year for Heart Transplants at Lucile Packard Children's Hospital Stanford
links imageWith 19 heart transplants, 2013 was the busiest year ever for the Children's Heart Center at Lucile Packard Children's Hospital Stanford, home to the only pediatric heart transplant program in Northern California. This success offers hope for those still waiting for this lifesaving gift. ... Athlete and sports nut Gavin Jack of Soquel, Calif., is in that club. Last October, the 18-year-old received a donor heart in a transplant surgery led by Katsuhide Maeda, MD, who is also a clinical assistant professor of cardiothoracic surgery at the medical school. "Gavin's recovery since his transplant has been amazing," said his mom, Michele, who expressed her extraordinary gratitude for the gift of organ donation. Patient families know that it takes a village to provide world-class, nurturing care before, during and after a heart transplant. "We have extraordinary experience," said David Rosenthal, MD, director of the hospital's pediatric heart failure program and professor of pediatric cardiology at the Stanford School of Medicine. Rosenthal noted that the hospital's busiest year prior was 2009, with 17 transplants. "Teams across the hospital understand the difficulties these patients and families are facing," he said. Read full article →


Nirav Y. Raval, MD
Piedmont Heart Institute, Atlanta, Georgia

3 men form friendship over the beat of a heart
links imageIt's an unusual way to start a friendship, but three men will forever be in each other's lives after spending months in the hospital together waiting for new hearts. Danny Herbst, 59, Bobby Regard, 61, and Jerry Kern, 60, spent months together at Florida Hospital bonding, celebrating the holidays like Christmas and Halloween, and joking around. "Keeps us alive inside, an opportunity to share each other's journey throughout this whole process," said Kern, who needs a new heart. "We made a little tin man hat, and he couldn't get out of bed so we pushed him down the hall and he had a little sign that said Dr. Serick for president," said Regard. "They know that at any given point we can get a heart, but sometimes it takes a long time," said Dr. Nirav Raval of Florida Hospital. Read full article →


Jeffrey A. Feinstein, MD, MPH
Stanford University Medical Center, Palo Alto, California

Clayton girl suffering from pulmonary hypertension on transplant list
Although Kathy Groebner knows pulmonary hypertension (PH) is a condition restricting the flow of blood and oxygen through the arteries traveling from her 11-year-old daughter's heart to her lungs, she thinks of PH as a thief. "Katie Grace used to have infectious laughter. She tries to laugh, but the disease pulls it back. That's the hardest part," Groebner says. After completing necessary tests, Katie Grace will "graduate" to a position her family hoped she'd never achieve. Her deteriorating condition has placed her on the active list for a heart and double lung transplant. Twenty-six tubes of blood, a sleep test and a complete write-up from Dr. Jeffrey A. Feinstein, associate professor of pediatrics and cardiology at Lucile Packard Children's Hospital at Stanford, are the final steps in her improbable, five-year odyssey. Read full article →


O. Howard Frazier, MD
Texas Heart Institute, Houston, Texas

Milestone reached with implantation of 1,000th pump to ease congestive heart failureSt. Luke's Medical Center (SLMC) and the Texas Heart Institute (THI) have announced that a milestone has been reached—implantation of the 1,000th left Ventricular Assist Device (LVAD)—a mechanical pump that assists patients with congestive heart failure. "It's a significant milestone for a significant medical problem, which is why we've made it a key focus of our work for so long," said O.H. "Bud" Frazier, MD, Director of Cardiovascular Surgery Research at THI & Chief of Transplant Service, St. Luke's Medical Centek, in a press release. Read full article →


David A. D'Alessandro, MD
Montefiore Medical Center, New York, NY
Joshua Sonett, MD
Columbia Presbyterian Medical Center, New York, NY

George Washington Bridge a lifeline for organ transplants at hospitals
links imageThe George Washington Bridge is more than a steel artery between two states, a crowded lifeline for harried commuters. Just ask transplant recipient Jasmine Figueroa. The ambulance transporting her donor heart raced across the span to reach the Washington Heights mom in a nick of time at New York-Presbyterian Hospital. ... Traffic on the bridge can be 'a real issue because we have to consider all the time it takes from the time the heart is removed from the donor,' said Dr. David D'Alessandro, surgical director of cardiac transplantation at Montefiore. Dr. Josh Sonett, director of the lung transplant program at New York-Presbyterian, said, "Fortunately, we didn't have medical issues because of the lane closures in September. A lung has to be transplanted within six to eight hours, so every minute counts. When there is traffic, the state troopers or local police will usually guide us through, but that can still be tough when there is a lot of congestion." Read full article →


Jennifer Ann Cowger, MD, MS
Indianapolis, Indiana

Biznet and Heart Doctor Introduce LVAD Calculator App to Help Heart Failure Patients Considering Life-Saving Heart Pump
An Indianapolis heart specialist has partnered with Biznet Internet Solutions of Southfield, Mich., to introduce an iPhone app that can help doctors and patients evaluate the risks of implanting an artificial heart. Jennifer Cowger, MD, MS, created the iPhone app to help doctors assess a patient's suitability for a LVAD (left ventricular assist device), which is used to support heart function and blood flow in patients waiting for a transplant or for long-term management of heart failure. The pump, sometimes called an artificial heart, has the potential to save tens of thousands of lives a year. More than 150,000 patients in the U.S. are candidates for a heart transplant, but this year there will be only about 2,200 heart transplants performed, according to the Centers for Disease Control. Implantation of an LVAD is a life-saving option. "The app is used to identify people who will do well on the pump," explains Dr. Cowger. Namely it provides a risk score for estimating a patient's survival rate at one year after surgery. "My aim is to improve patient outcomes and patient understanding of the risks and benefits of this device surgery." Read full article →


Scott Scheinin, MD and Matthias Loebe, MD, PhD
The Methodist Hospital, Houston, Texas

A pair of sisters get lung transplants from same donor
links imageThey quibble, joke and share knowing looks, finishing each other's thoughts and making snide comments - like many sisters. But a recent heated argument was unlike any other they've had, and it ended in a most surprising way. For months, 71-year-old Irma Myers-Santana and her younger sister, Anna Williamson, 69, had been debating who more urgently needed a lung transplant, each wanting the other to go first. Earlier this month, though, the sisters ended up in the same operating room, each getting one lung from the same donor in what doctors at Houston Methodist Hospital say is a first for their facility. "It's never happened. ... We've transplanted siblings before, but years apart," said Dr. Scott Scheinin, who did Myers-Santana's transplant. "It's a little bit of serendipity." Read full article →


Tajinder P. Singh, MD, MSc
Boston Children's Hospital, Boston, MA
Donna M. Mancini, MD
New York Presbyterian Hospital, New York, NY

Survival benefit from transplantation greatest in highest-risk patients
The risk for wait-list mortality varies among heart transplant candidates, and new study data found that survival benefit is increased for candidates with higher risk for wait-list mortality. However, researchers found no measurable survival benefit for many candidates at the lower end of the risk spectrum. Tajinder P. Singh, MD, MSc, of Boston Children's Hospital, and colleagues aimed to assess survival benefit from transplantation, as defined by reduction in risk for 30-day mortality and 1-year mortality upon receiving a heart transplant. This study "is a promising first step toward a novel organ allocation system based on distinct risk-prediction models that reflect our current medical and surgical treatment options, regional factors and regulatory limitations," Donna M. Mancini, MD, of Columbia University Medical Center, wrote in a related editorial. Read full article →


Hannah Copeland, MD
Loma Linda University, Loma Linda, CA

Children who undergo heart transplantation experience good outcomes
Infants and children who undergo heart transplantation are experiencing good outcomes after surgery and may expect to live beyond 15 years post-surgery with reasonable cardiac function and quality of life, according to a study released today at the 50th Annual Meeting of The Society of Thoracic Surgeons. Hannah Copeland, MD and colleagues from Loma Linda University in Loma Linda, CA, reviewed medical charts of 337 pediatric heart transplant patients who underwent transplantation at their institution since 1985. "The average adult survival rate following heart transplantation currently is 10 years," said Dr. Copeland. "We studied survival rates beyond 15 years for pediatric heart transplant patients to learn more about quality of life and factors that led to improved survival." Read full article →


Yoshiya Toyoda, MD, PHD
Temple University School of Medicine, Philadelphia, PA

Temple researchers shed new light on double-lung transplants
In the largest retrospective study to date using data from the United Network for Organ Sharing (UNOS) database for adult double-lung transplants, Temple University School of Medicine researchers have shown that there is no statistically significant difference between rejection and mortality rates among double-lung transplant recipients when their transplanted organs came from donors whose blood-type was identical or compatible to their own. "The study confirms what most of us in the transplant surgical community have recognized for some time based on our clinical experience," said senior author Yoshiya Toyoda, MD, PhD, Vice Chief of Cardiothoracic Surgery and Surgical Director Heart and Lung Transplantation at Temple University Hospital (TUH), in Philadelphia. Dr. Toyoda, who has performed more than 300 double-lung transplantations, also serves as Surgical Director of Mechanical Circulatory Support at TUH. Read full article →




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