Many thanks to Howie Eisen & Martin Schweiger for coordinating the content for this month's issue.

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In this issue, we measure our Thanksgiving with insightful contributions that reflect the success and collaboration of the ISHLT. Such reflections include a report from Joshua Mooney, Hannah Copeland and Daniel Kim on the "Associação Brasileira de Transplante de Órgãos (ABTO)/ISHLT Joint Symposium", after which Pablo Pego-Fernandes provides his perspective in "Joint ABTO/ISHLT Symposium on Thoracic Transplantation". Terry Noah, Arlene Davis, Debra Boyer and Elisabeth Dellon harvest anew the gluttony of challenges leaving us with simply humanity and benevolence, "Ethical Issues Surrounding Bridge Strategies to Pediatric Lung Transplant in Cystic Fibrosis: Case Series and Suggested Process Framework", while Diana Kim and Howard J. Eisen's present "Applications of CRISPR-Cas9 Technology in Heart Failure and Transplantation." Christina VanderPluym and Beth Hawkins offer a cornucopia of ideas, "IN THE SPOTLIGHT: The Use of Novel Ventricular Assist Device Smart Phone Application for Outpatient Management in Children." Pamela Combs transcends our care out of the hospital, "Perspective of the VAD Caregiver: The Transition Home." Finally, we sail away to Spain with Javier Carbone's, "A Big Bang in Barcelona: ESOT Congress 2017."

Happy Feasts!

Vincent Valentine, MD
Links Editor-in-Chief


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The Use of Novel Ventricular Assist Device Smart Phone Application for Outpatient Management in Children RPH

Beth Hawkins, MSN
Christina VanderPluym, MD

The era of smartphone technology is upon us. Everywhere you turn, from street corners to restaurants, adults and children are glued to their phones for information, entertainment and socialization. Based on data from the Pew Research Center, 77% of Americans own a smartphone as of 2016, up from only 35% smartphone ownership in 2011, with 100% of adults aged 18-29 owning a cell phone [1]. Given the success and popularity of smartphone technology - especially in the adolescent and young adult population - we felt that the crossover of this technology to home monitoring for the complex medical care of outpatient ventricular assist device (VAD) could prove more efficient and effective than traditional modes of communication and monitoring. Read more →


A Big Bang in Barcelona: ESOT Congress 2017

Javier Carbone, MD, PhD

links imageThe European Society for Organ Transplantation Congress held in Barcelona on September 24-27, helped refine our knowledge of basic science and clinical concepts to improve transplantation in a holistic approach. One interesting example of this was the session entitled, "The Devil's Advocate: a moderated controversy in basic science." During this session, a presentation of a basic science article was followed by a critical discussion with an 'opponent' and a general discussion with the audience. The first conference was "New insights in the priming of recipient's immune system: Donor dendritic cell-derived exosomes promote allograft-targeting immune response" by Adrian Morelli ('Defender', Pittsburgh, United States) and Gavin Pettigrew ('Opponent', Cambridge, United Kingdom). Read more →

Applications of CRISPR-Cas9 Technology in Heart Failure and Transplantation

Diana Kim
Howard J. Eisen, MD

As predicted, CRISPR-Cas9 has taken the field of heart failure and transplantation by storm, and we feel invigorated by recent efforts that will make tremendous impacts in patient care and research [1]. CRISPR-Cas9 is a bacterial-derived technology that takes advantage of a Cas9-induced double-strand DNA break that is then rejoined or replaced through non-homologous end joining, leading to efficient, site-specific DNA editing. As we previously discussed, CRISPR-Cas9 has tremendous implications for the field of heart failure and transplantation. Physicians and scientists must be aligned in their objectives to meet their mutual clinical needs. To this end, some major advances have recently been made. Read more →


Ethical Issues Surrounding Bridge Strategies to Pediatric Lung Transplant in Cystic Fibrosis: Case Series and Suggested Process Framework

Terry L. Noah, MD
Arlene Davis, BS, JD
Debra Boyer, MD
Elisabeth Potts Dellon, MD, MPH

Although the incidence for pediatric lung transplantation is decreasing worldwide, the need is still present for some pediatric CF patients with end stage lung disease. While these patients await their 'donor offer' and are hopeful for the promise of a longer and an improved quality of life, many deteriorate further. Such decline necessitates open discussions regarding the application of advanced life support such as ECMO or consideration for placement of external oxygenators that may allow a patient to be bridged to transplant. Despite initial experience resulting in poor outcomes with ECMO bridging to transplant, recent data suggest that this strategy is appropriate in selected cases [2]. Read more →


ISHLT Grant Applications Now Available!

November 15, 2017 at 11:59PM EST
Transplant Registry Early Career Award ($7,5000)

January 15, 2018, 11:59PM EST
Norman E. Shumway & Joel D. Cooper Career Development Awards ($160,000)

Nursing, Health Sciences & Allied Health Research Award ($12,000)

Research Fellowship Award ($40,000)

ISHLT/O.H. Frazier Award in MCS Translational Research Sponsored by Medtronic ($65,000)

Coming Soon:
NEW! ISHLT/Enduring Hearts Transplant Longevity Research Award ($160,000)

Enduring Hearts

ISHLT Online Library: Just Added - ISHLT Academy Core Competency Course Recordings!

Visit the new and improved ISHLT Online Library to access the following courses Available FREE to all ISHLT members:

Read more →

ISHLTConnect Code of Conduct

We wanted to take the time to remind everyone that there are rules and restrictions for activity on ISHLTConnect. There have been several posts recently that have violated the Code of Conduct for our online community, many of which have been promoting the meetings and events of other societies. If you review the Code of Conduct you will see that the first item under Rules states that members are not permitted to "post messages about other organizations' and institutions' meetings, publications, programs or services on any discussion list, resource library entry, or other area where others might see it".

We STRONGLY encourage all members to review the Code of Conduct for further guidelines and restrictions for posts to ISHLTConnect.


Perspective of the VAD Caregiver: The Transition Home

Pamela Combs, PhD, RN

links image"The two most powerful warriors are patience and time." - Leo Tolstoy (1828-1910).
The most dramatic impact of being a caregiver is reflected in one of the waves of the Caregiver Health Effects Study (CHES), which discovered that caregivers are at greater risk of death than those who do not administer care to a significant other (Bookwala, Zdaniuk, Burton, Lind, Jackson, & Schulz, 2004). We often fail in evaluating the perspective of the caregiver of a patient with a VAD regarding preparation to care at home. Exactly what the VAD caregivers perceive of the transitioning experience from hospital-to-home is an area that is neglected of research studies. Read more →

Associação Brasileira de Transplante de Órgãos (ABTO)/ISHLT Joint Symposium

Hannah Copeland, MD
Daniel Kim, MD
Joshua Mooney, MD

Foz do Iguaçu is one of the New 7 Wonders of Nature. These impressive falls sit in this beautiful international intersection straddling Brazil and Argentina, with Paraguay a stone throw away. A bridge goes down to the valley of the waterfall, called the Devil's throat. You can walk on the bridge, but bring your poncho because you are guaranteed to get drenched. In addition to beautiful natural wonders, there are unique delights; my favorite being savory breakfast crepes made of tapioca flour and bananas sweetened with cinnamon for breakfast. What a great place to have a meeting and that's just what ABTO (Associação Brasileira de Transplante de Órgãos) did! And better yet - they invited ISHLT to hold a joint symposium at this magnificent place on Oct 21, 2017. Read more →

Joint ABTO/ISHLT Symposium on Thoracic Transplantation

Paulo Manuel Pêgo-Fernandes, MD, PhD

links imageThe XV ABTO's meeting took place in Iguassu Falls October 18-21. There were 1350 people attending the meeting and part of these people are professionals that work with heart or lung transplantation. For these people was very special the opportunity to participate of the Joint ABTO/ISHLT Symposium on Thoracic Transplantation. During the 20 October afternoon cardiologists, heart surgeons, lung surgeons, pulmonologists, infectologists and nurses from the Chief Hospitals that performed heart or lung transplantation in Brazil could interact with ISHLT members as Daniel Kim, Hannah Copeland, Joshua Mooney and Alejandro Bertolotti. It was a very fruitful experience, with a lot of ideas that may improve the transplant activity in Brazil and South America. Read more →


The Discovery of Circulation

Vincent Valentine, MD

links imageAs you recall, modern science emerged in the 17th century with the scientific revolution and was largely based on skepticism. This same skepticism motivated Andreas Vesalius, the father of modern anatomy, in the 16th century. Among other things, it was William Harvey who reintroduced the notion of experimentation by basing his theories on human dissections and observations he made himself. Galen had originally introduced experimentation through his research; however, he dissected and observed animals rather than the human body. Also recollected from Galen were his philosophical contributions to medicine involving humoral imbalance, which lasted until Harvey's discovery of circulation. Read more →


Vincent G Valentine, MD

Editorial Staff

"I am not accustomed to saying anything with certainty after only one or two observations."
— Andreas Vesalius

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Disclaimer: Any opinion, conclusion or recommendation published by the Links is the sole expression of the writer(s) and does not necessarily reflect the views of the ISHLT.