scholarly journals Canadian Cardiovascular Society/Canadian Cardiac Transplant Network Position Statement on Heart Transplantation: Patient Eligibility, Selection, and Post-Transplantation Care

2020 ◽  
Vol 36 (3) ◽  
pp. 335-356 ◽  
Author(s):  
Sharon Chih ◽  
Michael McDonald ◽  
Anne Dipchand ◽  
Daniel Kim ◽  
Anique Ducharme ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Position Statement ◽  
Cardiac Transplant ◽  
Canadian Cardiovascular Society ◽  
Post Transplantation ◽  
Network Position ◽  
Transplantation Patient

Cardiac sarcoidosis in the donor heart without extracardiac manifestations

2021 ◽  
Vol 14 (4) ◽  
pp. e241902
Author(s):  
Mohammad Al-Ani ◽  
Mohamad Badie Taha ◽  
Brian D Stewart ◽  
Gabrielle S Graves ◽  
Mustafa M Ahmed ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Functional Imaging ◽  
Heart Block ◽  
Cardiac Sarcoidosis ◽  
Systolic Dysfunction ◽  
Donor Heart ◽  
Post Transplantation ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
End Stage

A middle-aged woman who received heart transplantation for end-stage sarcoid cardiomyopathy developed recurrent cardiac sarcoidosis in the donor heart. She presented 5 years post-transplantation with heart block and systolic dysfunction, without extracardiac involvement. Her disease was unresponsive to corticosteroids. Routine functional imaging may help identify such recurrences.

scholarly journals SEVERE HYPERTRIGLYCERIDEMIA ASSOCIATED WITH EVEROLIMUS TREATMENT AFTER HEART TRANSPLANTATION

2020 ◽  
Vol 6 (5) ◽  
pp. e269-e272
Author(s):  
Phillip Lo ◽  
Katherine Kearney ◽  
Christopher A. Muir ◽  
Ning Song ◽  
John A. Eisman ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Heart Transplant ◽  
Serum Triglyceride ◽  
Adverse Outcomes ◽  
Lipid Lowering ◽  
High Dose ◽  
Serum Triglyceride Level ◽  
Post Transplantation ◽  
Partial Lipodystrophy ◽  
Severe Hypertriglyceridemia

Objective: Everolimus, a mammalian target-ofrapamycin (mTOR) inhibitor, is increasingly used post-transplantation due to favorable effects on renal function and malignancy risk when compared to other immunosuppressive treatments such as calcineurin inhibitors. However, it can confer adverse effects such as dyslipidemia, which is not underpinned by any long-term screening and management of dyslipidemia in heart transplant recipients treated with everolimus. Methods: We report a case of severe hypertriglyceridemia which developed after commencement of everolimus in a heart transplant recipient with a background of Dunnigan-type familial partial lipodystrophy. Results: The patient is a 36-year-old woman who underwent heart transplantation for dilated cardiomyopathy. About 11 weeks following commencement of everolimus as part of her antirejection medication regime, serum triglyceride level concentration peaked at 5,093 mg/dL (normal, 0.0 to 177.2 mg/dL). There were no clinical complications with triglycerides at this elevated level and it improved substantially following cessation of everolimus and initiation of a high dose intravenous insulin-dextrose infusion. Conclusion: This case highlights dyslipidemia as a potential complication of everolimus treatment and that appropriate screening is important as lipid lowering medication can effectively control levels and minimize adverse outcomes.

P750Role of circulating endothelial cells post-heart transplantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Rywik ◽  
A Braniewska ◽  
I Kowalik ◽  
M Firczuk ◽  
K Kozar-Kaminska ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Post Transplantation ◽  
Endothelial Progenitor ◽  
Dynamic Changes ◽  
Antibody Mediated Rejection ◽  
The Difference ◽  
Cellular Rejection

Abstract Background The role of endothelial progenitor cells (EPC) in heart transplantation (HT) is not well defined. Thus, the aim of this study was to evaluate prospectively the dynamic changes of circulating EPC levels in relation to post-HT rejection risk. Methods There were 27 HT recipients who had EPC from peripheral blood quantified during 6 months follow-up after HT. Patients were monitored regularly, by right ventricular endomyocardial biopsy assessment, for cellular rejection (ACR) defined as grade ≥2 or an antibody-mediated rejection (AMR) characterized by histopathological changes recorded as AMR1H. The primary end-point was acute rejection, either AMR or ACR. Results ACR and AMR were observed in 7 (25.9%) and 6 (22.2%) subjects respectively. EPC levels, after logarithmic transformation, immediately post-HT were alike regardless of ACR status, however patients with lower EPC were at risk of AMR at 1 month (Table 1). On the other hand patients with a significant reduction of EPC at 1 month post-HT compared with HT were less likely to have either ACR or AMR (p=0.0003). During longer post-HT observation (12 months) patients had similar EPC levels regardless of the rejection events. Dynamic changes in EPC levels are presented in figure. Nonetheless, greater changes in EPC expressed by coefficient of variation were associated with the risk of either AMR or ACR compared to the participants without rejection (mean [lower–upper quartile]) 15 [13–18] vs 8 [5–13]; p=0.02) and (22 [14–26] vs 8 [5–13]; p=0.01) respectively. EPC by rejection – 1st month following HT ACR (+) AMR (+) ACR (−) and AMR (−) p^ p p N=3 (mean± SD) N=4 (mean± SD) N=20 (mean± SD) ACR (+) vs ACR (−) and AMR (−) AMR (+) vs ACR (−) and AMR (−) EPC log HT 5.14±1.55 3.81±1.01 5.30±0.88 0.0325 0.97 0.025 EPC log M1 4.97±0.59 3.69±1.33 4.15±1.29 0.4160 0.55 0.78 Delta EPC log M1-HT -0.17±1.98* −0.12±1.30* −1.15±1.18# 0.2195 0.44 0.32 ACR – acute cellular rejection; AMR or – acute antibody-mediated rejection; EPC log – endothelial progenitor cells after logarithmic transformation; HT – within 24 hours post-transplantation; M1 – at 1-month post-transplantation; Delta EPC log M1-HT – difference in EPC log between M1 and HT. #p=0.0003 for the difference between M1 vs HT; *p=ns for the difference between M1 vs HT; ^pP – for the difference among the groups. Changes in EPC level post-HT Conclusions Early reduction of EPC levels was predictive of a lower risk of ACR or AMR. Greater dynamic changes of EPC during 6 months of observation were associated with a higher risk of rejection suggesting an important role of EPC in the pathological processes post-HT. Thus our findings suggest significant role of EPC post-HT with respect to rejection status. Acknowledgement/Funding Intramural research grant from the Institute of Cardiology

Hepatic Dysfunction and MELD Score Improve After Orthotopic Heart Transplantation and Predict Post-Transplantation Mortality

2010 ◽  
Vol 16 (8) ◽  
pp. S43
Author(s):  
Aalap Chokshi ◽  
Faisal Cheema ◽  
Ken Schaefle ◽  
Tuba Khawaja ◽  
Maryjane Farr ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Hepatic Dysfunction ◽  
Meld Score ◽  
Orthotopic Heart Transplantation ◽  
Post Transplantation

scholarly journals Canadian Cardiovascular Society/Canadian Heart Failure Society Joint Position Statement on the Evaluation and Management of Patients With Cardiac Amyloidosis

2020 ◽  
Vol 36 (3) ◽  
pp. 322-334 ◽  
Author(s):  
Nowell M. Fine ◽  
Margot K. Davis ◽  
Kim Anderson ◽  
Diego H. Delgado ◽  
Genevieve Giraldeau ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Amyloidosis ◽  
Position Statement ◽  
Joint Position ◽  
Canadian Cardiovascular Society
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