THIS MONTH'S FOCUS:
HEART FAILURE & TRANSPLANTATION
Many thanks to David Nelson, Amresh Raina and Veronica Franco for coordinating the content for this month's issue.
HAPPY NEW YEAR! WELCOME TO 2015!
IN THE SPOTLIGHT:
ISHLT's Guide to Nice, France: Ode to Art
With the Holiday Season behind us, it's back to the daily grind. However, for us at ISHLT Headquarters, it means that the Annual Meeting in Nice is that much closer; as if the holidays hadn't been hectic enough! With this in mind, we wanted to remind everyone that there is always something to look forward to, even as the bright lights and holiday cheer fades.
This month, we have reached our Ode to Art! Nice has several art museums that feature famous pieces, as well as those that act as a stage for the more local talent. With varying styles, time periods, and cultural influences, one is simply not enough; time permitting, wander through as many as possible and soak up the works along with all that French sunshine. Read more →
HEART FAILURE & TRANSPLANTATION:
Donor Management: Past, Present and Future
David P. Nelson, MD
Once upon a time procurements went like this: Guys with knives showed up and management decisions were the products of competing interests contested by alpha dogs. There were no OPOs, no UNOS, and transplant center surgeons and coordinators ran the show. Then, federal regulation structured the process and, buffered by OPO personnel, transplanters gradually disengaged from donor management. A modern transplanter's procurement focus is A) Deciding if and for whom to accept an organ, B) Coordination of two surgeries, and C) Preoperative preparation of the recipient. Read more →
The "Art" of Donor Heart Selection
Kambiz Ghafourian, MD
Jon Kobashigawa, MD
Donor availability has always been a key limiting factor in heart transplantation. Since 2005, there has been an upward trend in the number of heart transplant candidates who are added each year to the waiting list . Based on the OPTN data as of December 19, 2014, there were 4,016 heart transplant candidates on the waiting list in the United States. However, only 2,513 heart transplants were performed in 2013. Contributing to this negative balance in demand and supply is the fact that about 63% of the currently available donor hearts are discarded, in part due to the stringent selection criteria . Read more →
Update on Combination Therapy for Pulmonary Arterial Hypertension
Marco A. Caccamo, DO
Pulmonary arterial hypertension (PAH) is associated with significant morbidity and mortality, and is often diagnosed relatively late in the disease course. As a result, the consequences can be devastating in terms of impact on right ventricular function, functional capacity and ultimately survival.
A similarly high morbidity and mortality can be seen in many rheumatologic and oncologic disorders, but these disorders are often approached in a different manner than PAH traditionally has been. How are they treated differently, you might ask? Read more →
Revisiting Balloon Pulmonary Angioplasty for the Treatment of Non-Operable Chronic Thromboembolic Pulmonary Hypertension
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable condition . The current treatment of choice for CTEPH is pulmonary endarterectomy (PEA) in patients who are considered candidates for surgical therapy. However, some CTEPH patients have thrombotic disease that affects the distal segmental pulmonary artery branches, while others have major medical co-morbidities which make them less than optimal candidates for surgical PEA. So, what are the alternatives when there is an inadequate response to medical therapy with pulmonary vasodilating agents such as Riociguat? Read more →
Team PHenomenal Hope and the Race of Our Lives: Racing Across America for Pulmonary Hypertension
Patricia George, MD
I wake up. No idea what town or state I'm in. The RV bed is not moving, which means I have somewhere between 30 minutes and maybe 2 hours before I ride. That's my only job, to get ready and ride my bike. I open my eyes and jump out of bed. Uniform on, helmet, shoes, race radio, sunglasses, and meet the crew outside. We're at the racer-crew transition point, waiting for our teammates to get in and our 6-hour shift to begin.
Beginnings. The journey began over two years ago, when my friends and I tossed around the idea to race in the Race Across America (RAAM), the most challenging bike race in the world. The idea of Team PHenomenal Hope was inspired, in part, by the 2010 Mount Kilimanjaro climb, and feeling the impact of what happens when people devote their passions and do something epic to lift up the pulmonary hypertension (PH) community. Read more →
OF SPECIAL INTEREST:
The Surgeon as Artist: A Gift of the Heart
Hassan A. Tetteh, MD, FACS
The recent Congress of the American College of Surgery held in San Francisco had a number of topics in the humanities offered among the many surgical science academic talks presented. To my surprise "The Surgeon as Artist" presentation was filled to capacity in a large room of the convention center. A panel of physicians and surgeons shared personal experiences and perspectives and displayed and commented on works of art created by surgeons. The depth, complexity, beauty, and brilliance of the collective works were impressive. Read more →
France, Revolutions, Constitutions and Liberty
Vincent Valentine, MD
In the November issue of the Links Newsletter, - Dedication, Deification and Divination of Voltaire: An Apotheosis, we were challenged on how to summarize a six month long immersion on Voltaire. We brushed by two seminal contemporaneous and interrelated events in history, the American and French Revolutions, both occurring as Voltaire was nearing the end of his life. The results of these Revolutions were as divergent and separate as the continents and the pond that separates these nations, but seemingly similar, with a common origin traced to France and Voltaire. The influence of Voltaire was profound. He triumphantly transformed intellectual thought and European civilization; changes from the Enlightenment that still reverberate across the globe today. But some of his enemies viewed him as the very cause of the French Revolution. We know the by-product of the American Revolution was a Constitution that has assured up liberty for more than 200 years. This issue of the Links will examine the legacy of the French Revolution, important French individuals who influenced history and how this legacy differs from the consequences of the American Revolution which serves to remind us that history can be made by great individuals and great events in our quest for freedom and liberty. Read more →
"Works of art make rules; rules do not make works of art"
— Claude Debussy
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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.