Many thanks to Stephanie Pouch and Jorge Silva for coordinating the content for this month's issue.

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First we have Andy Fisher's Decisions, Decisions...ISHLT membership lays down the gauntlet to the programme committee! in the Spotlight followed by the Strategic Planning Update. ID kicks off with Simon Kusne and Infection Control and Prevention Consensus for Mechanical Circulatory Support (MCS), an update on the ID-MCS Consensus Project. Next is Bortezomib in Highly Sensitized Patients Awaiting Heart Transplantation - A Potentially Sensitive ID Issue? by Stephanie Pouch. This is followed by Jorge Silva and Saima Aslam's LVAD Infections and Post-Transplant Outcomes: A Long Way to Go for JFTC. Also, we contemplate with Reflecting and Revisioning by Samantha Anthony's NHSAH report. Finally, Tereza Martinu shares with us her Rocky Mountain High and insightful Lung Transplant Clinical Year in Review at the ATS 2015.

Of course we are just a few days away from America's 239th birthday or separation from British rule. We continue our journey to Washington DC educating ourselves on seminal events in American History from America's Founding Fathers and Presidents of the United States with their contributions to the Declaration of Independence. For equipoise we pay tribute to the venerable Founding Mother, Abigail Adams who was America's first Presidential wife and mother of a President. The only other such First Lady was Barbara Bush. Chelsea Clinton had the initials and background to be next in line for such a venerable First Lady, however she married Marc Mezvinsky.

Vincent Valentine, MD
Links Editor-in-Chief


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Decisions, Decisions...ISHLT membership lays down the gauntlet to the programme committee!

Andrew Fisher, FRCP, PhD

Although memories of our excellent 2015 Annual Meeting in Nice are still fresh, there is no pause in preparation for what we hope will be another successful Annual Meeting in 2016 in Washington DC. ISHLT members have once again shown their enthusiasm and commitment to the success of their Annual Meeting by submitting a record number of proposals for symposium and plenary content for 2016. Close to 150 different proposals were received via our online portal and having reviewed them all personally, I am excited by the creativity and scientific excellence that these proposals are striving for. Read more →


A big THANK YOU to everyone who completed the Strategic Planning Survey. We received responses from 404 members whose specialties, ages, and geographic locations were very representative of the membership as a whole. We're off to a great start, but we would still like to hear from the rest of you! For those of you who did not participate in the survey but would like to provide input into the strategic planning process, you may do so by sending an email to or by communicating with your Council Chair. During the month of July, each of the Council Chairs will be facilitating discussions with their Council members regarding the future direction of ISHLT. Some will do this via surveys, others via conference calls, others via discussions in the online community. The Strategic Planning Task Force encourages you to be PROACTIVE in this process. Take the initiative to give us YOUR input into the future of YOUR Society.


Rising Impact of the JHLT - New Metrics Released 2015

Mandeep Mehra, MD, FACC, FACP, FRCP

links imageI am pleased to inform the members of the ISHLT that the JHLT (Journal of Heart and Lung Transplantation) has received its highest ever Impact Factor (IF) of 6.650, in the most recent 2014 release of the metrics. The Journal is now ranked FIRST in the transplantation category (1st / 25) and THIRD in all of surgical journals (3rd /214). In addition, we are now ranked in the TOP TEN in the cardiovascular journal category, a highly competitive landscape. Additional comparative metrics are attached for your more detailed review, reflecting our rankings in the two most comprehensively relevant categories. Read more →


Infection Control and Prevention Consensus for Mechanical Circulatory Support (MCS)

Shimon Kusne, MD

links imageInfection, with significant morbidity and mortality, is a common complication after implantation of Mechanical Circulatory Support (MCS) devices. In some early series up to 80% of the patients developed at least one infection. Until recently it was impossible to compare the rates of infection complications because authors used different definitions. In 2010 the Infectious Diseases Council developed and published definitions which are now being used by investigators in and outside the US. Currently there are no established infection prevention practices and most centers are using their own protocols. Read more →

Bortezomib in Highly Sensitized Patients Awaiting Heart Transplantation - A Potentially Sensitive ID Issue?

Stephanie Pouch

links imageSensitization to human leukocyte antigens, which occurs through blood transfusions, previous organ transplantation, pregnancy, prior cardiac surgery with homografts, and the presence of ventricular assist devices, has historically limited access to heart transplantation [1]. However, the percentage of patients with high panel reactive antibody (PRA) listed for heart transplantation has increased over the past decade [2], and intravenous immunoglobulin, plasmapheresis, and rituximab have been shown to decrease allosensitization by reducing circulating antibodies. More recently, bortezomib has shown promise as a novel treatment strategy for antibody-mediated rejection as well as pre-transplant desensitization [1, 3]. Read more →


LVAD Infections and Post-Transplant Outcomes: A Long Way to Go

Jorge Silva, MD
Saima Aslam, MD, MS

The sixth INTERMACS annual report summarizes data from over 10,000 MCSDs implanted worldwide.(1) Up to a third of patients continue to develop infectious complications such as sepsis and driveline infection (DLI). Driveline infections continue to occur with increasing hazard associated with increasing duration of device placement. Risk factors for driveline infection include obesity, diabetes, trauma to the exit site, surgical factors such as extra- cutaneous placement of the velour portion of the driveline, and length of implantation of the device. Read more →


Reflecting and Revisioning

Samantha Anthony, PhD, MSW

links imageThe year 2014 was memorable for the Nursing, Health Science and Allied Health Council. Our achievements were notable, including highlights such as: hosting the inaugural ISHLT Academy - Core Competencies in Nursing, Health Science and Allied Health; publishing a consensus report entitled "Adult Cardiothoracic Transplant Nursing: An ISHLT Consensus Document on the Current Adult Nursing Practice in Heart and Lung Transplantation" - Coleman et al. in the Journal of Heart and Lung Transplantation; awarding a Nursing, Health Science and Allied Health Research Grant, participating in the development of Guidelines for the Prevention and Management of VAD-related infections; and, contributing twelve LINKS articles that showcased the talent and experience of our members. Read more →

Lung Transplant Clinical Year in Review at the ATS 2015

Tereza Martinu, MD

links imageI had the pleasure to present the Clinical Year in Review session on lung transplantation at this year's American Thoracic Society (ATS) annual meeting in Denver, in May. It really was a "clinical 3 years in review," since our topic was last presented in 2012. That made the choosing of the top articles that much more impossible. My task was to select and discuss the 6 most important articles in lung transplantation published since 2012. I was allowed to further highlight another 15 articles. I have to admit that this was an incredibly difficult task, over which I agonized for many weeks. Read more →

Soldiering On With US Presidents

Vincent Valentine, MD

links imagePerhaps it's no accident that the first six Presidents were from the original permanent English settlements of the New World: Virginia in 1607 at a place named Jamestown and Massachusetts in 1620 a placed called Plymouth. As informed or forewarned in the prior issue of the links, we continue our very brief study of the U.S. Presidents. After George Washington, we start with John Adams and finish with John Quincy Adams. The first five Presidents represent the Founding Fathers and the sixth President the son of a Founding Father and a child witness of the American Revolution. The Father-son Adams clan balance out the Virginia dynasty which in a contradictory fashion represented a remnant of aristocracy within a new democracy. Read more →


The Declaration of Independence: America's Birthday

Vincent Valentine, MD

From the perspective of King George and his British government, the Americans resisted the king's officials in their lawful pursuit of policies intended to benefit the British Empire as a whole. The primary reason for this resistance was the unwillingness of the Americans to pay their fair share of taxes. The rebellious spirit of the Americans rose to a level such that they refused to be governed by the authority of Parliament. This was treason. Harsh measures were taken to break the rebellion in the American colonies. Massachusetts was initially singled out as the seat of rebellion in April 1775.

Edmund Burke commented, "the great contests for freedom were, from the earliest times, chiefly upon the question of taxes." Read more →

Remember the Ladies: The Stage of Liberty and Justice for All

Vincent Valentine, MD

Hundreds of letters have provided us clear pictures of Abigail Adam's character, marriage and everyday life from colonial Massachusetts and revolutionary America to the courts of Europe and the new democratic republic of America. She was upright, moralistic, devout, and possessed all the Yankee virtues of prudence, thrift, hard work and sobriety. She was widely read, headstrong and fascinated by the changing world around her. She described her experiences in writings to her husband, friends and relatives. At a time when women had no political rights, she raised the possibility that a revolutionary nation might consider the idea. At a time when slavery was all around her, she was one of the first critics of slavery. She was the first woman to live in the White House. Abigail and Martha Washington set the stage that American First Ladies have followed in American history.

She was born Abigail Smith on November 11, 1744 in Weymouth, Massachusetts. She was from a distinguished family where her father, a learned man, Congregationalist minister and an important figure, provided home schooling for Abigail and her two sisters. Read more →


Vincent G Valentine, MD

Editorial Staff

"When the past no longer illuminates the future, the spirit walks in darkness"
— Alexis de Tocqueville

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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.