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The International Society for
Heart and Lung Transplantation

A Society that Includes Basic Science, the Failing Heart and Advanced Lung Disease.

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Friday, April 5, 2019

In the Spotlight

‘Genius is Overrated’ and Other Life Lessons from an American Hero

Astronaut Col. Mike Mullane entertained the crowd at today’s Plenary Session with inspiring stories from his career as a U.S. Astronaut and Vietnam War veteran, sharing his most important life lesson: Tenacity matters. 
 
Mullane walked the crowd through his incredible career, which started with an obsession with rockets at the age of 12, just as Sputnik was dominating the news. From homemade rockets in the New Mexico desert – where he learned about true risk mitigation – to vowing at the age of 14 that he would be an astronaut, Mullane was laser-focused on his goal. Read more

Today's Highlights

Is the Future Now with Alternatives to Cardiac Transplantation?

Copy and Paste vs. Renovate: Cardiac 3D Printing and Its Future Direction
Doris Taylor, PhD, FAHA, FACC
 
‘When Pigs Fly’: Where Are We Now with Xenotransplantation
Richard Pierson, MD
 
Cardiac transplantation has a come a long way since the first human transplant several decades ago.  However, one of the major limitations to transplantation is the availability of donor organs.  In the United States alone, hundreds of thousands of Americans die each year from heart disease.  There are thousands of patients on the waiting list daily.  Unfortunately, there are always too few donors to meet this demand. As such, new strategies are being pursued to meet this demand.   Read more

Leukotriene B4 as a Mediator of CAV and Potentially Treatable with Bestatin

Leukotriene B4 Contributes to Development of Cardiac Allograft Vasculopathy
Kiran Khush, MD, MAS
 
Cardiac Allograft Vasculopathy (CAV) remains the Achilles heel of long-term outcomes after heart transplantation. It is often diagnosed at a late stage at which time progression is inevitable. While the pathogenesis is not completely elucidated, histologic evidence is suggestive of a macrophage response an important part of the immune pathway. Previous literature in pulmonary arterial hypertension (PAH) has shown that macrophage-derived leukotriene B4 (LTB4) induces proliferation of the pulmonary artery smooth muscle. The authors hypothesized that LTB4 may also play an important role in the development of CAV. Read more

DCD Lung Transplantation: A Promising Future

5-Year Results from the ISHLT DCD Lung Transplant Registry Confirm Excellent Recipient Survival from Donation after Circulatory Death Donors
Dirk Van Raemdonck, MD, PhD
 
Is Donor after Cardiac Death (DCD) lungs the answer to the ever-growing shortage of donor lungs? Researchers looking at the ISHLT thoracic transplant registry data for lung transplant reported that long term survival of DCD lungs were comparable to Donor after Brain Death (DBD) lungs.  Read more

Gene Expression Profile Score to Predict CAV Needs Further Studies

Are Gene Expression Profile Scores Associated with New Onset CAV
Anuradha Lala, MD
 
Gene Expression Profile as defined by the AlloMap (CareDx, Brisbane) is a score that ranges from 0-40 as a surrogate for acute cellular rejection. The Outcomes AlloMap Registry (OAR) is an ongoing multisite prospective registry including 35 sites in the United States enrolling highly-selected, low- risk patients. Detection of early cardiac allograft vasculopathy (CAV) may improve long term outcomes.  Read more

Chasing the Golden Snitch: Optimizing Outcomes of MCS Infections

Infections plaguing patients with LVAD have been linked to decreased survival and increased morbidity. Treating VAD-related infections can be challenging and the best prevention and treatment strategies remain elusive (like the golden snitch in a heated Quidditch match!). In this session we learn about the possible use of medical-grade honey in drive line dressing kits, the impact of delayed sternal closure on infections, and the mechanisms of …  Read more

The Heart Transplant Community is in Need of a Better Tool to Predict Primary Graft Dysfunction

Development and Validation of a Risk Model and Primary Graft Failure after Heart Transplantation and Comparison to the RADIAL Risk Score
Alexander Bernhardt, MD
 
Primary Graft Dysfunction (PGD) hinders short-term outcomes as the leading cause of early death after heart transplantation. Current tools to predict PGD include the RADIAL score (RAP > 10 mmHg, Age recipient> 60 yrs, DM, inotrope dependence, Age donor > 30, Ischemic time > 240 min). The authors of this study developed a new risk score and compared to the existing RADIAL score. 

Read more

DCD Lung Transplantation

Center Variability in Organ Offer Acceptance and Waitlist Mortality in Lung Transplantation
Ashley Choi, BA
 
Variable donor organ acceptance practices are linked to lung transplant waitlist mortality. Duke researchers reported that every 10 percent increase in adjusted center organ acceptance rate results in 36 percent reduction in waitlist mortality.  Read more

Diagnostics and Immunosuppression in Lung Transplantation

Ten-Year-Experience with Alemtuzumab as Induction Therapy: A Single-Center Analysis of More Than 500 Patients reduction of CNI doses led to low incidence of kidney insufficiency and long freedom rates from severe CLAD
Alberto Bennazo, MD
 
Is Alemtuzumab the wonder drug that will reduce chronic lung transplant rejection (CLAD) and transform long term survival in lung transplantation. Researchers from Vienna have reported in their retrospective study that alemtuzumab induction reduces long term CLAD rates and renal dysfunction.  Read more

To Divorce or Not to Divorce CMV Prophylaxis?

Quantiferon-CMV Guided Virostatic Prophylaxis after Heart Transplantation
Gregor Poglajen, MD, PhD
 
Cytomegalovirus (CMV) remains a significant cause of morbidity and mortality in the heart transplant community.  Nearly all transplant centers practice some form of prophylaxis (whether universal or preemptive), though duration of prophylaxis can vary.  Valganciclovir remains the most commonly used agent for prophylaxis.  However, prolonged use is not without its side effects and leukopenia is one of the biggest issues regarding valganciclovir use. Practicing a personalized approach to CMV prophylaxis remains a relatively unexplored area, but if possible, it could greatly decrease the risk CMV infection and disease while, at the same time, significantly decrease the risk of side effects from drug use.   Read more

#ISHLT2019 Announcements

We Want Your Opinions! Be Sure to Take the Survey

Help us make next year’s event as strong as possible by giving us feedback. Take the survey. You’ll find it in the app under Attendee Information or click here to take it online. 
 
Thanks in advance from the ISHLT Staff!

Today’s Press Releases

On the Horizon

And the Winner Is...Find out at Tomorrow’s Awards Ceremony in Pacifica 6

Our final Plenary Session is tomorrow morning from 8 to 10 AM in Pacifica 6 – a new location – and it’s a must-see event. On the agenda:

  • Awards Presentation! Who won what? Come find out. 
  • What’s Hot. What’s New. Basic Science Overview. 
  • The President’s Debate: Is it time to abandon retransplantation? 

Daily Pulse Reporters:

Roy Lee, PharmD

Yasbanoo Moayedi, MD

Nirmal Sharma, MD

Van-Khue Ton, MD, PhD

Newsletter Coordinators:

Nancy Mays

Megan Barrett

Disclaimer: This content reflects the opinions and perspectives of the individual authors and does not reflect the opinions and perspectives of the ISHLT or the Editor.