The International Society of Heart and Lung Transplantation (ISHLT) is a not-for-profit, multidisciplinary, professional organization dedicated to improving the care of patients with advanced heart or lung disease through transplantation, mechanical support and innovative therapies via research, education and advocacy. ISHLT's annual meeting is April 19-22 in Denver, Colorado. This meeting gathers healthcare delivery teams that manage patients with end-stage heart or lung disease.
Baylor Scott & White Health clinicians and researchers will be involved in more than 20 presentations, scheduled talks, education sessions and panel discussions.
A snapshot of talks and presentations with Baylor Scott & White involvement can be found below. Additional details about the annual meeting are on the event website.
Shelley Hall, MD, chief of transplant cardiology, mechanical circulatory support and advanced heart failure at Baylor University of Medical Center at Dallas provides overview of Baylor Scott & White’s participation at the International Society for Heart & Lung Transplantation
Highlights:
Shelley Hall, MD, chief of transplant cardiology, mechanical circulatory support and advanced heart failure at Baylor University of Medical Center at Dallas invites you to join “Value of CPRA and Virtual Crossmatch in New Heart and Lung Allocation Algorithms in Transplanting Sensitized Patients” session.
Jaime Hernandez-Montfort, cardiologist for advanced heart failure, mechanical circulatory support and heart transplantation at Baylor Scott & White Medical Center – Temple leads a discussion, in Spanish, on “Abordaje del Shock Cardiopulmonar (Strategies to Manage Cardiopulmonary Shock)”
Featured Presentations And Sessions Highlighting Heart And Lung Transplant Research
WEDNESDAY, APRIL 19, 2023
Special Session – ISHLT en Español: Abordaje del Shock Cardiopulmonar (Strategies to Manage Cardiopulmonary Shock)
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Speaker: Jaime Hernandez-Montfort, MD, MPH, MSc
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Time: 11:30-11:38 a.m. MST
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Abstract/Study Purpose: El disertante analizará los diferentes modelos de equipos de choque cardiogénico en todo el mundo. El orador discutirá quiénes componen estos equipos, es decir, cirujanos, intensivistas, cardiólogos, etc. El orador discutirá el papel de cada miembro del equipo y su contribución al equipo. (The speaker will discuss various models of cardiogenic shock teams across the world. The speaker will discuss who makes up these teams, i.e., surgeons, intensivists, cardiologists etc. The speaker will discuss each team member's role and contribution to the team.)
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Session 26: Recipient Outcomes with Extended Criteria Donors: An Analysis of the Guardian Heart Registry
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Research Collaborator: Dan Meyer, MD
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Time: 5-5:10 p.m. MST
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ORAL ABSTRACT: Comparison Of Patient Characteristics and Outcomes of Left Ventricular Assist Devices Before and after the Heart Transplant Allocation Change
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Author: Katharina Fetten, MD
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Time: 6:24-6:28 p.m. MST
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Abstract/Study Purpose: Heart transplant organ allocation in the U.S. changed in October 2018 from a three- tier to a six-tier system aiming to reduce waitlist mortality and increase broader sharing. This change has led to fewer LVAD recipients being transplanted. We reviewed the differences in preoperative status and overall outcomes in contemporary LVAD recipients in our hospital compared to before the allocation change.
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ORAL ABSTRACT: Incorporating Palliative Care Services in the Advanced Heart Failure Clinic
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Author: Elizabeth Brown, MSN
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Time/Location: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: Multidisciplinary team management of Advanced Heart Failure and Left Ventricular Assist Devices (LVADs) patients is essential. However, the incorporation of palliative services is often inconsistent. Herein we describe two patients who received consultations from a unique palliative service embedded in the clinic.
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ORAL ABSTRACT: Human Papilloma Virus-Associated Malignancies in Heart Transplant Recipients
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Author: Elizabeth Brown, MSN
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Time: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: Human Papilloma Virus (HPV) is a common viral infection that can have negative outcomes in Solid Organ Transplant (SOT) recipients. HPV lesions may progress to malignant carcinomas. Here we discuss two cases of oropharyngeal HPV identified early post-heart transplant.
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ORAL ABSTRACT: Impact of Indeterminate Donor-Derived Cell-Free DNA Results on Clinical Events in the First Year after Heart Transplantation
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Research Collaborator: Shelley Hall, MD
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Time: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: The goal of this analysis was to evaluate whether patients with "indeterminate" elevations (0.12-0.19%) in donor-derived cell-free DNA (dd-cfDNA) have an increased risk of acute cellular rejection (ACR), antibody mediated rejection (AMR), de novo donor specific antibodies (dnDSA) and graft dysfunction using data from the Surveillance HeartCare Outcomes Registry (SHORE).
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ORAL ABSTRACT: How Long Can We Go? Redefining the Upper Limit of Ischemic Times for Hypothermic Donor Heart Preservation
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Research Collaborator: Dan Meyer, MD
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Time: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: The 2018 United Network for Organ Sharing expanded geographic range for organ procurement resulting in longer ischemic times. Risk factors associated with historic ice storage resulted in limiting donor heart ischemic times to less than four hours. The Paragonix SherpaPak Cardiac Transport System (CTS) is an organ preservation technology designed to maintain donor heart temperatures between 4°C - 8°C, which may minimize both prolonged ischemic and potential freezing-related tissue injury. Transplant centers are pushing the boundaries of historical ischemic time limitations using this technology, and we seek to investigate the impact on clinical outcomes.
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ORAL ABSTRACT: Is Off-Pump Coronary Bypass Surgery the Savior of Low EF Coronary Artery Disease Patients?
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Author: Amber Malhotra, MD
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Time: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: Coronary artery disease (CAD) with EF less than 35% prompts the patients to higher complication rates and death. On-pump CABG (ONCAB) should intuitively have higher complication rates than Off-pump (OPCAB), given the usually compromised status of other end organs. We studied in-hospital and seven-year follow-up outcomes between the two procedures in our CABG patients with an EF ≤ 35%.
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ORAL ABSTRACT: Improved Outcomes in Older Recipients Undergoing Transplant Using the Sherpapak System: A Subgroup Analysis of the Guardian Heart Registry
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Research Collaborator: Dan Meyer, MD
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Time: 6:30-7:30 p.m. MST
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Abstract/Study Purpose: The 2018 United Network for Organ Sharing expanded geographic range for organ procurement resulting in longer ischemic times. Risk factors associated with historic ice storage resulted in limiting donor heart ischemic times to less than four hours. The Paragonix SherpaPak Cardiac Transport System (CTS) is an organ preservation technology designed to maintain donor heart temperatures between 4°C - 8°C, which may minimize both prolonged ischemic and potential freezing-related tissue injury. Transplant centers are pushing the boundaries of historical ischemic time limitations using this technology, and we seek to investigate the impact on clinical outcomes.
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THURSDAY, APRIL 20, 2023
ORAL ABSTRACT: Impella 5.5 Use as a Bridge to Transplant in Hereditary Transthyretin Amyloidosis
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Author: Neville Maliakkal
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Little is known about the use of the newer generation's temporary mechanical circulatory (tMCS) device, the Impella 5.5, in patients with restrictive cardiomyopathies.
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ORAL ABSTRACT: Transcatheter Aortic Valve-In-Valve Implantation in Patients with Left Ventricular Assisted Device
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Author: Rakushumimarika Harada, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Patients with left ventricular assist device (LVAD) can develop progressive aortic insufficiency (AI) secondary to continuous flow against a closed aortic valve. Transcatheter aortic valve-in-valve (VIV) implantation has been utilized to correct failed surgical bioprosthetic aortic valves for high-surgical-risk patients. Herein, we present two cases of transcatheter aortic VIV implantations correcting severe AI in patients with LVAD.
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ORAL ABSTRACT: Successful Ventricular Tachycardia Ablation in a Patient with Biventricular Support Post Heartmate 3 Implantation
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Author: Omar Al-Abboud, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Left ventricular assisted devices (LVAD) have increased survival and quality of life in patients with end stage heart failure. However, elimination of malignant arrhythmia in these patients remains challenging. Reportedly, 35% of patients with LVADs develop ventricular arrhythmias in the first month of implantation, often refractory to anti-arrhythmic agents, which can lead to profound RV failure. The application of catheter ablation of ventricular tachycardia (VT) has been widely adopted in patients with cardiomyopathy, but its application among patients with LVAD is limited. We present a case of successful catheter ablation of VT performed in a patient with LVAD with an RV assist device in place for severe RV failure.
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ORAL ABSTRACT: Successful Surgical and Percutaneous Ventricular Tachycardia Ablation for Heartmate-3 LVAD Management: A Case Series
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Author: Gurjaspreet Bhattal, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Ventricular arrhythmias (VA) are common in ischemic cardiomyopathy (ICM) resulting in RV failure with greater morbidity and mortality after left ventricular assist device (LVAD) implantation. A 2013 study reported lower incidence of VA after cryoablation during HeartMate (HM) 2™ implantation, however the data for ablation with HM 3™ implants is scarce. We present a single-center, 4-patient case series from 2019 to 2022 of surgical and percutaneous VT ablation for HM 3™ implantation.
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ORAL ABSTRACT: Hemi-Diaphragmatic Plication in LVAD Patients with Post-Implantation Diaphragm Paralysis
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Author: Modar Alom, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Acquired diaphragmatic paralysis can result from injury to the phrenic nerve following adult cardiac surgery. While occurring in 1-2% of patients undergoing traditional cardiac surgery, diaphragm paralysis is a rare complication of Left ventricular assisted device (LVAD) implantation but can result in significant morbidity. We present a case series of two patients who underwent diaphragmic plication post LVAD implantation.
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ORAL ABSTRACT: Hemodynamic Optimization in Patients With a Durable Leftventricular Assisted Device with CardioMEMS
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Author: Rakushumimarika Harada, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: The CardioMEMS Heart Failure (HF) System is a device implanted in the pulmonary artery (PA) to monitor pulmonary artery pressures. It has been reported to reduce the recurrence of HF hospitalization in patients with both reduced and preserved ejection fraction by optimizing diuretics based on pressure changes. However, the role of CardioMEMS in patients with durable left ventricular assist device (LVAD) remains unknown.
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ORAL ABSTRACT: One Hundred Consecutive Heartmate 3 Left Ventricular Assist Device Implants at a Destination Therapy Center
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Author: Timothy George, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Although left ventricular assist device (LVAD) implantation is associated with improved survival in patients with advanced heart failure, data regarding outcomes of the latest generation device at destination therapy centers is lacking. We undertook this study to evaluate short-term outcomes of the Heartmate 3 device at a non-transplant center.
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ORAL ABSTRACT: Mechanical Circulatory Support as a Weaning Platform from Extracorporeal Membrane Oxygenation
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Author: Timothy George, MD
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: Although mechanical circulatory support (MCS) can be used to salvage patients in refractory cardiogenic shock, its role as a weaning platform from venoarterial extracorporeal membrane oxygenation (VA-ECMO) is largely unknown. We undertook this study to evaluate our experience using MCS to wean patients from VA-ECMO.
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ORAL ABSTRACT: Preoperative Pulmonary Function is Associated with Left Ventricular Assist Device Outcomes
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Author: Austin Kluis
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Time: 4:15-5:15 p.m. MST
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Abstract/Study Purpose: While left ventricular assist device (LVAD) implantation is associated with improved survival in patients with end-stage heart failure, the impact of preoperative pulmonary function on short-term outcomes is unclear.
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FRIDAY, APRIL 21, 2023
SESSION 57: Value of CPRA and Virtual Crossmatch in New Heart and Lung Allocation Algorithms in Transplanting Sensitized Patients
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Speaker: Shelley Hall, MD
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Time: 10:30-10:40 a.m. MST
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Abstract/Study Purpose: Discuss the revised heart and lung allocation policy proposals that eliminate the Donation Service Area and Region as distribution units. Discuss the importance of CPRA points and virtual crossmatch in facilitating the transplantation of highly sensitized patients.
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SESSION 62: Results from over 800 Transplant Recipients Enrolled in the Guardian Heart Registry
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Research Collaborator: Dan Meyer, MD
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Time: 10:30-10:40 a.m. MST
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Abstract/Study Purpose: The decades long gold standard for preservation of donor hearts in ice appears to be rapidly shifting to advanced hypothermic preservation. At the time of this abstract, over 25% of donor hearts in the US in 2022 have been transported in a Paragonix SherpaPak Cardiac Transport System (CTS). This controlled hypothermic technology in clinical use since 2018 preserving organ temperatures between 4 - 8°C. Real-world evidence on the clinical benefits of using CTS compared to conventional ice storage (ICE) is evaluated in the GUARDIAN Heart Registry to assess whether improved outcomes are achieved with this technology.
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SESSION 75: Validating the 2014 Consensus Primary Graft Definition: An Analysis on the 1,056 Patients from the Multi-Center Guardian Registry
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Research Collaborator: Dan Meyer, MD
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Time: 2:30-2:40 p.m. MST
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Abstract/Study Purpose: In 2014, an international collaboration developed the first modern, universal definition of Primary Graft Dysfunction (PGD). This definition was based on expert opinion and surgical experience of clinical risk factors. However, validating this definition has proved challenging as historic registries such as the UNOS registry do not capture the necessary information to report PGD, and single center studies are too limited in power to generate meaningful analyses. The GUARDIAN Registry is the largest multi-center registry focused on analysis of peri-operative outcomes following donor heart preservation, which provides a unique opportunity to substantiate the 2014 PGD definition.
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ORAL ABSTRACT: Leveraging Advanced Hypothermic Preservation to Achieve Transplant Program Goals
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Research Collaborator: Dan Meyer, MD
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Time: 5:00-5:04 p.m. MST
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Abstract/Study Purpose: This session will present our current understanding and future directions in the evaluation and management of the various categories of cardiogenic shock. Presentations will include pharmacologic and mechanical support strategies and ways to mitigate complications of temporary mechanical cardiac support devices, and current and future clinical trials and progress toward the creation of guidelines.
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ORAL ABSTRACT: Role of Sherpapak in Donors with Drug Overdose and Long Ischemic Times
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Research Collaborator: Dan Meyer, MD
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Time: 5:24-5:28 p.m. MST
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Abstract/Study Purpose: Over the last several years, the number of deaths from drug overdose has increased. Heart transplantation (HT) utilizing donor hearts from patients dying from drug overdose has expanded the donor pool. The current standard method of organ procurement includes the use of an ice cooler (ICE), which adds the risk of tissue freezing injury. The SherpaPak Cardiac Transport System (CTS) is a controlled hypothermic organ preservation technology that maintains donor heart temperatures between 4°C - 8°C, potentially mitigating this risk.
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ORAL ABSTRACT: Sherpapak Reduces Mcs Use Post Heart Transplant in Long Donor Down and Ischemic Times
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Research Collaborator: Dan Meyer, MD
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Time: 5:30-5:34 p.m. MST
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Abstract/Study Purpose: As demand for heart transplant (HT) increases, there is growing interest in expanding the donor pool. Donor hearts with multiple risk factors are often avoided, such as long down times in combination with long recovery distances resulting in longer ischemic times. The [SherpaPak] Cardiac Transport System (CTS) is a controlled hypothermic organ preservation technology potentially mitigating this risk when compared to ice. We aim to assess outcomes following HT from donors having both longer down and ischemic times.
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ORAL ABSTRACT: Can Controlled Hypothermic Preservation Provide Clinical Benefits in the Setting of Shorter Ischemic Times Prior to Heart Transplant
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Research Collaborator: Dan Meyer, MD
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Time: 5:54-5:58 p.m. MST
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Abstract/Study Purpose: The SherpaPak Cardiac Transport System (CTS) is gaining widespread use as an organ preservation technology, particularly in cases where greater ischemic times are anticipated. However, exposure of donor organs to freezing temperatures even for short duration may induce cellular and tissue damage. The unique design of the CTS may minimize trauma through suspension of the heart in solution and maintains donor heart temperatures continuously between 4°C - 8°C, which may minimize freezing-related tissue injury even over short-term use. A subgroup analysis of the GUARDIAN Heart Registry examined outcomes in transplants with less than 3 hours total ischemic time.
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ORAL ABSTRACT: Routine Use of Non-Heparin Purge Solution with Temporary Transvalvular Ventricular Assist Devices
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Author: Kyle Simonsen, MD
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Time: 5:00-6:00 p.m. MST
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Abstract/Study Purpose: Temporary transvalvular left ventricular assist devices traditionally utilize a continuous heparin purge solution to prevent thrombosis. Alternative purge solutions are attractive to decrease heparin-associated complications, particularly among patients expecting further invasive procedures and surgery.
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SATURDAY, APRIL 22, 2023
SESSION 85: Incidence and Predictors of Vasoplegia after Heart Transplantation: Results from the International PGD Consortium
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Research Collaborator: Johanna Van Zyl
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Time: 8:00-8:10 a.m. MST
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Abstract/Study Purpose: Post-operative vasoplegia is a leading cause of mortality after cardiac surgery. The purpose of this study is to investigate the incidence and predictors of vasoplegia after heart transplantation (HT).
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