Current status and outcomes in heart transplantation: a narrative review

Awad, M.; Shah, Aakash; Griffith, Bartley P.

doi:10.31083/j.rcm2301011

Cited by 39 publications

(28 citation statements)

References 133 publications

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“…Die Prävalenz der CAV steigt von 8 % nach 1 Jahr auf über 30 % nach 5 Jahren und ist mit einem schlechten Überleben assoziiert. 81,82 Der Einsatz der ECP begann bereits Anfang der 90er Jahre und im Jahr 1998 wurde die erste multizentrische, randomisierte Studie vorgestellt, in der 60 Patienten entweder eine immunsuppressive Tripeltherapie oder zusätzlich eine ECP erhielten. In der ECP-Gruppe wurden signifikant weniger Abstoßungsepisoden beobachtet, jedoch keine Verbesserung der Überlebensrate.…”

Section: Herztransplantationunclassified

Wirkweise, Indikationen und Therapieempfehlungen der extrakorporalen Photopherese (ECP)

Cho,

Paulitschke,

Knobler

2023

J Deutsche Derma Gesell

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ZusammenfassungDie extrakorporale Photopherese (ECP) hat in jüngster Zeit bei der Behandlung verschiedener Krankheiten an Bedeutung gewonnen. Ursprünglich als neue Therapie zur Behandlung von Patienten mit kutanem T‐Zell‐Lymphom vorgestellt, hat sich der Indikationsbereich für die ECP auf Hämatologie und Transplantationsimmunologie erweitert. Die ECP hat ihren festen Platz im Therapieplan bei kutanen T‐Zell‐Lymphomen, systemischer Sklerose, Graft‐versus‐Host‐Erkrankung, Organtransplantationen wie Herz und Lunge, teilweise als Erstlinientherapie und sehr häufig in Kombination mit verschiedenen systemischen immunsuppressiven Therapien. Das Verfahren besteht im Wesentlichen aus drei Schritten: Leukapherese, Photoaktivierung und Reinfusion. Im folgenden Artikel werden die noch nicht vollständig verstandenen Wirkmechanismen dargestellt, die fünf häufigsten Indikationen für die Behandlung mit ECP diskutiert und Therapieempfehlungen für die jeweilige Indikation gegeben.

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Section: Herztransplantationunclassified

Wirkweise, Indikationen und Therapieempfehlungen der extrakorporalen Photopherese (ECP)

Cho,

Paulitschke,

Knobler

2023

J Deutsche Derma Gesell

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“…The prevalence of CAV increases from 8% in the first year to more than 30% in the fifth year and is associated with poor survival. 81,82 The use of ECP began in the early 1990s, and in 1998 the first multicenter randomized trial was presented in which 60 patients received either triple immunosuppressive therapy or ECP. Significantly fewer rejection episodes were observed in the ECP group, but not improved survival.…”

Section: Heart Transplantationmentioning

confidence: 99%

Mode of action, indications and recommendations on extracorporeal photopheresis (ECP)

Cho,

Paulitschke,

Knobler

2023

J Deutsche Derma Gesell

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SummaryExtracorporeal photopheresis (ECP) has gained importance in the treatment of several diseases. Initially introduced as a new therapeutic modality for the treatment of patients with cutaneous T‐cell lymphoma, the indications for the use of ECP have expanded to include hematology and transplantation immunology. Extracorporeal photopheresis has found its place in the treatment plan of cutaneous T‐cell lymphoma, systemic sclerosis, graft‐versus‐host disease, organ transplantation such as heart and lung, sometimes as first‐line therapy and very often in combination with various systemic immunosuppressive therapies. The procedure basically consists of three steps: leukapheresis, photoactivation and reinfusion. The following article presents possible theories about the mechanism of action, which is not yet fully understood, and discusses the five most common indications for ECP treatment with corresponding therapy recommendations.

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“…However, LVAD power demand is high, usually 5–30 W. This requires an external power source connected to the LVAD via a percutaneous driveline. The driveline frequently becomes infected, resulting in recurrent hospital admissions and complications including life-threatening sepsis, LVAD failure and premature death [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Pulsed RF Energy Transfer Mitigates Tissue Heating in High Power Demand Implanted Device Applications: In Vivo and In Silico Models Results

Karim

Bosnjak

McLaughlin

et al. 2022

Sensors

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This article presents the development of a power loss emulation (PLE) system device to study and find ways of mitigating skin tissue heating effects in transcutaneous energy transmission systems (TETS) for existing and next generation left ventricular assist devices (LVADs). Skin thermal profile measurements were made using the PLE system prototype and also separately with a TETS in a porcine model. Subsequent data analysis and separate computer modelling studies permit understanding of the contribution of tissue blood perfusion towards cooling of the subcutaneous tissue around the electromagnetic coupling area. A 2-channel PLE system prototype and a 2-channel TETS prototype were implemented for this study. The heating effects resulting from power transmission inefficiency were investigated under varying conditions of power delivery levels for an implanted device. In the part of the study using the PLE setup, the implanted heating element was placed subcutaneously 6–8 mm below the body surface of in vivo porcine model skin. Two operating modes of transmission coupling power losses were emulated: (a) conventional continuous transmission, and (b) using our proposed pulsed transmission waveform protocols. Experimental skin tissue thermal profiles were studied for various levels of LVAD power. The heating coefficient was estimated from the porcine model measurements (an in vivo living model and a euthanised cadaver model without blood circulation at the end of the experiment). An in silico model to support data interpretation provided reliable experimental and numerical methods for effective wireless transdermal LVAD energization advanced solutions. In the separate second part of the study conducted with a separate set of pigs, a two-channel inductively coupled RF driving system implemented wireless power transfer (WPT) to a resistive LVAD model (50 Ω) to explore continuous versus pulsed RF transmission modes. The RF-transmission pulse duration ranged from 30 ms to 480 ms, and the idle time (no-transmission) from 5 s to 120 s. The results revealed that blood perfusion plays an important cooling role in reducing thermal tissue damage from TETS applications. In addition, the results analysis of the in vivo, cadaver (R1Sp2) model, and in silico studies confirmed that the tissue heating effect was significantly lower in the living model versus the cadaver model due to the presence of blood perfusion cooling effects.

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Current status and outcomes in heart transplantation: a narrative review

Cited by 39 publications

References 133 publications

Wirkweise, Indikationen und Therapieempfehlungen der extrakorporalen Photopherese (ECP)

Wirkweise, Indikationen und Therapieempfehlungen der extrakorporalen Photopherese (ECP)

Mode of action, indications and recommendations on extracorporeal photopheresis (ECP)

Transcutaneous Pulsed RF Energy Transfer Mitigates Tissue Heating in High Power Demand Implanted Device Applications: In Vivo and In Silico Models Results

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