First Pediatric Heart Transplantation From a Pediatric Donor Heart in Japan

Ueno, Takayoshi; Fukushima, Norihide; Sakaguchi, Taichi; Ide, Hiroki; Ozawa, Hideto; Saito, Shunsuke; Ichikawa, Hajime; Sawa, Yoshiki

doi:10.1253/circj.cj-11-1001

Cited by 14 publications

(6 citation statements)

References 8 publications

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“…Although a recent law in Japan now makes it possible for children to undergo heart transplantation, there are few options for those with terminal heart failure due to the shortage of donor hearts and the unavailability of VADs [24,33,34]. The implantable VAD systems suitable for adult patients are too large for use in pediatric patients, thus, paracorporeal systems are routinely utilized.…”

Section: Future Perspectives Of the Duraheart And Hvad In Japanmentioning

confidence: 99%

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

Sawa

2014

Surg Today

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Recently, left ventricular assist devices (LVADs) have become a viable therapeutic approach as a bridge to cardiac transplantation, as well as destination therapy or as part of the bridge to recovery. In Japan, paracorporeal pneumatic devices are the only choice for such therapy, as implantable LVADs are not yet generally available due to device lag, which represents a serious problem in this field. Clinical trials of four different continuous-flow pumps, both axial and centrifugal flow types, were completed at about the same time, and two of those devices, DuraHeart and EVAHEART, have already been approved for use in Japan. Thus, reports of advanced treatment for severe heart failure with these devices are expected. The DuraHeart (Terumo Heart, Ann Arbor, MI, USA) and another device named the HeartWare (HeartWare Inc, Miami Lakes, FL, USA) are so-called third-generation devices, as they have achieved miniaturization and improvements in performance from the use of magnetic levitation. Based on our experiences from both clinical research and experimental use, we herein discuss the DuraHeart and HeartWare devices, with a focus on the clinical outcomes and management strategies. Because of the long waiting period for heart transplantation in Japan, these two devices are considered to have important roles in the near future for the treatment of severe heart failure, and a comprehensive strategy for LVAD therapy including such third-generation implantable devices is expected.

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Section: Future Perspectives Of the Duraheart And Hvad In Japanmentioning

confidence: 99%

Current status of third-generation implantable left ventricular assist devices in Japan, Duraheart and HeartWare

Sawa

2014

Surg Today

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“…We did not include pediatric recipients in the present analysis, although the frequency of use of any induction therapy in pediatric patients, including IL-2 inhibitors, has been increasing recently. 19 The number of pediatric transplants is expected to increase in Japan and other Asian countries; 20,21 therefore, verification of the safety and efficacy of this drug in pediatric patients would be particularly warranted. Further, we were unable to analyze the association between induction therapy and the occurrence of transplant coronary artery disease because we did not perform coronary angiograms on the present patients.…”

Section: Discussionmentioning

confidence: 99%

Similar Survival in Patients Following Heart Transplantation Receiving Induction Therapy Using Daclizumab vs. Basiliximab

Martin

Kato

Farr

et al. 2015

Circ J

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Background Induction therapy with interleukin-2 receptor antagonists has been established as an effective immunosuppressive strategy in the management of heart transplant (HTx) recipients. We compared outcomes following HTx in patients receiving basiliximab, daclizumab, or no induction therapy. Methods and Results We investigated post-transplant prognosis of patients receiving basiliximab (n=67), daclizumab (n=98) or no induction therapy (n=70). Patients treated with daclizumab (50.3±14.7 years) were younger than those receiving basiliximab (55.8±11.2 years) or no induction therapy (54.9±14.1 years; both P<0.05). Patients receiving either induction therapy showed better survival 1 year after HTx (95%) than those without induction therapy (82%; P<0.001). Survival was similar between patients receiving basiliximab and daclizumab. The incidence of acute cellular or antibody-mediated rejections did not differ among the groups. The main reason that patients did not receive induction therapy was ongoing infection (65.7%), which was more common in patients on ventricular assist device (VAD) support than those without VAD (76.1% vs. 45.8%; P=0.004). The VAD-related infection rate in the entire study cohort was 29.7% (35/118 VAD recipients). Conclusions Survival following HTx was worse in patients not receiving induction therapy. No differences were noted in survival or the incidence of rejection between the daclizumab- and basiliximab-treated groups. Induction therapy was less used in patients with infection, which was related to prior VAD support.

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“…And the first pediatric heart transplantation using a pediatric donor heart was performed in 2011. 7 Selection of heart transplant candidates in Japan is a 2-stage process, with an assessment of suitability by both the treating institution and the Heart Transplant Candidate Registry Committee of the Japanese Circulation Society. 4 Commencing in 1997 with enactment of the Organ Transplant Law, the Heart Transplant Candidate Registry Committee initially assessed 40-60 applicants per year.…”

Section: Waiting Statusmentioning

confidence: 99%

“…One heart transplantation has been performed in a child aged <10 years old, at Osaka University. 7 The number of heart transplantations performed at each institution is as follows: 58 (27 pre-revision/31 post-revision) at the National Cerebral and Cardiovascular cipients who are on BTT therapy using extracorporeal type and implantable type VADs.…”

Section: Waiting Statusmentioning

confidence: 99%