The Eurotransplant High-Urgency Heart Transplantation Program: An Option for Patients in Acute Heart Failure?

Koch, Achim; Tochtermann, U.; Remppis, Andrew; Tj, Dengler; Pa, Schnabel; Hagl, S.; Sack, FU

doi:10.1055/s-2006-924245

Cited by 8 publications

(8 citation statements)

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“…However, data from the European Transplant Organization (Eurotransplant International, Leiden, The Netherlands) show an increasing shortage of organ donors [1]. As a result, it is mainly the critically ill patients with a "high-urgency" status who have a chance to receive a heart transplant [2]. Overall, waiting times for cardiac transplant exceed 2 to 3 years for patients with the blood groups A or 0.…”

mentioning

confidence: 99%

“…With increasing waiting times for cardiac transplantation and changes in the allocation process of the European Transplant Organization (Eurotransplant International Foundation, Leiden, The Netherlands), heart transplants will only be available to the sickest patients [12]. At least in Germany, only patients who are inotrope dependent or have complications during mechanical assist device support have a chance to get a heart within a relatively short time [2,6]. Accordingly, the time frame to bridge patients with optimized medical therapy, including resynchronization therapy, to heart transplantation is relatively long.…”

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confidence: 99%

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Partial Mechanical Long-Term Support with the CircuLite® Synergy® Pump as Bridge-to-Transplant in Congestive Heart Failure

Klotz

Meyns²,

Simon

et al. 2010

Thorac cardiovasc Surg

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confidence: 99%

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confidence: 99%

Partial Mechanical Long-Term Support with the CircuLite® Synergy® Pump as Bridge-to-Transplant in Congestive Heart Failure

Klotz

Meyns²,

Simon

et al. 2010

Thorac cardiovasc Surg

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“…Unfortunately, the registry does not collect these data. However, with the improvement of heart failure treatment and mechanical assist devices, the waiting-list mortality has decreased and the post transplant outcome has become more significant [9,37–40]. The predicted survival in this study did not account for the race mismatch and may have underestimated the mortality rates in these cases.…”

Section: Discussionmentioning

confidence: 98%

The International Heart Transplant Survival Algorithm (IHTSA): A New Model to Improve Organ Sharing and Survival

et al. 2015

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BackgroundHeart transplantation is life saving for patients with end-stage heart disease. However, a number of factors influence how well recipients and donor organs tolerate this procedure. The main objective of this study was to develop and validate a flexible risk model for prediction of survival after heart transplantation using the largest transplant registry in the world.Methods and FindingsWe developed a flexible, non-linear artificial neural networks model (IHTSA) and classification and regression tree to comprehensively evaluate the impact of recipient-donor variables on survival over time. We analyzed 56,625 heart-transplanted adult patients, corresponding to 294,719 patient-years. We compared the discrimination power with three existing scoring models, donor risk index (DRI), risk-stratification score (RSS) and index for mortality prediction after cardiac transplantation (IMPACT). The accuracy of the model was excellent (C-index 0.600 [95% CI: 0.595–0.604]) with predicted versus actual 1-year, 5-year and 10-year survival rates of 83.7% versus 82.6%, 71.4% – 70.8%, and 54.8% – 54.3% in the derivation cohort; 83.7% versus 82.8%, 71.5% – 71.1%, and 54.9% – 53.8% in the internal validation cohort; and 84.5% versus 84.4%, 72.9% – 75.6%, and 57.5% – 57.5% in the external validation cohort. The IHTSA model showed superior or similar discrimination in all of the cohorts. The receiver operating characteristic area under the curve to predict one-year mortality was for the IHTSA: 0.650 (95% CI: 0.640–0.655), DRI 0.56 (95% CI: 0.56–0.57), RSS 0.61 (95% CI: 0.60–0.61), and IMPACT 0.61 (0.61–0.62), respectively. The decision-tree showed that recipients matched to a donor younger than 38 years had additional expected median survival time of 2.8 years. Furthermore, the number of suitable donors could be increased by up to 22%.ConclusionsWe show that the IHTSA model can be used to predict both short-term and long-term mortality with high accuracy globally. The model also estimates the expected benefit to the individual patient.

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“…However, due to strict transplantation regulations and lack of public awareness, shortage of transplantable organs persists worldwide, and waiting list mortality is still unacceptably high [1,2]. The human heart lacks the ability to regenerate after tissue necrosis.…”

Section: Introductionmentioning

confidence: 99%

Impedimetric Analysis of the Effect of Decellularized Porcine Heart Scaffold on Human Fibrosarcoma, Endothelial, and Cardiomyocyte Cell Lines

et al. 2017

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BackgroundExperiments on porcine heart scaffold represent significant assays in development of immunoneutral materials for cardiac surgery. Characterization of cell-cell and cell-scaffold interactions is essential to understand the homing process of cardiac cells into the scaffolds.Material/MethodsIn the present study, the highly sensitive and real-time impedimetric technique of xCELLigence SP was used to monitor cell adhesion, which is the key process of recellularization in heart scaffolds. Our objectives were: (i) to characterize the effect of decellularized porcine heart scaffold on cell adhesion of human cardiovascular cells potentially used in the recellularization process; and (ii) to investigate cell-extracellular matrix element interactions for building artificial multi-layer systems, applied as cellular models of recellularization experiments. Human fibrosarcoma, endothelial, and cardiomyocyte cells were investigated and the effect of decellularized porcine heart scaffold (HS) and fibronectin on cell adhesion was examined. Adhesion was quantified as slope of curves.ResultsHeart scaffold had neutral effect on cardiomyocytes as well as on endothelial cells. Adhesion of cardiomyocytes was increased by fibronectin (1.480±0.021) compared to control (0.745±0.029). The combination of fibronectin and HS induced stronger adhesion of cardiomyocytes (2.407±0.634) than fibronectin alone. Endothelial and fibrosarcoma cells showed similarly strong adhesion profiles with marked enhancer effect by fibronectin.ConclusionsDecellularized porcine HS does not inhibit adhesion of human cardiovascular cells at the cell biological level, while fibronectin has strong cell adhesion-inducer effect, as well as an enhancer effect on activity of HS. Consequently, decellularized porcine hearts could be used as scaffolds for recellularization with cardiomyocytes and endothelial cells with fibronectin acting as a regulator, leading to construction of working bioartificial hearts.

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The Eurotransplant High-Urgency Heart Transplantation Program: An Option for Patients in Acute Heart Failure?

Cited by 8 publications

References 1 publication

Partial Mechanical Long-Term Support with the CircuLite® Synergy® Pump as Bridge-to-Transplant in Congestive Heart Failure

Partial Mechanical Long-Term Support with the CircuLite® Synergy® Pump as Bridge-to-Transplant in Congestive Heart Failure

The International Heart Transplant Survival Algorithm (IHTSA): A New Model to Improve Organ Sharing and Survival

Impedimetric Analysis of the Effect of Decellularized Porcine Heart Scaffold on Human Fibrosarcoma, Endothelial, and Cardiomyocyte Cell Lines

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