Background and Aims Hepatitis C virus (HCV)‐viremic organs are underutilized, and there is limited real‐world experience on the transplantation of HCV‐viremic solid organs into recipients who are HCV negative. Approach and Results Patients listed or being evaluated for solid organ transplant after January 26, 2018, were educated and consented by protocol on the transplantation of HCV‐viremic organs. All recipients were HCV nucleic acid test and anti‐HCV antibody negative at the time of transplant and received an HCV‐viremic organ. The primary outcome was sustained virological response (SVR) at 12 weeks after completion of direct‐acting antiviral (DAA) therapy (SVR12). Seventy‐seven patients who were HCV negative underwent solid organ transplantation from a donor who was HCV viremic. No patients had evidence of advanced hepatic fibrosis. Treatment regimen and duration were at the discretion of the hepatologist. Sixty‐four patients underwent kidney transplant (KT), and 58 KT recipients had either started or completed DAA therapy. Forty‐one achieved SVR12, 10 had undetectable viral loads but are not eligible for SVR12, and 7 remain on treatment. One KT recipient was a nonresponder because of nonstructural protein 5A resistance. Four patients underwent liver transplant and 2 underwent liver‐kidney transplant. Three patients achieved SVR12, 1 has completed DAA therapy, and 2 remain on treatment. Six patients underwent heart transplant and 1 underwent heart‐kidney transplant. Six patients achieved SVR12 and 1 patient remains on treatment. Conclusions Limited data exist on the transplantation of HCV‐viremic organs into recipients who are HCV negative. Our study is the largest to describe a real‐world experience of the transplantation of HCV‐viremic organs into recipients who are aviremic. In carefully selected patients, the use of HCV‐viremic grafts in the DAA era appears to be efficacious and well tolerated.

AIM: Pulmonary Hypertension (PH) currently has minimal guidelines for outpatient disease management. Congestive heart failure (CHF) studies however have shown effectiveness of disease management plans in reducing all-cause mortality and all-cause and CHF related hospital readmissions. Heart failure exacerbation is a common reason for readmission in both PH and CHF. Our aim was to review individual studies and comprehensive meta-analyses to identify effective CHF interventions that can be used to develop similar disease management plans for PH. METHODS: A comprehensive literature review from 1993 to 2019, including original articles, systematic reviews and meta-analyses. We reviewed topics of outpatient CHF interventions to decrease CHF mortality and readmission and patient management strategies in CHF. RESULTS: The most studied interventions included case management (CM), multidisciplinary Intervention (MI), structured telephone strategy (STS) and tele-monitoring (TM). CM showed decreased all-cause mortality (ACM) at 12 months, all-cause readmission (ACR) at 12 months and CHF readmission at 6 and 12 months. MI resulted in decreased ACR and CHF readmission. There was some discrepancy on effectiveness of TM programs in individual studies, however meta-analyses suggest TM provided reduced ACM and risk of CHF hospitalization. STS had similar results to TM including decreased risk of CHF hospitalization, without effect on mortality. CONCLUSIONS: Extrapolating from CHF data, it seems strategies to improve the health of PH patients and development of comprehensive care programs (CCP) should include structured telephone strategy and/ or tele-monitoring, case management strategies and multi-disciplinary interventions.

A comprehensive approach is necessary in managing heart failure in frail older adults. To provide optimal care, physicians need to draw on knowledge from the fields of internal medicine, geriatrics, and cardiology. The acronym "MORE" is a mnemonic for what heart failure management should include: multidisciplinary care, attention to other (ie, comorbid) diseases, restrictions (of salt, fluid, and alcohol), and discussion of end-of-life issues.

El parto pretérmino incluye los nacimientos antes de la semana 37 de gestación, es de etiología aún desconocida y parece ser una patología multifactorial considerada en el mundo como la principal causa de morbilidad y mortalidad perinatal.Objetivos: Identificar los factores de riesgo para parto pretérmino en las gestantes del departamento de Caldas durante los años 2003 y 2006. Materiales y métodos: Se realizó un estudio retrospectivo descriptivo de casos y controles en los hospitales locales de la República Hospitalaria de Caldas (Manizales, Caldas, Colombia). La selección de los casos (partos pretérmino entre semana 24 hasta la semana 36 con 6 días) y la selección de los controles (partos a término semana 37 hasta la semana 41 con 6 días). Resultados: Analizadas 669 pacientes, se encontró significancia en las siguientes variables: escolaridad, amenaza de parto pretérmino, infecciones urinarias, serología positiva, el inicio del parto y la anemia. Además el número de controles prenatales es un predictor importante con respecto a esta patología. Conclusiones: Los factoresde riesgo encontrados tienen relación con los analizados en otros estudios, lo cual muestra que en dichos factores hay significancia y por esto hay que tener en cuentasu detección temprana y su prevención. En relación con el riesgo del parto pretérmino, se demuestra la relevancia de los controles prenatales.

High volume extracorporeal membrane oxygenation (ECMO) centers have developed mobile ECMO programs in recent years to facilitate the implementation of ECMO support at hospitals with lower capabilities, and transfer these patients for further care. We report a case of mobile ECMO on a patient with coronavirus disease 2019‐related acute respiratory distress syndrome, and discuss the potential application in the current severe acute respiratory syndrome coronavirus 2 pandemic.