WITHDRAWN: Executive Summary - The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients

Dhital, K.; Azeka, Estela; Colvin, Monica; DePasquale, E.C.; Farrero, Marta; García-Guereta, Luis; Jamero, Gina; Khush, Kiran K.; Lavee, Jacob; Pouch, Stephanie M.; Patel, J.; Michaud, Christopher J.; Shullo, M.; Schubert, Stephan; Angelini, Annalisa; Carlos, Lilibeth; Mirabet, Sònia; Patel, Jignesh; Pham, Michael; Urschel, Simon; Kim, Kyung-Hee; Miyamoto, Shelly; Chih, Sharon; Daly, Kevin P.; Grossi, Paolo; Jennings, Douglas L.; Kim, In Cheol; Lim, Hoong Sern; Miller, Tara; Potena, Luciano; Velleca, A.; Eisen, Howard J.; Bellumkonda, Lavanya; Danziger‐Isakov, Lara; Dobbels, Fabienne; Harkess, M.; Kim, Daniel H; Lyster, Haifa; Peled, Yael; Reinhardt, Zdenka

doi:10.1016/j.healun.2022.09.023

Cited by 19 publications

(30 citation statements)

References 833 publications

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“…In the 2022 International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients, PHM was deemed to be the optimal metric for donor and recipient size matching, based on multiple large registry studies, providing a new recommendation for its use (Grade IIa, Level of evidence C). 9 These guidelines caution against use of significantly undersized or oversized donor hearts.…”

Section: Discussionmentioning

confidence: 99%

Predicted Heart Mass: A Tale of 2 Ventricles

Ródenas-Alesina,

Foroutan,

Fan

et al. 2023

Circ: Heart Failure

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BACKGROUND: Total predicted heart mass (PHM) is the recommended metric to assess donor-recipient size matching in patients undergoing heart transplantation. Separately measuring right ventricular (RV) and left ventricular (LV) PHM may improve risk prediction of 1-year graft failure. METHODS: Adult heart transplant recipients from the UNOS database from 2000 to 2018 were included in the study. LV and RV PHM were modeled as restricted cubic splines. The association with 1-year graft failure was determined using adjusted Cox regression. The risk reclassification of using both LV and RV PHM versus total PHM was assessed using the net reclassification index. RESULTS: A total of 34 976 recipients were included. We observed a U -shaped association between total PHM and 1-year graft failure, such that risk increased for hearts undersized by >15% and those oversized by more than 27%. Graft failure incrementally increased when LV PHM was undersized by more than 5% and when RV was oversized by >5%. There was 1.5-fold greater risk of graft failure for an LV undersized by >26% or an RV oversized by more than 40%. Using LV and RV PHM risk-assessment separately led to a net reclassification index=8.5% ([95% CI, 5.3%–11.7%], nonevent net reclassification index=9.1%, event net reclassification index=−0.6%). CONCLUSIONS: The association between donor-recipient PHM match and the risk of graft failure after heart transplantation can be further understood as risk attributable to LV undersizing and RV oversizing. Assessing LV and RV PHM separately instead of total PHM could further refine the methods used to match donors and recipients for heart transplantation, minimize the risk of 1-year graft failure, and increase the use of donor organs.

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Section: Discussionmentioning

confidence: 99%

Predicted Heart Mass: A Tale of 2 Ventricles

Ródenas-Alesina,

Foroutan,

Fan

et al. 2023

Circ: Heart Failure

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“…In one study, patients who had an elevated PRA > 6%, the use of rituximab significantly decreased the risk of rejection. 6 It is frequently paired with the administration of intravenous immune globulin G (IVIG) to improve effectiveness in lowering antibody levels.…”

Section: Rituximabmentioning

confidence: 99%

“…In 2022 the International Society for Heart and Lung Transplantation (ISHLT) published updated guidelines for the care of HT recipients. 6 It is important to note that most programs utilize centerspecific protocols for post-HT management with nurses and pharmacists playing a crucial role in implementation and direct patient care.…”

Section: General Principlesmentioning

confidence: 99%

“…Daily allowance for calcium is 1000-1500 mg depending on age and menopausal status, while daily allowance for vitamin D is 400-1000 IU or as necessary to maintain serum 25-hydroxyvitamin D levels above 30 ng/mL. 6 Iron deficiency anemia is common after HT and often associated with chronic kidney disease (CKD). There is limited evidence for routine iron replacement post transplant.…”

Section: Vitamins and Mineralsmentioning

confidence: 99%

“…65 In addition to limiting CNI as appropriate, strategies to limit progression of CKD post transplant should follow guidelines identified for management of DM and hypertension for the general population. 6…”

Section: Optimization Of Cardiovascualar Risk Factorsmentioning

confidence: 99%

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Pharmacotherapy in the heart transplant recipient: A primer for nurse clinicians and pharmacists

Fraser,

Page,

Chow

et al. 2024

Clinical Transplantation

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Heart transplantation (HT) is the definitive treatment for eligible patients with end‐stage heart disease. A major complication of HT is allograft rejection which can lead to graft dysfunction and death. The guiding principle of chronic immunosuppression therapy is to prevent rejection of the transplanted organ while avoiding oversuppression of the immune system, which can cause opportunistic infections and malignancy. The purpose of this review is to describe immunosuppressive management of the HT recipient—including agent‐specific pharmacology and pharmacokinetics, outcomes data, adverse effects, clinical considerations, and recent guideline updates. We will also provide recommendations for medical prophylaxis of immunosuppressed patients based on the most recent clinical guidelines. Additionally, we highlight the importance of medical therapy adherence and the effect of social determinants of health on the long‐term management of HT. HT recipients are a complex and high‐risk population. The objective of this review is to describe basic pharmacotherapy in HT and implications for nurses and pharmacists.

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