Abstract Heart transplantation (HT) and durable left ventricular assist device (LVAD) support are established surgical treatment options for patients with end-stage systolic heart failure (HF) and/or nonrecoverable cardiogenic shock. HT..
Read MoreAbstract Normothermic regional perfusion (NRP) has emerged as one of the most consequential innovations in modern liver transplantation, particularly in the context of controlled donation after circulatory death (cDCD). Historically,..
Read MoreAbstract Background Lung transplantation represents the most definitive treatment option for patients with advanced-stage lung diseases. In recent years, improvements in anesthetic techniques, medical technologies, and coordinated perioperative care have..
Read MoreAbstract SINCE THE FIRST lung transplant in 1963 and the introduction of extracorporeal membrane oxygenation (ECMO) as a bridge to transplant (BTT) in 1977, both have advanced remarkably. Lung transplantation is now..
Read MoreAbstract Background Severe acute respiratory distress syndrome (ARDS) complicated by necrotizing pneumonia and septic shock carries a mortality exceeding 80%. Lung transplantation is rarely pursued because persistent sepsis, uncertainty regarding..
Read MoreAbstract The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no..
Read MoreAbstract Background Goal-directed perfusion (GDP) during cardiopulmonary bypass (CPB) commonly targets indexed oxygen delivery (DO2i), yet fixed delivery thresholds may ignore patient-specific metabolic demand. The oxygen extraction ratio (O2ER) integrates..
Read MoreAbstract Heart transplantation (HT) is the definitive therapy for end-stage heart failure. Patients unwilling to receive blood product transfusions are often considered ineligible for HT due to the significant perioperative..
Read MoreI. PRE-PROCUREMENT PREPARATION (DCD CONTEXT) 1. Donor Selection and Planning •Confirm controlled DCD donor (Maastricht Category III). •Review: •Warm ischemic time (WIT) thresholds •Functional warm ischemia (fWIT) •Hemodynamics prior..
Read MoreAlgorithmic Step-by-Step Technique for Combined Heart and Lung Procurement Technique of Dr. Sam Zeraatiannejaddavani, MD ⸻ I. Fundamental Principles Combined heart and lung procurement is a physiology-driven, time-sensitive operation..
Read MoreAbstract Background Heart transplantation remains the gold standard for the treatment of end-stage heart failure, but severe pulmonary hypertension (PH) poses a significant challenge due to the increased risk of..
Read MoreAbstract Mitral regurgitation (MR) in lung transplant (LTx) recipients is a rare but complex cardiopulmonary phenomenon. The overlap between symptoms of MR and post-LTx complications, such as primary graft dysfunction,..
Read MorePRO Cardioplegia, the intentional and temporary arrest of the heart during cardiac surgery, has been a cornerstone of modern heart transplantation, enabling myocardial protection during ischemic periods. Its use dates..
Read MoreAbstract Background (ECMO) may be used to support critically ill patients before . The relationship between preoperative venoarterial and venovenous ECMO and their relationship with indications remain poorly elucidated. Methods This study..
Read MoreEn-bloc Heart–Liver Procurement 1. Exposure and Preparation The procedure begins with a midline sternotomy extended into a midline laparotomy, allowing simultaneous access to both the thoracic and abdominal cavities. The..
Read MoreAbstract Objective To discuss technical strategies and considerations to facilitate intraoperative extracorporeal membrane oxygenation (ECMO) management during lung transplantation. Methods We review our institutional approach to the management of intraoperative..
Read MoreAbstract Cardiac allotransplantation is warranted in children with end-stage heart failure or irreparable congenital heart disease. A dearth of organs for transplantation has contributed to long wait-list times and resultant..
Read MoreAbstract Background Donation after circulatory death (DCD) heart transplants have increased in the United States with direct procurement with machine perfusion (DPP) and thoracoabdominal normothermic regional perfusion (TA-NRP) techniques. There..
Read MoreAbstract Background Normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) allow for transplantation with donation after circulatory death (DCD) hearts. This study aimed to characterize the use of..
Read MoreAbstract Background Survival for hypoplastic left heart syndrome (HLHS) and variants has improved over the past 4 decades; however, survival remains low compared with other forms of congenital heart disease...
Read MoreAbstract Poor or worsening functional status of lung transplant (LTx) candidates is a key risk factor for waitlist and post-transplant mortality. As more critically ill adults and children are listed..
Read MoreAbstract Organ preservation plays a critical role in addressing transplantation challenges, including donor shortages and ischemia-reperfusion injury (IRI). Continuous advancements in preservation technologies are essential to meet the increasing demand..
Read MoreAbstract Extracorporeal membrane oxygenation (ECMO) traditionally has been used under deep sedation and mechanical ventilation. However, recent advancements have led to the development of awake ECMO strategies, allowing patients to..
Read MoreAbstract Donation after circulatory death (DCD) is driving the increase in deceased organ donors in the United States. Normothermic regional perfusion (NRP) and ex situ machine perfusion (es-MP) have been..
Read MoreAbstract Venovenous extracorporeal membrane oxygenation is the most commonly used mode of support in pre-lung transplant recipients. In patients who experience right ventricular dysfunction, venopulmonary ECMO is an excellent option..
Read MoreAbstract OBJECTIVES Although lung transplantation has experienced great development in the past decades, the survival rate remains low, and lung ischaemia–reperfusion injury during transplantation is a major cause of primary..
Read MoreAbstract Objective To report differences between 2 anticoagulation protocols during venoarterial extracorporeal membrane oxygenation (VA-ECMO) intraoperative support and their effects on outcomes after lung transplantation. Methods We performed a retrospective..
Read MoreAbstract Cytokine storm (CS) is a severe systemic inflammatory syndrome characterized by the excessive activation of immune cells and a significant increase in circulating levels of cytokines. This pathological process..
Read MoreAbstract Background:Mechanical circulatory support, and specifically extra-corporeal membrane oxygenation, plays a critical role in managing paediatric cardiac patients with severe heart failure. Whilst these technologies are vital for bridging patients..
Read MoreIntroduction Superlatives and acronyms abound in this year’s edition of annual noteworthy literature for Seminars in Cardiothoracic and Vascular Anesthesia. By the numbers, over 22 000 publications from 2024 were screened, and approximately..
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