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Vanegas-Arroyave N, Caroff SN, Citrome L, Crasta J, McIntyre RS, Meyer JM, Patel A, Smith JM, Farahmand K, Manahan R, Lundt L, Cicero SA. An Evidence-Based Update on Anticholinergic Use for Drug-Induced Movement Disorders. CNS Drugs 2024; 38:239-254. [PMID: 38502289 PMCID: PMC10980662 DOI: 10.1007/s40263-024-01078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
Drug-induced movement disorders (DIMDs) are associated with use of dopamine receptor blocking agents (DRBAs), including antipsychotics. The most common forms are drug-induced parkinsonism (DIP), dystonia, akathisia, and tardive dyskinesia (TD). Although rare, neuroleptic malignant syndrome (NMS) is a potentially life-threatening consequence of DRBA exposure. Recommendations for anticholinergic use in patients with DIMDs were developed on the basis of a roundtable discussion with healthcare professionals with extensive expertise in DIMD management, along with a comprehensive literature review. The roundtable agreed that "extrapyramidal symptoms" is a non-specific term that encompasses a range of abnormal movements. As such, it contributes to a misconception that all DIMDs can be treated in the same way, potentially leading to the misuse and overprescribing of anticholinergics. DIMDs are neurobiologically and clinically distinct, with different treatment paradigms and varying levels of evidence for anticholinergic use. Whereas evidence indicates anticholinergics can be effective for DIP and dystonia, they are not recommended for TD, akathisia, or NMS; nor are they supported for preventing DIMDs except in individuals at high risk for acute dystonia. Anticholinergics may induce serious peripheral adverse effects (e.g., urinary retention) and central effects (e.g., impaired cognition), all of which can be highly concerning especially in older adults. Appropriate use of anticholinergics therefore requires careful consideration of the evidence for efficacy (e.g., supportive for DIP but not TD) and the risks for serious adverse events. If used, anticholinergic medications should be prescribed at the lowest effective dose and for limited periods of time. When discontinued, they should be tapered gradually.
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Affiliation(s)
- Nora Vanegas-Arroyave
- Department of Neurology, Baylor College of Medicine, 7200 Cambridge Street, Suite 9A, Houston, TX, 77030, USA.
| | - Stanley N Caroff
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Jonathan M Meyer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Amita Patel
- Dayton Psychiatric Associations, Dayton, OH, USA
- Joint Township District Memorial Hospital, St. Marys, OH, USA
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Hasan SA, Morsi M, Frakes BS, Bryson ME, Schmidt CW, Seshiah P, Choo J, Smith JM, Answini GA, Stewart-Dehner TL, Yasar SJ, Jollis JG, Berlacher MD, Ratajczak TM, Chung ES, Kereiakes DJ, Garcia S. Management strategies and prognosis of patients ineligible for transcatheter mitral valve replacement. Cardiovasc Revasc Med 2024:S1553-8389(24)00023-X. [PMID: 38355340 DOI: 10.1016/j.carrev.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/08/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Transcatheter mitral valve replacement (TMVR) faces anatomical challenges, currently limiting widespread adoption. OBJECTIVES To describe the natural history and prognosis of patients ineligible for various TMVR devices. METHODS During a 4-year period (2019-2023) 3 TMVR devices (SAPIEN M3, Intrepid and Alta Valve) became available at a single institution (The Christ Hospital, Cincinnati, OH) in the setting of pivotal clinical trials or early feasibility study. Consenting patients who were deemed ineligible ≥1 of these trials were prospectively studied to capture anatomical reasons for ineligibility, cross-over to alternative mitral valve therapies (surgery or high-risk mitral transcatheter edge to edge repair [M-TEER]), and clinical events. RESULTS A total of 61 patients (out of 71 consenting patients or 85.9 %) were deemed ineligible for TMVR during the study period. The mean age was 79.2 ± 8.8 years, 65.6 % were female, with elevated surgical risk (median STS 4.3, IQR: 2.7-7.3). The 2 most common anatomical reasons for ineligibility were increased risk of left ventricular outflow tract obstruction (LVOTO) (n = 24, 39.3 %) and annular size (n = 29, 47.5 %). During follow-up (median 277 [162-555] days) there were 7 deaths (11.5 %) and 12 (19.7 %) hospitalizations for heart failure. Management strategies included high-risk M-TEER in 11 patients (1 death [9.0 %], 0 HF hospitalizations [0 %]), surgery in 9 patients (0 deaths, 1 HF hospitalizations [11.1 %]), and medical management in 41 patients (6 deaths [14.6 %], 11 HF hospitalizations [26.8 %]) (p = 0.715 for mortality and p = 0.093 for HF hospitalizations). Residual MR ≥ moderate was 0 %, 50 %, and 100 % for surgery, M-TEER and medical treatment, respectively (p < 0.001). CONCLUSIONS One third of patients deemed ineligible for TMVR are candidates for high-risk M-TEER or surgery with acceptable morbidity and mortality. Our results have practical implications for patient management.
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Affiliation(s)
- Syeda A Hasan
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Moustafa Morsi
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Belinda S Frakes
- Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Marien E Bryson
- Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Christian W Schmidt
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Puvi Seshiah
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Joseph Choo
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - J Michael Smith
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Geoffrey A Answini
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Terri L Stewart-Dehner
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Senan J Yasar
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - James G Jollis
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Mark D Berlacher
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Teresa M Ratajczak
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Eugene S Chung
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Dean J Kereiakes
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America
| | - Santiago Garcia
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, OH, United States of America.
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3
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Krijgh DD, Smith JM, Tilney G, Lyu H, Traweek RS, Witt RG, Roubaud MJ, Correa AM, Roland CL, Mericli AF. Identifying risk factors and analyzing reconstructive outcomes in patients with lower-extremity soft-tissue sarcoma. J Plast Reconstr Aesthet Surg 2024; 89:174-185. [PMID: 38199219 DOI: 10.1016/j.bjps.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Reconstructing defects after resecting soft-tissue sarcoma (STS) can be challenging. The aim of this retrospective study was to analyze the reconstructive outcomes and identify the potential risk factors in patients undergoing reconstruction after excision of lower-extremity STS. METHODS Patients with lower-extremity STS were included. This database was compiled of patients from a single, large National Cancer Institute-accredited academic hospital. In total, 302 patients were included between January 2016 to January 2022. Univariate and multivariate analyses were performed to calculate odds ratios (ORs) for developing complications for each patient and surgical characteristic. RESULTS The following factors were independent predictors of any complication: benign pulmonary disease (OR = 4.2; p = 0.02), preoperative radiotherapy (RT; OR = 2.5; p = 0.047), a tumor in the medial thigh (OR = 1.9; p = 0.03), body mass index (BMI) > 30 kg/m2 (OR = 1.05; p = 0.037), and full-thickness skin graft (OR = 5.4; p = 0.01). In the preoperative RT subgroup, reconstructing a defect via undermining and layered closure alone was an independent predictor of dehiscence (OR = 2.1; p = 0.02) and seroma (OR = 3.1; p = 0.02), whereas pedicled flaps (OR = 0.08; p = 0.001) and free flaps (OR = 0.05; p = 0.001) were independent protectors against any complication. CONCLUSION Information derived from this analysis will assist with accurate preoperative patient counseling, which is crucial for informed decision-making and expectation management in lower-extremity STS. BMI and pulmonary function should be optimized to the extent possible to reduce postoperative complications. Patients treated preoperatively with RT should be reconstructed with a pedicled or free flap to optimize recovery.
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Affiliation(s)
- David D Krijgh
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Michael Smith
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gordon Tilney
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Heather Lyu
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Raymond S Traweek
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Russell G Witt
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Margaret J Roubaud
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Arlene M Correa
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Christina L Roland
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alexander F Mericli
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Kupferschmid JP, Turek JW, Hughes GC, Austin EH, Alsoufi B, Smith JM, Scholl FG, Rankin JS, Badhwar V, Chen JM, Nuri MA, Romano JC, Ohye RG, Si MS. Early Outcomes of Patients Undergoing Neoaortic Valve Repair Incorporating Geometric Ring Annuloplasty. World J Pediatr Congenit Heart Surg 2022; 13:304-309. [PMID: 35446224 DOI: 10.1177/21501351221079523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES During congenital heart surgery, the pulmonary valve and root may be placed into the systemic position, yielding a "neoaortic" valve. With the stress of systemic pressure, the pulmonary roots can dilate, creating aneurysms and/or neoaortic insufficiency (neoAI). This report analyzes the early outcomes of patients undergoing neoaortic valve repair incorporating geometric ring annuloplasty. METHODS Twenty-one patients underwent intended repair at six centers and formed the study cohort. Thirteen had previous Ross procedures, five had arterial switch operations, and three Fontan physiology. Average age was 21.7 ± 12.8 years (mean ± SD), 80% were male, and 11 (55%) had symptomatic heart failure. Preoperative neoAI Grade was 3.1 ± 1.1, and annular diameter was 30.7 ± 6.5 mm. RESULTS Valve repair was accomplished in 20/21, using geometric annuloplasty rings and leaflet plication (n = 13) and/or nodular release (n = 7). Fourteen had neoaortic aneurysm replacement (13 with root remodeling). Two underwent bicuspid valve repair. Six had pulmonary conduit changes, one insertion of an artificial Nodulus Arantius, and one resection of a subaortic membrane. Ring size averaged 21.9 ± 2.3 mm, and aortic clamp time was 171 ± 54 minutes. No operative mortality or major morbidity occurred, and postoperative hospitalization was 4.3 ± 1.4 days. At discharge, neoAI grade was 0.2 ± 0.4 (P < .0001), and valve mean gradient was ≤20 mm Hg. At average 18.0 ± 9.1 months of follow-up, all patients were asymptomatic with stable valve function. CONCLUSIONS Neoaortic aneurysms and neoAI are occasionally seen late following Ross, arterial switch, or Fontan procedures. Neoaortic valve repair using geometric ring annuloplasty, leaflet reconstruction, and root remodeling provides a patient-specific approach with favorable early outcomes.
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Affiliation(s)
| | | | - G Chad Hughes
- 22957Duke University Medical Center, Durham, NC, USA
| | | | | | | | - Frank G Scholl
- Joe Dimaggio 24931Children's Hospital, Hollywood, FL, USA
| | | | | | - Jonathan M Chen
- 24931Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Muhammad A Nuri
- 24931Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Kwong AJ, Ebel NH, Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Foutz J, Gauntt K, Cafarella M, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2020 Annual Data Report: Liver. Am J Transplant 2022; 22 Suppl 2:204-309. [PMID: 35266621 DOI: 10.1111/ajt.16978] [Citation(s) in RCA: 186] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This year was marked by the COVID-19 pandemic, which altered transplant program activity and affected waitlist and transplant outcomes. Still, 8906 liver transplants were performed, an all-time high, across 142 centers in the United States, and pretransplant as well as graft and patient survival metrics, continued to improve. Living donation activity decreased after several years of growth. As of June 30, 2020, 98989 liver transplant recipients were alive with a functioning graft, and in the context of increasing liver transplant volume, the size of both the adult and pediatric liver transplant waitlists have decreased. On February 4, 2020, shortly before the pandemic began, a new liver distribution policy based on acuity circles was implemented, replacing donor service area- and region-based boundaries. A policy change to direct pediatric livers to pediatric recipients led to an increase in deceased donor transplant rates and a decrease in pretransplant mortality rate among children, although the absolute number of pediatric transplants did not increase in 2020. Among adults, alcohol-associated liver disease became the predominant indication for liver transplant in 2020. After implementation of the National Liver Review Board and lower waitlist priority for most exception cases in 2019, fewer liver transplants were being performed via exception points, and the transplant rate between those with and without hepatocellular carcinoma has equalized. Women continue to experience higher pretransplant mortality and lower rates of liver transplant than men.
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Affiliation(s)
- A J Kwong
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
| | - N H Ebel
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, CA
| | - W R Kim
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J R Lake
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - D P Schladt
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - K Gauntt
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - M Cafarella
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, Minneapolis, MN
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6
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Valapour M, Lehr CJ, Skeans MA, Smith JM, Miller E, Goff R, Mupfudze T, Gauntt K, Snyder JJ. OPTN/SRTR 2020 Annual Data Report: Lung. Am J Transplant 2022; 22 Suppl 2:438-518. [PMID: 35266615 DOI: 10.1111/ajt.16991] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
For the first time in a decade, both the number of candidates added to the waiting list and the number of lung transplants performed decreased from the year prior; the number of lung donors also declined. This slowing of transplant activities in 2020 was associated with a modest increase in waitlist mortality. The year 2020 was notable for the global outbreak of the COVID-19 pandemic, which undoubtedly influenced all trends noted in lung transplantation. Time to transplant continued to decrease, with a median time to transplant of 1.4 months across all waitlist candidates. Posttransplant survival remained stable, with 89.4% of transplant recipients surviving to 1 year, 74.8% to 3 years, and 61.2% to 5 years.
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Affiliation(s)
- M Valapour
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - C J Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - E Miller
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - R Goff
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - T Mupfudze
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - K Gauntt
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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Lentine KL, Smith JM, Hart A, Miller J, Skeans MA, Larkin L, Robinson A, Gauntt K, Israni AK, Hirose R, Snyder JJ. OPTN/SRTR 2020 Annual Data Report: Kidney. Am J Transplant 2022; 22 Suppl 2:21-136. [PMID: 35266618 DOI: 10.1111/ajt.16982] [Citation(s) in RCA: 162] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The year 2020 presented significant challenges to the field of kidney transplantation. After increasing each year since 2015 and reaching the highest annual count to date in 2019, the total number of kidney trans- plants decreased slightly, to 23642, in 2020. The decrease in total kidney transplants was due to a decrease in living donor transplants; the number of deceased donor transplants rose in 2020. The number of patients waiting for a kidney transplant in the United States declined slightly in 2020, driven by a slight drop in the number of new candidates added in 2020 and an increase in patients removed from the waiting list owing to death-important patterns that correlated with the COVID-19 pandemic. The complexities of the pandemic were accompanied by other ongoing challenges. Nationwide, only about a quarter of waitlisted patients receive a deceased donor kidney transplant within 5 years, a proportion that varies dramatically by donation service area, from 14.8% to 73.0%. The nonutilization (discard) rate of recovered organs rose to its highest value, at 21.3%, despite a dramatic decline in the discard of organs from hepatitis C-positive donors. Nonutilization rates remain particularly high for Kidney Donor Profile Index ≥85% kidneys and kidneys from which a biopsy specimen was obtained. Due to pandemic-related disruption of living donation in spring 2020, the number of living donor transplants in 2020 declined below annual counts over the last decade. In this context, only a small proportion of the waiting list receives living donor transplants each year, and racial disparities in living donor transplant access persist. As both graft and patient survival continue to improve incrementally, the total number of living kidney transplant recipients with a functioning graft exceeded 250,000 in 2020. Pediatric transplant numbers seem to have been impacted by the COVID-19 pandemic. The total number of pediatric kidney transplants performed decreased to 715 in 2020, from a peak of 872 in 2009. Despite numerous efforts, living donor kidney transplant remains low among pediatric recipients, with continued racial disparities among recipients. Of concern, the rate of deceased donor transplant among pediatric waitlisted candidates continued to decrease, reaching its lowest point in 2020. While this may be partly explained by the COVID-19 pandemic, close attention to this trend is critically important. Congenital anomalies of the kidney and urinary tract remain the leading cause of kidney disease in the pediatric population. While most pediatric de- ceased donor recipients receive a kidney from a donor with KDPI less than 35%, most pediatric deceased donor recipients had four or more HLA mis- matches. Graft survival continues to improve, with superior survival for living donor recipients versus deceased donor recipients.
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Affiliation(s)
- K L Lentine
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - A Hart
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, Minneapolis, MN
| | - J Miller
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - L Larkin
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - K Gauntt
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - R Hirose
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Surgery, University of California San Francisco, San Fran- cisco, CA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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8
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Colvin M, Smith JM, Ahn Y, Skeans MA, Messick E, Bradbrook K, Gauntt K, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2020 Annual Data Report: Heart. Am J Transplant 2022; 22 Suppl 2:350-437. [PMID: 35266620 DOI: 10.1111/ajt.16977] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
As we enter the third year of the new adult heart allocation policy, we are faced with the new challenges of the COVID-19 pandemic. In 2020, new listings (adult and pediatric) decreased slightly, with 4000 new listings in 2020, compared with 4087 in 2019; however, the number of adult heart transplants performed continued to increase, to 3715 in 2020. The number of pediatric heart transplants declined from 509 in 2019 to 465 in 2020. One-year and six-month posttransplant mortality rates in adult recipients have increased slightly since 2015 but have not significantly changed over the past decade. Overall, posttransplant mortality rates for adult recipients were 7.4% at six months and 9.4% at one year for transplants in 2019, 14.0% at three years for transplants in 2017, and 19.1% at five years for transplants in 2015. Although shorter-term posttransplant mortality rates have slightly increased, there has been a steady downward trend in longer-term mortality. Mortality rates for pediatric recipients were 5.7% at six months and 8.1% at one year for transplants in 2019, 11.6% at three years for transplants in 2017, and 15.2% at five years for transplants in 2015.
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Affiliation(s)
- M Colvin
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Cardiology, University of Michigan, Ann Arbor, MI
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - Y Ahn
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - E Messick
- Organ Procurement and Transplantation Network, United Network for Organ Sharing
| | - K Bradbrook
- Organ Procurement and Transplantation Network, United Network for Organ Sharing
| | - K Gauntt
- Organ Procurement and Transplantation Network, United Network for Organ Sharing
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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Abstract
Despite small increases in additions to the intestine transplant wait- list, total waitlist numbers, overall intestine transplant rates, and overall transplants performed from 2019 to 2020, the trend over the last decade is still toward less intestine transplant activity. Waitlist mortality continues to fall for pediatric populations and is relatively stable for adults. While 1- year graft survival continues to improve, there has been no noticeable improvement in 3- and 5-year graft survival. Immunosuppression practices continue to favor use of an induction agent followed by tacrolimus-based regimens. Patient survival at 5 years is currently identical for isolated intestines and liver-inclusive allograft recipients.
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Affiliation(s)
- S P Horslen
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Resear- ch Institute, Minneapolis, MN.,Department of Pediatrics, UPMC Children's hospital of Pittsburgh, Pitts- burgh PA
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Resear- ch Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - T Weaver
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Resear- ch Institute, Minneapolis, MN
| | - M Cafarella
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
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10
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Guiltinan C, Candelaria JI, Rabaglino MB, Smith JM, Denicol AC. 160 Derivation and evaluation of bovine embryonic stem cells from early and full blastocyst-stage embryos. Reprod Fertil Dev 2021; 34:318. [PMID: 35231369 DOI: 10.1071/rdv34n2ab160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- C Guiltinan
- Department of Animal Science, University of California, Davis, Davis, CA, USA
| | - J I Candelaria
- Department of Animal Science, University of California, Davis, Davis, CA, USA
| | - M B Rabaglino
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland
| | - J M Smith
- Department of Animal Science, University of California, Davis, Davis, CA, USA
| | - A C Denicol
- Department of Animal Science, University of California, Davis, Davis, CA, USA
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11
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Peters KJH, Geng Z, Malmir K, Smith JM, Rodriguez SRK. Extremely Broadband Stochastic Resonance of Light and Enhanced Energy Harvesting Enabled by Memory Effects in the Nonlinear Response. Phys Rev Lett 2021; 126:213901. [PMID: 34114877 DOI: 10.1103/physrevlett.126.213901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
We report the first observation of non-Markovian stochastic resonance (SR), and we discover that memory effects in the nonlinearity extremely enlarge the SR bandwidth. Our experimental system is an oil-filled microcavity which, driven by a continuous wave laser, has memory in its nonlinear optical response. Modulating the cavity length while adding noise to the driving laser, we observe a peak in the transmitted signal-to-noise ratio as a function of the noise variance. Through simulations, we reproduce our observations and extrapolate that the SR bandwidth could be ∼3000 times larger in our cavity than in a Kerr-nonlinear cavity. Experiments evidencing this memory-enhanced bandwidth across two decades are presented. As an extension of our results, we numerically demonstrate an order-of-magnitude enhancement in energy harvesting thanks to a nonlinearity with memory.
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Affiliation(s)
- K J H Peters
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - Z Geng
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - K Malmir
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - J M Smith
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - S R K Rodriguez
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
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12
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Kwong AJ, Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Noreen SM, Foutz J, Booker SE, Cafarella M, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2019 Annual Data Report: Liver. Am J Transplant 2021; 21 Suppl 2:208-315. [PMID: 33595192 DOI: 10.1111/ajt.16494] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This year was notable for changes to exception points determined by the geographic median allocation Model for End-Stage Liver Disease (MELD) and implementation of the National Liver Review Board, which took place on May 14, 2019. The national acuity circle liver distribution policy was also implemented but reverted to donor service area- and region-based boundaries after 1 week. In 2019, growth continued in the number of new waiting list registrations (12,767) and transplants performed (8,896), including living-donor transplants (524). Compared with 2018, living-donor liver transplants increased 31%. Women continued to have a lower deceased-donor transplant rate and a higher pretransplant mortality rate than men. The median waiting time for candidates with a MELD of 15-34 decreased, while the number of transplants performed for patients with exception points decreased. These changes may have been related to the policy changes that took effect in May 2019, which increased waiting list priority for candidates without exception status. Hepatitis C continued to decline as an indication for liver transplant, as the proportion of liver transplant recipients with alcohol-related liver disease and clinical profiles consistent with non-alcoholic steatohepatitis increased. Graft and patient survival have improved despite changing recipient demographics including older age, higher MELD, and higher prevalence of obesity and diabetes.
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Affiliation(s)
- A J Kwong
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
| | - W R Kim
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J R Lake
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - D P Schladt
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S M Noreen
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - S E Booker
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - M Cafarella
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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13
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Smith JM, Cancienne JM, Brockmeier SF, Werner BC. Vitamin D deficiency and total shoulder arthroplasty complications. Shoulder Elbow 2021; 13:99-105. [PMID: 33717223 PMCID: PMC7905506 DOI: 10.1177/1758573220906520] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/12/2019] [Accepted: 01/24/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The primary objective of this study was to examine the relationship between vitamin D deficiency and implant-related and medical complications following total shoulder arthroplasty. METHODS Using the PearlDiver database, patients who underwent total shoulder arthroplasty from 2005 to 2016 with vitamin D deficiency were identified. These were compared to a 3:1 control group matched by age, sex, and presence of a concomitant osteoporosis diagnosis. Primary outcome measures were implant-related complications (loosening, periprosthetic fracture, periprosthetic joint infection, and revision total shoulder arthroplasty) in addition to medical complications within 90 days of surgery. A multivariable logistic regression analysis was utilized to control for patient demographics and comorbidities. RESULTS One thousand and six hundred and seventy-four patients with vitamin D deficiency were identified and compared to 5022 controls. There was a significantly higher rate of revision total shoulder arthroplasty in the vitamin D deficient patients compared to controls (2.3% versus 0.8%, odds ratio 3.3, p < 0.0001). After controlling for confounding variables, there were no significant differences in any of the remaining implant-related or medical complications with the exception of higher rates of urinary tract infections in patients with vitamin D deficiency. CONCLUSIONS Vitamin D deficiency is associated with a higher rate of all-cause revision total shoulder arthroplasty but not medical complications compared to controls.Level of evidence: Level III case control study.
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Affiliation(s)
- J Michael Smith
- Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, USA
| | | | - Stephen F Brockmeier
- Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, USA
| | - Brian C Werner
- Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, USA,Brian C Werner, Department of Orthopaedic Surgery, University of Virginia Health System, PO Box 800159, Charlottesville, VA, USA.
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14
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Valapour M, Lehr CJ, Skeans MA, Smith JM, Miller E, Goff R, Foutz J, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2019 Annual Data Report: Lung. Am J Transplant 2021; 21 Suppl 2:441-520. [PMID: 33595190 DOI: 10.1111/ajt.16495] [Citation(s) in RCA: 107] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The number of lung transplants performed continues to increase annually and reached an all-time high in 2019, with decreasing waitlist mortality. These trends are attributable to an increasing number of candidates listed for transplant each year and a continuing increase in the number of donors. Despite these favorable trends, 6.4% of lungs recovered for transplant were not transplanted in 2019, and strategies to optimize use of these available organs may reduce the number of waitlist even further. Time to transplant continued to decrease, as over 50% of candidates waited 3 months or less in 2019, yet regional heterogeneity remained despite policy changes intended to improve allocation equity. Small gains continued in posttransplant survival, with 1-year survival at 88.8%; 3 year, 74.4%; 5 year, 59.2%, and 10 year, 33.1 %.
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Affiliation(s)
- M Valapour
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - C J Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - E Miller
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - R Goff
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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15
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Colvin M, Smith JM, Ahn Y, Skeans MA, Messick E, Goff R, Bradbrook K, Foutz J, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2019 Annual Data Report: Heart. Am J Transplant 2021; 21 Suppl 2:356-440. [PMID: 33595196 DOI: 10.1111/ajt.16492] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The new adult heart allocation policy was approved in 2016 and implemented in October 2018. This year's Annual Data Report provides early insight into the effects of this policy. In 2019, new listings continued to increase, with 4086 new candidates. Also in 2019, 3597 heart transplants were performed, an increase of 157 (4.6%) from 2018; 509 transplants occurred in children and 3088 in adults. Short- and long-term posttransplant mortality rates improved. Overall, Mortality rates for adult recipients were 6.4% at 6 months and 7.9% at 1 year for transplants in 2018, 14.4% at 3 years for transplants in 2016, and 20.1% at 5 years for transplants in 2014. Mortality rates for pediatric recipients were 6.3% at 6 months and 8.2% at 1 year for transplants in 2018, 10.3% at 3 years for transplants in 2016, and 17.8% at 5 years for transplants in 2014.
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Affiliation(s)
- M Colvin
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Cardiology, University of Michigan, Ann Arbor, Ml
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - Y Ahn
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - E Messick
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - R Goff
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - K Bradbrook
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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16
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Horslen SP, Smith JM, Ahn Y, Skeans MA, Cafarella M, Noreen SM, Snyder JJ, Israni AK. OPTN/SRTR 2019 Annual Data Report: Intestine. Am J Transplant 2021; 21 Suppl 2:316-355. [PMID: 33595193 DOI: 10.1111/ajt.16498] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Intestine transplant can be life-saving and can improve quality of life for patients with intestinal failure. Medical and surgical advances in treatment of intestinal failure over the past 10 to 15 years have resulted in fewer patients being added to the waiting list for intestine transplant alone or for intestine transplant in combination with liver transplant (and sometimes other organs). Consequently, fewer transplants are being performed. The numbers of listings and transplants fell to new lows in 2019. The number of programs performing transplants in at least one patient in 2019 was the lowest in the last decade, equal to 2014, at 15. Graft failure plateaued over the past decade, but early graft loss has increased in the past 2 years, notably in recipients of a combined liver and intestine allograft. Five-year patient survival for transplants in 2012-2014 varied little by graft type.
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Affiliation(s)
- S P Horslen
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Liver and Intestine Transplantation Program, Seattle Children's Hospital, Seattle, WA
| | - J M Smith
- Liver and Intestine Transplantation Program, Seattle Children's Hospital, Seattle, WA
| | - Y Ahn
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M Cafarella
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - S M Noreen
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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17
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Hart A, Lentine KL, Smith JM, Miller JM, Skeans MA, Prentice M, Robinson A, Foutz J, Booker SE, Israni AK, Hirose R, Snyder JJ. OPTN/SRTR 2019 Annual Data Report: Kidney. Am J Transplant 2021; 21 Suppl 2:21-137. [PMID: 33595191 DOI: 10.1111/ajt.16502] [Citation(s) in RCA: 238] [Impact Index Per Article: 79.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite the ongoing severe shortage of available kidney grafts relative to candidates in need, data from 2019 reveal some promising trends. After remaining relatively stagnant for many years, the number of kidney transplants has increased each year since 2015, reaching the highest annual count to date of 24,273 in 2019. The number of patients waiting for a kidney transplant in the United States was relatively stable, despite an increase in the number of new candidates added in 2019 and a decrease in patients removed from the waiting list owing to death or deteriorating medical condition. However, these encouraging trends are tempered by ongoing challenges. Nationwide, only a quarter of waitlisted patients receive a deceased-donor kidney transplant within 5 years, and this proportion varies dramatically by donation service area, from 15.5% to 67.8%. The non-utilization (discard) rate of recovered organs remains at 20.1%, despite adramatic decline in the discard of organs from hepatitis C-positive donors. Non-utilization rates remain particularly high for Kidney Donor Profile Index ≥85% kidneys and kidneys from which a biopsy specimen was obtained. While the number of living-donor transplants increased again in 2019, only a small proportion of the waiting list receives living-donor transplants each year, and racial disparities in living-donor transplant access persist. As both graft and patient survival continue to improve incrementally, the total number of living kidney transplant recipients with a functioning graft is anticipated to exceed 250,000 in the next 1-2 years. Over the past decade, the total number of pediatric kidney transplants performed has remained stable. Despite numerous efforts, living donor kidney transplant remains low among pediatric recipients with continued racial disparities among recipients. Congenital anomalies of the kidney and urinary tract remain the leading cause of kidney disease. While most deceased donor recipients receive a kidney from a donor with KDPI less than 35%, the majority of pediatric recipients had four or more HLA mismatches. Graft survival continues to improve with superior outcomes for living donor recipients.
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Affiliation(s)
- A Hart
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - K L Lentine
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - J M Miller
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M Prentice
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - S E Booker
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - R Hirose
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department Surgery, University of California San Francisco, San Francisco, CA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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18
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Molina-Burbano F, Smith JM, Ingargiola MJ, Motakef S, Sanati P, Lu J, Taub PJ, Hill ME. Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms. Aesthet Surg J 2021; 41:1-12. [PMID: 31907534 DOI: 10.1093/asj/sjaa002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, significant procedural variation exists between providers. OBJECTIVES The primary purpose of this systematic review was to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. METHODS A systematic review of the Cochrane Library and MEDLINE databases as completed was undertaken to identify all clinical reports of fat grafting combined with facelift surgery based on the following key terms: ("fat grafting" OR "lipotransfer" OR "lipofilling" OR "fat transfer") AND ("facelift" OR "rhytidectomy" OR "SMASectomy" OR "facial rejuvenation"). Data on techniques, outcomes, complications, and patient satisfaction were collected. RESULTS The systematic review was performed in April 2017. In total, 248 articles were identified for review. After application of exclusion criteria, 15 primary studies were included in this review. Various facelift techniques were reported, including deep-plane or sub-superficial musculoaponeurotic system (SMAS) facelift, SMAS facelift, modified minimal access cranial suspension lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvements in facial volume and aesthetic assessments. CONCLUSIONS Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Felipe Molina-Burbano
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Michael Smith
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Texas Medical Branch, Galveston, TX
| | - Michael J Ingargiola
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Saba Motakef
- Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA
| | - Paymon Sanati
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jocelyn Lu
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael E Hill
- Department of Plastic and Reconstructive Surgery, Loma Linda University, Loma Linda, CA
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19
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Broyles JM, Smith JM, Schaverien M. Response to comment on "the effect of sarcopenia on perioperative complications in abdominally based free-flap breast reconstruction. J Surg Oncol 2020; 122:1829. [PMID: 32959383 DOI: 10.1002/jso.26231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Justin M Broyles
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - J Michael Smith
- Division of Plastic Surgery, University of Texas Medial Branch, Galveston, Texas, USA
| | - Mark Schaverien
- Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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20
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Boukovalas S, Goepfert RP, Smith JM, Mecham E, Liu J, Zafereo ME, Chang EI, Hessel AC, Hanasono MM, Gross ND, Yu P, Lewin JS, Lewis CM, Diaz EM, Weber RS, Myers JN, Offodile AC. Association between postoperative complications and long-term oncologic outcomes following total laryngectomy: 10-year experience at MD Anderson Cancer Center. Cancer 2020; 126:4905-4916. [PMID: 32931057 DOI: 10.1002/cncr.33185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Postoperative complications are an independent predictor of poor survival across several tumors. However, there is limited literature on the association between postoperative morbidity and long-term survival following total laryngectomy (TL) for cancer. METHODS We conducted a retrospective review of all TL patients at a single institution from 2008 to 2013. Demographic and clinical data were collected and analyzed, including postsurgical outcomes, which were classified using the Clavien-Dindo system. Multivariable Cox regression analyses were performed to identify factors associated with overall survival (OS) and disease-free survival (DFS). RESULTS A total of 362 patients were identified. The mean age was 64 years, and the majority of patients were male (81%). The median follow-up interval was 21 months. Fifty-seven percent of patients had received preoperative radiation, and 40% had received preoperative chemotherapy. Fifty-seven percent of patients underwent salvage TL, and 60% underwent advanced reconstruction (45% free flap and 15% pedicled flap). A total of 136 patients (37.6%) developed postoperative complications, 92 (25.4%) of which were major. Multivariable modeling demonstrated that postoperative complications independently predicted shorter OS (hazard ratio [HR], 1.50; 95% CI, 1.16-1.96; P = .002) and DFS (HR, 1.36; 95% CI, 1.05-1.76; P = .021). Other independent negative predictors of OS and DFS included positive lymph node status, preoperative chemotherapy, comorbidity grade, and delayed adjuvant therapy. Severity of complication and reason for TL (salvage vs primary) were not shown to be predictive of OS or DFS. CONCLUSION Postoperative complications are associated with worse long-term OS and DFS relative to uncomplicated cases. Patient optimization and timely management of postoperative complications may play a critical role in long-term survival.
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Affiliation(s)
- Stefanos Boukovalas
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - J Michael Smith
- Division of Plastic Surgery, The University of Texas Medical Branch, Galveston, Texas
| | | | - Jun Liu
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark E Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Edward I Chang
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amy C Hessel
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matthew M Hanasono
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Peirong Yu
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jan S Lewin
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carol M Lewis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eduardo M Diaz
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anaeze C Offodile
- Department of Plastic and Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
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21
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Shreenivas S, Choo J, Answini G, Sarembock IJ, Griffin J, Smith JM, Kereiakes D. TAVR During the COVID-19 Pandemic: The ACC/SCAI Consensus Statement. JACC Cardiovasc Interv 2020; 13:1605-1606. [PMID: 32646703 PMCID: PMC7196374 DOI: 10.1016/j.jcin.2020.04.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/02/2022]
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22
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Geng Z, Peters KJH, Trichet AAP, Malmir K, Kolkowski R, Smith JM, Rodriguez SRK. Universal Scaling in the Dynamic Hysteresis, and Non-Markovian Dynamics, of a Tunable Optical Cavity. Phys Rev Lett 2020; 124:153603. [PMID: 32357047 DOI: 10.1103/physrevlett.124.153603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
We investigate, experimentally and theoretically, the dynamics of a laser-driven cavity with noninstantaneous effective photon-photon interactions. Scanning the laser-cavity frequency detuning at different speeds across an optical bistability, we find a hysteresis area that is a nonmonotonic function of the speed. In the limit of fast scans comparable to the memory time of the interactions, we demonstrate that the hysteresis area decays following a universal power law with scaling exponent -1. We further demonstrate a regime of non-Markovian dynamics emerging from white noise. This regime is evidenced by peaked distributions of residence times in the metastable states of our system. Our results offer new perspectives for exploring the physics of scaling, universality, and metastability, in non-Markovian regimes using arrays of bistable optical cavities with low quality factors, driven by low laser powers, and at room temperature.
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Affiliation(s)
- Z Geng
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - K J H Peters
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - A A P Trichet
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - K Malmir
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - R Kolkowski
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
| | - J M Smith
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, United Kingdom
| | - S R K Rodriguez
- Center for Nanophotonics, AMOLF, Science Park 104, 1098 XG Amsterdam, Netherlands
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23
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Valapour M, Lehr CJ, Skeans MA, Smith JM, Uccellini K, Goff R, Foutz J, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2018 Annual Data Report: Lung. Am J Transplant 2020; 20 Suppl s1:427-508. [PMID: 31898416 DOI: 10.1111/ajt.15677] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The primary goal of US lung allocation policy is to ensure that candidates with the highest risk for mortality receive appropriate access to lung transplant. In 2018, 2562 lung transplants were performed in the US, reflecting a 31% increase over the past 5 years. More candidates are being listed for lung transplant, and the number of donors has increased substantially. Despite an increase of 84 lung transplants in 2018, 365 adult candidates died or became too sick to undergo transplant. In 2018, 24 new child (ages 0-11 years) candidates were added to the lung transplant waiting list. Fifteen lung transplants were performed in recipients aged 0-11 years, three in recipients aged younger than 1 year, two in recipients aged 1-5 years, and ten in recipients aged 6-11 years. Of 27 child candidates removed from the waiting list in 2018, 16 (59.3%) were removed due to undergoing transplant, six (22.2%) due to death, one (3.7%) due to improved condition, and one (3.7%) due to becoming too sick to undergo transplant.
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Affiliation(s)
- M Valapour
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - C J Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - K Uccellini
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - R Goff
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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24
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Colvin M, Smith JM, Hadley N, Skeans MA, Uccellini K, Goff R, Foutz J, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2018 Annual Data Report: Heart. Am J Transplant 2020; 20 Suppl s1:340-426. [PMID: 31898418 DOI: 10.1111/ajt.15676] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The new adult heart allocation policy was approved in 2016 and implemented in October 2018, so its effect was not yet evident in 2018 data. However, the more granular data being collected are anticipated to allow for improved analyses. In 2018, new listings continued to increase; 3883 new adult and 685 new pediatric candidates were added. In 2018, 3440 heart transplants were performed, an increase of 167 over 2017; 473 transplants occurred in pediatric recipients and 2967 in adult recipients. Short-term and long-term posttransplant mortality improved. Overall 1-year survival for adults who underwent heart transplant in 2011-2013 was 90.3%, 3-year survival was 84.7%, and 5-year survival was 79.6%. Mortality rates for pediatric recipients were 4.5% at 6 months and in 5.9% at 1 year posttransplant, 12.5% at 3 years for transplants in 2014-2015, 14.8% at 5 years for transplants in 2012-2013, and 29.8% at 10 years for transplants performed in 2008-2009.
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Affiliation(s)
- M Colvin
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Cardiology, University of Michigan, Ann Arbor, MI
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - N Hadley
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - K Uccellini
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - R Goff
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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25
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Smith JM, Weaver T, Skeans MA, Horslen SP, Miller E, Noreen SM, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2018 Annual Data Report: Intestine. Am J Transplant 2020; 20 Suppl s1:300-339. [PMID: 31898410 DOI: 10.1111/ajt.15675] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite medical and surgical advances in treatment of intestinal failure, intestine transplant still plays an important role. However, the number of new patients added to the intestine transplant waiting list has decreased over the past decade, reaching a low of 135 in 2018. The number of intestine donors also decreased, reaching a low of 106 in 2018, and the number of intestine transplants performed declined to its lowest level, 104, of which 59% were intestine-liver transplants. Graft failure has plateaued over the past decade. Patient survival for transplants in 2011-2013 varied by age and transplant type. Patient survival was lowest for adult intestine-liver recipients (1-and 5-year survival 66.7% and 49.1%, respectively) and highest for pediatric intestine recipients (1-and 5-year survival 89.1% and 76.4%, respectively).
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Affiliation(s)
- J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - T Weaver
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S P Horslen
- Liver and Intestine Transplantation Program, Seattle Children's Hospital, Seattle, WA
| | - E Miller
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - S M Noreen
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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26
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Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Castro S, Foutz J, Wainright JL, Snyder JJ, Kasiske BL, Israni AK. OPTN/SRTR 2018 Annual Data Report: Kidney. Am J Transplant 2020; 20 Suppl s1:20-130. [PMID: 31898417 DOI: 10.1111/ajt.15672] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite the ongoing severe mismatch between organ need and supply, data from 2018 revealed some promising trends. For the fourth year in a row, the number of patients waiting for a kidney transplant in the US declined and numbers of both deceased and living donor kidney transplants increased. These encouraging trends are tempered by ongoing challenges, such as a large proportion of listed patients with dialysis time longer than 5 years. The proportion of candidates aged 65 years or older continued to rise, and the proportion undergoing transplant within 5 years of listing continued to vary dramatically nationwide, from 10% to nearly 80% across donation service areas. Increasing trends in the recovery of organs from hepatitis C positive donors and donors with anoxic brain injury warrant ongoing monitoring, as does the ongoing discard of nearly 20% of recovered organs. While the number of living donor transplants increased, racial disparities persisted in the proportion of living versus deceased donors. Strikingly, the total number of kidney transplant recipients alive with a functioning graft is on track to pass 250,000 in the next 1-2 years. The total number of pediatric kidney transplants remained steady at 756 in 2018. Deeply concerning to the pediatric community is the persistently low level of living donor kidney transplants, representing only 36.2% in 2018.
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Affiliation(s)
- A Hart
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S K Gustafson
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - A R Wilk
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - S Castro
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J L Wainright
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - A K Israni
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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27
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Kwong A, Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Noreen SM, Foutz J, Miller E, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2018 Annual Data Report: Liver. Am J Transplant 2020; 20 Suppl s1:193-299. [PMID: 31898413 DOI: 10.1111/ajt.15674] [Citation(s) in RCA: 288] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Data on adult liver transplants performed in the US in 2018 are notable for (1) continued growth in numbers of new waitlist registrants (11,844) and transplants performed (8250); (2) continued increase in the transplant rate (54.5 per 100 waitlist-years); (3) a precipitous decline in waitlist registrations and transplants for hepatitis-C-related indications; (4) increases in waitlist registrants and recipients with alcoholic liver disease and with clinical profiles consistent with non-alcoholic fatty liver disease; (5) increased use of hepatitis C virus antibody-positive donor livers; and (6) continued improvement in graft survival despite changing recipient characteristics such as older age and higher rates of obesity and diabetes. Variability in transplant rates remained by candidate race, hepatocellular carcinoma status, urgency status, and geography. The volume of pediatric liver transplants was relatively unchanged. The highest rate of pre-transplant mortality persisted for children aged younger than 1 year. Children underwent transplant at higher acuity than in the past, as evidenced by higher model for end-stage liver disease/pediatric end-stage liver disease scores and listings at status 1A and 1B at transplant. Despite higher illness severity scores at transplant, pediatric graft and patient survival posttransplant have improved over time.
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Affiliation(s)
- A Kwong
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
| | - W R Kim
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J R Lake
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.,Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN
| | - J M Smith
- Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA.,Department of Pediatrics, University of Washington, Seattle, WA
| | - D P Schladt
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S M Noreen
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J Foutz
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - E Miller
- Organ Procurement and Transplantation Network, United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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28
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Lissauer D, Cheshire J, Dunlop C, Taki F, Wilson A, Smith JM, Daniels R, Kissoon N, Malata A, Chirwa T, Lwesha VM, Mhango C, Mhango E, Makwenda C, Banda L, Munthali L, Nambiar B, Hussein J, Williams HM, Devall AJ, Gallos I, Merriel A, Bonet M, Souza JP, Coomarasamy A. Development of the FAST-M maternal sepsis bundle for use in low-resource settings: a modified Delphi process. BJOG 2019; 127:416-423. [PMID: 31677228 PMCID: PMC7384197 DOI: 10.1111/1471-0528.16005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2019] [Indexed: 01/14/2023]
Abstract
Objective To develop a sepsis care bundle for the initial management of maternal sepsis in low resource settings. Design Modified Delphi process. Setting Participants from 34 countries. Population Healthcare practitioners working in low resource settings (n = 143; 34 countries), members of an expert panel (n = 11) and consultation with the World Health Organization Global Maternal and Neonatal Sepsis Initiative technical working group. Methods We reviewed the literature to identify all potential interventions and practices around the initial management of sepsis that could be bundled together. A modified Delphi process, using an online questionnaire and in‐person meetings, was then undertaken to gain consensus on bundle items. Participants ranked potential bundle items in terms of perceived importance and feasibility, considering their use in both hospitals and health centres. Findings from the healthcare practitioners were then triangulated with those of the experts. Main outcome measure Consensus on bundle items. Results Consensus was reached after three consultation rounds, with the same items deemed most important and feasible by both the healthcare practitioners and expert panel. Final bundle items selected were: (1) Fluids, (2) Antibiotics, (3) Source identification and control, (4) Transfer (to appropriate higher‐level care) and (5) Monitoring (of both mother and neonate as appropriate). The bundle was given the acronym ‘FAST‐M’. Conclusion A clinically relevant maternal sepsis bundle for low resource settings has been developed by international consensus. Tweetable abstract A maternal sepsis bundle for low resource settings has been developed by international consensus. A maternal sepsis bundle for low resource settings has been developed by international consensus.
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Affiliation(s)
- D Lissauer
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi
| | - J Cheshire
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK
| | - C Dunlop
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK
| | - F Taki
- The Hillingdon Hospitals NHS Foundation Trust, London, UK
| | - A Wilson
- World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK.,Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - J M Smith
- The Bill & Melinda Gates Foundation's Maternal, Newborn & Child Health Team, Seattle, WA, USA
| | - R Daniels
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - N Kissoon
- Department of Pediatrics and Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Malata
- Malawi University of Science and Technology, Limbe, Malawi
| | - T Chirwa
- Chitipa District Hospital, Chitipa, Malawi
| | - V M Lwesha
- Save the Children Norway, Lilongwe, Malawi
| | - C Mhango
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - E Mhango
- Chitipa District Hospital, Chitipa, Malawi
| | - C Makwenda
- Parent and Child Health Initiative (PACHI) Trust, Lilongwe, Malawi
| | - L Banda
- Parent and Child Health Initiative (PACHI) Trust, Lilongwe, Malawi
| | - L Munthali
- Parent and Child Health Initiative (PACHI) Trust, Lilongwe, Malawi
| | - B Nambiar
- Institute for Global Child Health, University College London, London, UK
| | - J Hussein
- Independent Maternal Health Consultant, Aberdeen, UK
| | - H M Williams
- World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK.,Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - A J Devall
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK
| | - I Gallos
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK
| | - A Merriel
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - M Bonet
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - J P Souza
- Department of Social Medicine, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - A Coomarasamy
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.,World Health Organization Collaborating Centre for Global Women's Health Research, University of Birmingham, Birmingham, UK
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Søndergaard L, Popma JJ, Reardon MJ, Van Mieghem NM, Deeb GM, Kodali S, George I, Williams MR, Yakubov SJ, Kappetein AP, Serruys PW, Grube E, Schiltgen MB, Chang Y, Engstrøm T, Sorajja P, Sun B, Agarwal H, Langdon T, den Heijer P, Bentala M, O’Hair D, Bajwa T, Byrne T, Caskey M, Paulus B, Garrett E, Stoler R, Hebeler R, Khabbaz K, Scott Lim D, Bladergroen M, Fail P, Feinberg E, Rinaldi M, Skipper E, Chawla A, Hockmuth D, Makkar R, Cheng W, Aji J, Bowen F, Schreiber T, Henry S, Hengstenberg C, Bleiziffer S, Harrison JK, Hughes C, Joye J, Gaudiani V, Babaliaros V, Thourani V, Dauerman H, Schmoker J, Skelding K, Casale A, Kovac J, Spyt T, Seshiah P, Smith JM, McKay R, Hagberg R, Matthews R, Starnes V, O’Neill W, Paone G, García JMH, Such M, de la Tassa CM, Cortina JCL, Windecker S, Carrel T, Whisenant B, Doty J, Resar J, Conte J, Aharonian V, Pfeffer T, Rück A, Corbascio M, Blackman D, Kaul P, Kliger C, Brinster D, Teefy P, Kiaii B, Leya F, Bakhos M, Sandhu G, Pochettino A, Piazza N, de Varennes B, van Boven A, Boonstra P, Waksman R, Bafi A, Asgar A, Cartier R, Kipperman R, Brown J, Lin L, Rovin J, Sharma S, Adams D, Katz S, Hartman A, Al-Jilaihawi H, Crestanello J, Lilly S, Ghani M, Bodenhamer RM, Rajagopal V, Kauten J, Mumtaz M, Bachinsky W, Nickenig G, Welz A, Olsen P, Watson D, Chhatriwalla A, Allen K, Teirstein P, Tyner J, Mahoney P, Newton J, Merhi W, Keiser J, Yeung A, Miller C, Berg JT, Heijmen R, Petrossian G, Robinson N, Brecker S, Jahangiri M, Davis T, Batra S, Hermiller J, Heimansohn D, Radhakrishnan S, Fremes S, Maini B, Bethea B, Brown D, Ryan W, Kleiman N, Spies C, Lau J, Herrmann H, Bavaria J, Horlick E, Feindel C, Neumann FJ, Beyersdorf F, Binder R, Maisano F, Costa M, Markowitz A, Tadros P, Zorn G, de Marchena E, Salerno T, Chetcuti S, Labinz M, Ruel M, Lee JS, Gleason T, Ling F, Knight P, Robbins M, Ball S, Giacomini J, Burdon T, Applegate R, Kon N, Schwartz R, Schubach S, Forrest J, Mangi A. Comparison of a Complete Percutaneous Versus Surgical Approach to Aortic Valve Replacement and Revascularization in Patients at Intermediate Surgical Risk: Results From the Randomized SURTAVI Trial. Circulation 2019; 140:1296-1305. [PMID: 31476897 DOI: 10.1161/circulationaha.118.039564] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND For patients with severe aortic stenosis and coronary artery disease, the completely percutaneous approach to aortic valve replacement and revascularization has not been compared with the standard surgical approach. METHODS The prospective SURTAVI trial (Safety and Efficiency Study of the Medtronic CoreValve System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement) enrolled intermediate-risk patients with severe aortic stenosis from 87 centers in the United States, Canada, and Europe between June 2012 and June 2016. Complex coronary artery disease with SYNTAX score (Synergy Between PCI with Taxus and Cardiac Surgery Trial) >22 was an exclusion criterion. Patients were stratified according to the need for revascularization and then randomly assigned to treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Patients assigned to revascularization in the TAVR group underwent percutaneous coronary intervention, whereas those in the SAVR group had coronary artery bypass grafting. The primary end point was the rate of all-cause mortality or disabling stroke at 2 years. RESULTS Of 1660 subjects with attempted aortic valve implants, 332 (20%) were assigned to revascularization. They had a higher Society of Thoracic Surgeons risk score for mortality (4.8±1.7% versus 4.4±1.5%; P<0.01) and were more likely to be male (65.1% versus 54.2%; P<0.01) than the 1328 patients not assigned to revascularization. After randomization to treatment, there were 169 patients undergoing TAVR and percutaneous coronary intervention, 163 patients undergoing SAVR and coronary artery bypass grafting, 695 patients undergoing TAVR, and 633 patients undergoing SAVR. No significant difference in the rate of the primary end point was found between TAVR and percutaneous coronary intervention and SAVR and coronary artery bypass grafting (16.0%; 95% CI, 11.1-22.9 versus 14.0%; 95% CI, 9.2-21.1; P=0.62), or between TAVR and SAVR (11.9%; 95% CI, 9.5-14.7 versus 12.3%; 95% CI, 9.8-15.4; P=0.76). CONCLUSIONS For patients at intermediate surgical risk with severe aortic stenosis and noncomplex coronary artery disease (SYNTAX score ≤22), a complete percutaneous approach of TAVR and percutaneous coronary intervention is a reasonable alternative to SAVR and coronary artery bypass grafting. CLINICAL TRIAL REGISTRATION URL: https://www. CLINICALTRIALS gov. Unique identifier: NCT01586910.
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Affiliation(s)
- Lars Søndergaard
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark (L.S., T.E.)
| | - Jeffrey J. Popma
- Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA (J.J.P.)
| | - Michael J. Reardon
- Department of Cardiovascular Surgery, Methodist DeBakey Heart and Vascular Center, Houston, TX (M.J.R.)
| | - Nicolas M. Van Mieghem
- Departments of Cardiology and Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands (N.M.V.M., A.P.K.)
| | - G. Michael Deeb
- Department of Cardiac Surgery, University of Michigan, Ann Arbor (G.M.D.)
| | - Susheel Kodali
- Department of Surgery, Columbia University Medical Center, New York (S.K., I.G.)
| | - Isaac George
- Department of Surgery, Columbia University Medical Center, New York (S.K., I.G.)
| | - Mathew R. Williams
- Departments of Medicine (Cardiology) and Cardiothoracic Surgery, NYU-Langone Medical Center, New York (M.R.W.)
| | - Steven J. Yakubov
- Department of Cardiology, OhioHealth Riverside Methodist Hospital, Columbus (S.J.Y.)
| | - Arie P. Kappetein
- Departments of Cardiology and Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands (N.M.V.M., A.P.K.)
- Structural Heart, Medtronic plc, Minneapolis, MN (A.P.K., M.B.S., Y.C.)
| | - Patrick W. Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Eberhard Grube
- Department of Medicine II, Heart Center Bonn, Germany (E.G.)
| | | | - Yanping Chang
- Structural Heart, Medtronic plc, Minneapolis, MN (A.P.K., M.B.S., Y.C.)
| | - Thomas Engstrøm
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark (L.S., T.E.)
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Caselli C, Rocchiccioli S, Rosendael A, Buechel R, Teresinska A, Pizzi MN, Smith JM, Poddighe R, Campolo J, Vozzi F, Knuuti J, Pelosi G, Parodi O, Scholte A, Neglia D. P6167Low leptin plasma levels are associated with progression of coronary atherosclerosis in patients with stable coronary artery disease from the SMARTool Study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Leptin is an adipokine involved in energy homeostasis and has been related with established vascular risk factors. However, studies on the association of leptin plasma levels with coronary artery disease (CAD) have yielded conflicting results.
Purpose
Aim of the present study was to evaluate the association between leptin plasma levels and presence, severity and progression of coronary atherosclerosis in patients with suspected stable CAD.
Methods
In a cohort of 257 patients with symptoms of stable CAD enrolled in the SMARTool study, coronary computed tomography angiography (CTA), plasma leptin levels and clinical and bio-humoral CAD risk profile (including glucose, lipid and inflammation variables) were obtained at enrolment and after 6±1yrs of follow-up. Sixty-four patients were revascularized and the remaining 193 represent the population for the present study. CTA findings were categorised as no-minimal CAD (<30% stenosis), non-obstructive CAD (30%-50% stenosis) and obstructive CAD (≥50% stenosis in at least one major coronary vessel). A CTA risk score (based on plaque extent, severity, composition, and location) was calculated at baseline and at follow-up to assess coronary atherosclerotic burden and its progression (Δ CTA score≥5).
Results
CTA findings showed obstructive CAD in 11% of patients at baseline and in 15% at follow-up (p<0.0001). CTA risk score, was 8.03±7.80 at baseline and increased to 10.33±8.17 at follow-up (p<0.0001) with CAD progression in 20% of patients. Leptin plasma levels were inversely related with CTA findings both at baseline and follow-up (Figure). In a Cox model, baseline plasma leptin was an independent predictor of CAD progression, after adjustment for clinical risk factors, biomarkers, and treatment (HR 0.572, 95% CI 0.393–0.834, P=0.0037).
Figure 1
Conclusion
Plasma leptin is inversely associated with coronary atherosclerotic burden and disease progression in patients with stable CAD. This association is independent of known factors affecting leptin levels. These results could prompt further investigations on the pathophysiological mechanisms of this association.
Acknowledgement/Funding
EU H2020 research and innovation program under grant agreement No 689068
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - A Rosendael
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Buechel
- University of Zurich, Zurich, Switzerland
| | | | - M N Pizzi
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J M Smith
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Poddighe
- Versilia Hospital, Lido Di Camaiore, Italy
| | - J Campolo
- CNR Institute of Clinical Physiology, Milan, Italy
| | - F Vozzi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - J Knuuti
- University of Turku, Turku, Finland
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - A Scholte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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31
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Gomez-Stallons MV, Tretter JT, Hassel K, Gonzalez-Ramos O, Amofa D, Ollberding NJ, Mazur W, Choo JK, Smith JM, Kereiakes DJ, Yutzey KE. Calcification and extracellular matrix dysregulation in human postmortem and surgical aortic valves. Heart 2019; 105:1616-1621. [PMID: 31171628 DOI: 10.1136/heartjnl-2019-314879] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Calcific aortic valve disease (CAVD) is a progressive disease ranging from aortic valve (AoV) sclerosis to AoV stenosis (AS), characterised by severe calcification with impaired leaflet function. Due to the lack of early symptoms, the pathological progression towards valve dysfunction is poorly understood. The early patterns of AoV calcification and altered extracellular matrix (ECM) organisation were analysed in individuals postmortem without clinical AS compared with clinical AS. METHODS Histological patterns of calcification and ECM organisation in postmortem AoV leaflets without clinical AS obtained from a tissue repository and surgical specimens obtained from individuals with clinical AS were compared with in vivo imaging prior to transcatheter AoV implantation. RESULTS AoV calcification was detected in all samples from individuals >50 years old, with severity increasing with age, independent of known CAVD risk factors. Two distinct types of calcification were identified: 'Intrinsic', primarily found at the leaflet hinge of postmortem leaflets, accompanied by abnormal collagen and proteoglycan deposition; and 'Nodular', extending from the middle to the tip regions in more severely affected postmortem leaflets and surgical specimens, associated with increased elastin fragmentation and loss of elastin integrity. Even in the absence of increased thickening, abnormalities in ECM composition were observed in postmortem leaflets without clinical AS and worsen in clinical AS. CONCLUSIONS Two distinct phenotypes of AoV calcification are apparent. While the 'nodular' form is recognised on in vivo imaging and is present with CAVD and valve dysfunction, it is unclear if the 'intrinsic' form is pathological or detected on in vivo imaging.
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Affiliation(s)
- M Victoria Gomez-Stallons
- Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Justin T Tretter
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Keira Hassel
- Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Osniel Gonzalez-Ramos
- Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Dorothy Amofa
- Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Nicholas J Ollberding
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Wojciech Mazur
- The Ohio Heart and Vascular Center, The Christ Hospital, Cincinnati, Ohio, USA
| | - Joseph K Choo
- The Ohio Heart and Vascular Center, The Christ Hospital, Cincinnati, Ohio, USA
| | | | - Dean J Kereiakes
- The Ohio Heart and Vascular Center, The Christ Hospital, Cincinnati, Ohio, USA
| | - Katherine E Yutzey
- Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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32
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Colvin M, Smith JM, Hadley N, Skeans MA, Uccellini K, Lehman R, Robinson AM, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2017 Annual Data Report: Heart. Am J Transplant 2019; 19 Suppl 2:323-403. [PMID: 30811894 DOI: 10.1111/ajt.15278] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In 2017, 3273 heart transplants were performed in the United States. New listings continued to increase, and 3769 new adults were listed for heart transplant in 2017. Over the past decade, posttransplant mortality has declined. The number of new pediatric listings increased over the past decade, as did the number of pediatric heart transplants, although some fluctuation has occurred more recently. New listings for pediatric heart transplants increased from 481 in 2007 to 623 in 2017. The number of pediatric heart transplants performed each year increased from 330 in 2007 to 432 in 2017, slightly fewer than in 2016. Short-term and long-term mortality improved. Among pediatric patients who underwent transplant between 2015-2016, 4.8% had died by 6 months and 6.2% by 1 year.
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Affiliation(s)
- M Colvin
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Cardiology, University of Michigan, Ann Arbor, MI
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - N Hadley
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - K Uccellini
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - R Lehman
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A M Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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33
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Valapour M, Lehr CJ, Skeans MA, Smith JM, Uccellini K, Lehman R, Robinson A, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2017 Annual Data Report: Lung. Am J Transplant 2019; 19 Suppl 2:404-484. [PMID: 30811892 DOI: 10.1111/ajt.15279] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Each year since 2012, the number of lung transplants has increased, reflecting an increase in the number of donors, improved use of recovered organs, and more candidates being listed for transplant. However, the need for organs continues to outpace available donors. Despite an increase of 126 donors in 2017, 1360 candidates remained on the waiting list at the end of the year, and 326 patients died or became too sick to undergo transplant. Approximately 14,000 individuals were living with a lung transplant in 2017; 9492 were aged 50 years or older, 4075 were aged 18-49 years, and 408 were aged younger than 18 years.
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Affiliation(s)
- M Valapour
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - C J Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - K Uccellini
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - R Lehman
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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34
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Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Noreen SM, Robinson AM, Miller E, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2017 Annual Data Report: Liver. Am J Transplant 2019; 19 Suppl 2:184-283. [PMID: 30811890 DOI: 10.1111/ajt.15276] [Citation(s) in RCA: 220] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Data on adult liver transplants performed in the US in 2017 are notable for (1) continued growth in numbers of new waitlist registrants (11,514) and of transplants performed (8,082); (2) continued increase in the transplant rate (51.5 per 100 waitlist-years); (3) a precipitous decrease in waitlist registrations and transplants for hepatitis C-related indications; (4) reciprocal increases in waitlist registrants and recipients with alcoholic liver disease and with clinical profiles consistent with non-alcoholic fatty liver disease; and (5) continued improvement in graft survival despite changing recipient characteristics such as older age and higher rates of obesity. Variability in transplant rates remained by candidate race, presence of hepatocellular carcinoma, urgency status (status 1A versus model for end-stage liver disease (MELD) score >35), and geography. More than half of all children listed for liver transplant in 2017 were aged younger than 5 years in 2017, and the highest rate of pretransplant mortality persisted for children aged younger than 1 year. Children underwent transplant at higher acuity than the past, as evidenced by higher MELD/pediatric end-stage liver disease scores and listings at status 1A and 1B. Higher acuity at transplant is likely due to lack of access to suitable donor organs, which has been compensated for by persistent trends toward use of partial or split liver grafts and ABO-incompatible grafts. Despite higher illness severity scores at transplant, pediatric graft and patient survival posttransplant have improved over time.
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Affiliation(s)
- W R Kim
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
| | - J R Lake
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - D P Schladt
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S M Noreen
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A M Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - E Miller
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Castro S, Robinson A, Wainright JL, Snyder JJ, Kasiske BL, Israni AK. OPTN/SRTR 2017 Annual Data Report: Kidney. Am J Transplant 2019; 19 Suppl 2:19-123. [PMID: 30811893 DOI: 10.1111/ajt.15274] [Citation(s) in RCA: 246] [Impact Index Per Article: 49.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Many positive trends in kidney transplantation were notable in 2017. Deceased donor kidney transplant rates and counts continued to rise, the kidney transplant waiting list declined for the third year in a row after decades of growth, and both short- and long-term allograft survival continued to improve year over year. In total, more than 220,000 patients were living in the United States with a functioning allograft. With 3 years of data available since implementation of the new kidney allocation system, better prediction of longer-term results of the allocation policy changes became possible. The data also reveal several areas in need of improvement and attention. Overall, the challenge of providing adequate access to kidney transplant persisted nationally, with additional dramatic regional variation. The proportion of living donor kidney transplants in both adults and children continued to fall, and racial disparities in living donor kidney transplant grew in the past decade.
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Affiliation(s)
- A Hart
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S K Gustafson
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - A R Wilk
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - S Castro
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J L Wainright
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - A K Israni
- Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN.,Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
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36
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Smith JM, Weaver T, Skeans MA, Horslen SP, Noreen SM, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2017 Annual Data Report: Intestine. Am J Transplant 2019; 19 Suppl 2:284-322. [PMID: 30811888 DOI: 10.1111/ajt.15277] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite improvements in medical and surgical treatment of intestinal failure, intestine transplant continues to play an important role. In 2017, 109 intestine transplants were performed, 62 in adults and 47 in children, reflecting the changed age distribution over the past decade of candidates waitlisted for intestine and intestine-liver transplant from largely pediatric to increasing proportions of adults. In 2017, 56.0% of candidates on the intestine list at any time during the year were aged younger than 18 years, with a decrease over time in those aged younger than 6 years and an increase in those aged 6-17 years. Adults accounted for 44.0% of candidates on the list at any time during the year, with an increase since 2013 in those aged 18-34 years and a decrease in those aged 35 years or older. By age, the pretransplant mortality rate was highest for adult candidates at 7.9 per 100 waitlist-years and lowest for pediatric candidates at 3.7 per 100 waitlist-years. Patient survival varied by age and type of transplant, and was lowest for adult intestine-liver recipients (1- and 5-year survival 66.7% and 42.6%, respectively) and highest for pediatric intestine recipients (1- and 5-year survival 86.2% and 75.4%, respectively).
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Affiliation(s)
- J M Smith
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - T Weaver
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN
| | - S P Horslen
- Liver and Intestine Transplantation Program, Seattle Children's Hospital, Seattle, WA
| | - S M Noreen
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN.,Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN
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Smith JM, Sanders R, Kosoko-Lasaki O, Stone JR. Training Community Health Ambassadors to Administer SOPARC. J Health Sci Educ 2019; 3:1-7. [PMID: 37538301 PMCID: PMC10398416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Preparing lay Community Health Ambassadors (CHA) to assess, document and monitor physical activity using standardized instruments can be daunting. Administering some instruments needs specialized training. System for Observing Play and Recreation in Communities (SOPARC) is a standardized instrument requiring extensive training. The question guiding this project was: Can lay Community Health Ambassadors (CHA) be trained to administer SOPARC at Racial and Ethnic Approaches to Community Health (REACH) physical activity fitness sites? This manuscript presents the process undertaken to train Community Health Ambassadors (CHAs) and some preliminary results. Preliminary results are that fifty-six (56) Community Health Ambassadors (CHAs) representing four (4) community partner groups were certified in the SOPARC training. These CHAs successfully documented pre/post data for 20 different physical activity sites. Additionally, the results support the premise that Community Health Ambassadors are a viable liaison in community health delivery.
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Affiliation(s)
- JM Smith
- Corresponding author: Jeffrey M. Smith, Counselor Education Program, Room 412 Eppley Building, Creighton University, Omaha, NE 68178, USA; Tel: 402.280.2413, Fax: 402.2801117,
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Murphy D, Smith JM, Siwek L, Langford DA, Robinson JR, Reynolds B, Seshadri-Kreaden U, Engel AM. Multicenter Mitral Valve Study: A Lateral Approach Using the da Vinci Surgical System. Innovations 2018. [DOI: 10.1177/155698450700200202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - J. Michael Smith
- Department of Surgery, Good Samaritan Hospital, Cincinnati, OH
- Cardiac, Vascular, and Thoracic Surgeons, Inc, Cincinnati, OH
| | | | | | - John R. Robinson
- Department of Surgery, Good Samaritan Hospital, Cincinnati, OH
- Cardiac, Vascular, and Thoracic Surgeons, Inc, Cincinnati, OH
| | | | | | - Amy M. Engel
- E. Kenneth Hatton, MD, Institute for Research and Education, Cincinnati, OH
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Dufferwiel S, Lyons TP, Solnyshkov DD, Trichet AAP, Catanzaro A, Withers F, Malpuech G, Smith JM, Novoselov KS, Skolnick MS, Krizhanovskii DN, Tartakovskii AI. Valley coherent exciton-polaritons in a monolayer semiconductor. Nat Commun 2018; 9:4797. [PMID: 30442886 PMCID: PMC6237922 DOI: 10.1038/s41467-018-07249-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/19/2018] [Indexed: 11/11/2022] Open
Abstract
Two-dimensional transition metal dichalcogenides (TMDs) provide a unique possibility to generate and read-out excitonic valley coherence using linearly polarized light, opening the way to valley information transfer between distant systems. However, these excitons have short lifetimes (ps) and efficiently lose their valley coherence via the electron-hole exchange interaction. Here, we show that control of these processes can be gained by embedding a monolayer of WSe2 in an optical microcavity, forming part-light-part-matter exciton-polaritons. We demonstrate optical initialization of valley coherent polariton populations, exhibiting luminescence with a linear polarization degree up to 3 times higher than displayed by bare excitons. We utilize an external magnetic field alongside selective exciton-cavity-mode detuning to control the polariton valley pseudospin vector rotation, which reaches 45° at B = 8 T. This work provides unique insight into the decoherence mechanisms in TMDs and demonstrates the potential for engineering the valley pseudospin dynamics in monolayer semiconductors embedded in photonic structures. The short exciton life time in atomically thin transition metal dichalcogenides poses limitations to efficient control of the valley pseudospin and coherence. Here, the authors manipulate the exciton coherence in a WSe2 monolayer embedded in an optical microcavity in the strong light-matter coupling regime.
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Affiliation(s)
- S Dufferwiel
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK.
| | - T P Lyons
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK.
| | - D D Solnyshkov
- Institut Pascal, PHOTON-N2, Université Clermont Auvergne, CNRS, SIGMA Clermont, F-63000, Clermont-Ferrand, France
| | - A A P Trichet
- Department of Materials, University of Oxford, Parks Road, Oxford, OX1 3PH, UK
| | - A Catanzaro
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK
| | - F Withers
- Centre for Graphene Science, CEMPS, University of Exeter, Exeter, EX4 4QF, UK
| | - G Malpuech
- Institut Pascal, PHOTON-N2, Université Clermont Auvergne, CNRS, SIGMA Clermont, F-63000, Clermont-Ferrand, France
| | - J M Smith
- Department of Materials, University of Oxford, Parks Road, Oxford, OX1 3PH, UK
| | - K S Novoselov
- School of Physics and Astronomy, University of Manchester, Manchester, M13 9PL, UK
| | - M S Skolnick
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK
| | - D N Krizhanovskii
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK
| | - A I Tartakovskii
- Department of Physics and Astronomy, University of Sheffield, Sheffield, S3 7RH, UK.
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Smith JM, Broyles JM, Guo Y, Tuffaha SH, Mathes D, Sacks JM. Human acellular dermis increases surgical site infection and overall complication profile when compared with submuscular breast reconstruction: An updated meta-analysis incorporating new products✰. J Plast Reconstr Aesthet Surg 2018; 71:1547-1556. [DOI: 10.1016/j.bjps.2018.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 05/31/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022]
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Meher S, Cuthbert A, Kirkham JJ, Williamson P, Abalos E, Aflaifel N, Bhutta ZA, Bishop A, Blum J, Collins P, Devane D, Ducloy‐Bouthors A, Fawole B, Gülmezoglu AM, Gutteridge K, Gyte G, Homer CSE, Mallaiah S, Smith JM, Weeks AD, Alfirevic Z. Core outcome sets for prevention and treatment of postpartum haemorrhage: an international Delphi consensus study. BJOG 2018; 126:83-93. [DOI: 10.1111/1471-0528.15335] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2018] [Indexed: 11/26/2022]
Affiliation(s)
- S Meher
- Department of Women's and Children's Health University of Liverpool Liverpool UK
- Birmingham Women's and Children's NHS Foundation Trust Birmingham UK
| | - A Cuthbert
- Department of Women's and Children's Health University of Liverpool Liverpool UK
| | - JJ Kirkham
- Department of Biostatistics University of Liverpool Liverpool UK
| | - P Williamson
- Department of Biostatistics University of Liverpool Liverpool UK
| | - E Abalos
- Centro Rosarino de Estudios Perinatales (CREP) Rosario Argentina
| | - N Aflaifel
- Department of Women's and Children's Health University of Liverpool Liverpool UK
| | - ZA Bhutta
- Division of Women and Child Health Aga Khan University Karachi Pakistan
- The Hospital for Sick Children Toronto Canada
| | - A Bishop
- Cochrane Pregnancy and Childbirth Group University of Liverpool Liverpool UK
| | - J Blum
- Gynuity Health Projects New York NY USA
| | - P Collins
- Institute of Infection and Immunity School of Medicine Cardiff University Cardiff UK
| | - D Devane
- HRB‐Trials Methodology Research Network School of Nursing and Midwifery National University of Ireland Galway Galway Ireland
| | | | - B Fawole
- Department of Obstetrics and Gynaecology College of Medicine University of Ibadan Ibadan Nigeria
| | - AM Gülmezoglu
- The UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) World Health Organization Geneva Switzerland
| | - K Gutteridge
- Sandwell and West Birmingham Hospitals NHS Trust Birmingham UK
| | - G Gyte
- Cochrane Pregnancy and Childbirth Group University of Liverpool Liverpool UK
| | - CSE Homer
- Centre for Midwifery, Child and Family Health University of Technology Sydney Sydney NSW Australia
| | | | - JM Smith
- Jhpiego/Johns Hopkins University Baltimore MD USA
| | - AD Weeks
- Department of Women's and Children's Health University of Liverpool Liverpool UK
| | - Z Alfirevic
- Department of Women's and Children's Health University of Liverpool Liverpool UK
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Hundeshagen G, Jay JW, Prasai A, Foncerrada G, Smith JM, Nguyen AV, Cambiaso-Daniel J, Herndon DN, Enkhbaatar P, Branski LK, Finnerty CC. 35 First in Vitro and in Vivo Experiences with a New Synthetic Dermal Substitute with Dual Microporous Structure. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- G Hundeshagen
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - J W Jay
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - A Prasai
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - G Foncerrada
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - J M Smith
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - A V Nguyen
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - J Cambiaso-Daniel
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - D N Herndon
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - P Enkhbaatar
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - L K Branski
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
| | - C C Finnerty
- University of Texas Medical Branch, Galveston, TX; Shrines Hospitals for Children Galveston, Galveston, TX
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Dolan PR, Adekanye S, Trichet AAP, Johnson S, Flatten LC, Chen YC, Weng L, Hunger D, Chang HC, Castelletto S, Smith JM. Robust, tunable, and high purity triggered single photon source at room temperature using a nitrogen-vacancy defect in diamond in an open microcavity. Opt Express 2018; 26:7056-7065. [PMID: 29609391 DOI: 10.1364/oe.26.007056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/04/2018] [Indexed: 05/23/2023]
Abstract
We report progress in the development of tunable room temperature triggered single photon sources based on single nitrogen-vacancy (NV) centres in nanodiamond coupled to open access optical micro-cavities. The feeding of fluorescence from an NV centre into the cavity mode increases the spectral density of the emission and results in an output stream of triggered single photons with spectral line width of order 1 nm, tunable in the range 640 - 700 nm. We record single photon purities exceeding 96% and estimated device efficiencies up to 3%. We compare performance using plano-concave microcavities with radii of curvature from 25 μm to 4 μm and show that up to 17% of the total emission is fed into the TEM00 mode. Pulsed Hanbury-Brown Twiss (HBT) interferometry shows that an improvement in single photon purity is facilitated due to the increased spectral density.
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Bayani J, Crozier C, Quintayo MA, Amemiya Y, Zhang X, Larivière M, Sadis S, Smith JM, Hasenburg A, Kieback D, Markopoulos C, Dirix L, Yaffe M, Seth A, Feilotter H, Rea D, Bartlett JMS. Abstract P2-09-17: Evaluation of the oncomine comprehensive assay for the identification of actionable mutations for therapeutic stratification from the TEAM pathology cohort. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Large-scale sequencing initiatives have revealed a wealth of common and novel variants as well as copy-number aberrations, across different malignancies. This growing list of variants/aberrations can sometimes be matched to specific therapeutics. Such “actionable mutations/changes” hold promise for personalized treatment in the future, with treatments tailored to molecular abnormalities. Presently, women with hormone positive early breast cancer continue to experience improved survival on adjuvant anti-hormone therapy, but a significant number of women continue to progress. Therefore, there is a need to identify those women for whom current therapies are insufficient and to identify alternative therapeutic interventions. We explored the used of genetic profiling using a comprehensive solid tumor next generation sequencing (NGS) assay (the Oncomine Comprehensive Assay, OCA) to characterize early invasive breast cancer. The OCA is based on the Ion Torrent™ NGS platform and Ion AmpliSeq™ library preparation technology, coupled to the Oncomine™ Knowledgebase, for target selection, variant calling, and data annotations. The OCA includes 87 genes for hotspot mutation detection, 48 genes for full length sequencing and 43 genes for focal copy number assessment. The OCA provides a standardized informatics workflow and quality control (QC) parameters to process samples in a translational clinical research setting. To explore the application of the OCA to early invasive breast cancers, we performed a retrospective pilot study in a subset of cases from the TEAM trial. From the TEAM pathology samples, 420 were chosen in a case-control fashion, 413 samples were analyzed, 388 samples passed standard QC metrics, and 254 samples (65%) were found to contain 368 variants with Oncomine Knowledgebase annotations. Briefly, variants of PIK3CA were most frequent at 42.7% (157/368), followed by TP53 at 27.2% (100/368), PTEN at 5.7% (21/368), BRCA2 at 3.8% (14/368), SF3B1 (12/368), AKT1 (11/368) and PTCH1 (11/368) at 3.3%, 3.0%, 3.0%; respectively. Other variants were detected in ATM, ERBB2, RB1, FGFR2, NF1, CDKN2A, PIK3R1 and others. Amongst the 43 genes assessed for copy-number, 23 showed copy-number changes across 132 samples totalling 167 CNVs. 256 samples showed no copy-number alterations in any of the genes on the panel. ERBB2 was most frequently altered at 28.1% (47/167), followed by FGFR1 at 23.4% (39/167), CCND1 at 15.0% (25/167) and MDM2 at 10.2% (17/167). Copy-number losses were identified in TP53, RB1, PTEN, BRCA2 at 0.6% each; as well as CDKN2A at 1.8% (3/167). Analytical validation of a subset of gene variants and copy-number changes will be presented in addition to the evidence of potential future application of the Oncomine Comprehensive Assay to precision oncology goals.
Citation Format: Bayani J, Crozier C, Quintayo MA, Amemiya Y, Zhang X, Larivière M, Sadis S, Smith JM, Hasenburg A, Kieback D, Markopoulos C, Dirix L, Yaffe M, Seth A, Feilotter H, Rea D, Bartlett JMS. Evaluation of the oncomine comprehensive assay for the identification of actionable mutations for therapeutic stratification from the TEAM pathology cohort [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-17.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Crozier
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - MA Quintayo
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - Y Amemiya
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - X Zhang
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - M Larivière
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - S Sadis
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - JM Smith
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Hasenburg
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - D Kieback
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Markopoulos
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - L Dirix
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - M Yaffe
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Seth
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - H Feilotter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - D Rea
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - JMS Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
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Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Harper AM, Wainright JL, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2016 Annual Data Report: Liver. Am J Transplant 2018; 18 Suppl 1:172-253. [PMID: 29292603 DOI: 10.1111/ajt.14559] [Citation(s) in RCA: 282] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Data on adult liver transplants performed in the US in 2016 are no-table for (1) the largest total number of transplants performed (7841); (2) the shortest median waiting time in recent history (11.3 months); (3) continued reduction in waitlist registrations and transplants for hepatitis C-related indications; (4) increasing numbers of patients whose clinical profiles are consistent with non-alcoholic fatty liver disease; and (5) equilibration of transplant rates in patients with and without hepatocellular carcinoma. Despite the increase in the number of available organs, waitlist mortality remained an important concern. Graft survival rates continued to improve. In 2016, 723 new active candidates were added to the pediatric liver transplant waiting list, down from a peak of 826 in 2005. The number of prevalent candidates (on the list on December 31 of the given year) was stable, 408 active and 169 inactive. The number of pediatric living donor liver transplants decreased from a peak of 79 in 2015 to 62 in 2016, with most from donors closely related to the recipients. Graft survival continued to improve over the past decade among recipients of deceased donor and living donor livers.
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Affiliation(s)
- W R Kim
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA
| | - J R Lake
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - D P Schladt
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - A M Harper
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J L Wainright
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
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46
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Smith JM, Weaver T, Skeans MA, Horslen SP, Harper AM, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2016 Annual Data Report: Intestine. Am J Transplant 2018; 18 Suppl 1:254-290. [PMID: 29292606 DOI: 10.1111/ajt.14560] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Despite improvements in medical and surgical treatment of intestinal failure, intestine transplant continues to play an important role. In 2016, a total of 147 intestine transplants were performed, 80 intestine-without-liver and 67 intestine-liver. Over the past decade, the age distribution of candidates waitlisted for intestine and intestine-liver transplant shifted from primarily pediatric to increasing proportions of adults. In 2016, 58.2% of candidates on the intestine list at any time during the year were aged younger than 18 years, with a decrease over time in those aged younger than 6 years and an increase in those aged 6-17 years. Adults accounted for 41.9% of candidates on the list at any time during the year, with a stable proportion of those aged 18-34 years and a decrease in those aged 35 years or older. By age, pretransplant mortality rate was highest for adult candidates at 11.7 per 100 waitlist years and lowest for children aged younger than 6 years at 2.2 per 100 waitlist years. For intestine transplants with or without a liver in 2009-2011, 1- and 5-year graft survival was 72.0% and 54.1%, respectively, for recipients aged younger than 18 years, and 70.5% and 44.1%, respectively, for recipients aged 18 years or older.
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Affiliation(s)
- J M Smith
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - T Weaver
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - S P Horslen
- Liver and Intestine Transplantation Program, Seattle Children's Hospital, Seattle, WA
| | - A M Harper
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - A K Israni
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
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47
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Colvin M, Smith JM, Hadley N, Skeans MA, Carrico R, Uccellini K, Lehman R, Robinson A, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2016 Annual Data Report: Heart. Am J Transplant 2018; 18 Suppl 1:291-362. [PMID: 29292604 DOI: 10.1111/ajt.14561] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In 2016, 3209 heart transplants were performed in the United States. New, active listings increased 57% since 2005. The number of adult heart transplant survivors continued to increase, and in 2016, 30,622 recipients were living with heart transplants. Patient mortality following transplant has declined. The number of pediatric candidates and transplants performed also increased. New listings for pediatric heart transplants increased from 454 in 2005 to 624 in 2016. The number of pediatric heart transplants performed each year increased from 319 in 2005 to 445 in 2016. Among pediatric patients who underwent transplant in 2015, death occurred in 5.9% at 6 months and 7.2% at 1 year.
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Affiliation(s)
- M Colvin
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Cardiology, University of Michigan, Ann Arbor, MI
| | - J M Smith
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - N Hadley
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - R Carrico
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - K Uccellini
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - R Lehman
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
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48
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Valapour M, Lehr CJ, Skeans MA, Smith JM, Carrico R, Uccellini K, Lehman R, Robinson A, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2016 Annual Data Report: Lung. Am J Transplant 2018; 18 Suppl 1:363-433. [PMID: 29292602 DOI: 10.1111/ajt.14562] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In 2016, 2692 candidates aged 12 years or older were added to the lung transplant waiting list; 2345 transplants were performed, the largest number of any prior year. The median waiting time for listed candidates in 2016 was 2.5 months, and waiting times were shortest for group D candidates. The transplant rate increased to 191.9 transplants per 100 waitlist years in 2016, with a slight decrease in waitlist mortality to 15.1 deaths per 100 waitlist years. Short-term survival continued to improve, with a 6-month death rate of 6.6% and a 1-year death rate of 10.8% among recipients in 2015 compared with 8.0% and 13.3%, respectively, among recipients in 2014. Long-term survival rates remained unchanged; 55.6% of recipients were alive at 5 years. In 2016, 23 new candidates aged 0-11 years were added to the waiting list and 16 lung transplants were performed. Incidence of posttransplant mortality for lung transplant recipients aged 0-11 years who underwent transplant in 2014-2015 was 13.8% at 6 months and 19.6% at 1 year. Changes in waitlist and transplant demographic features continued to evolve following implementation of the revised lung allocation score in 2015. Some early trends that may be attributable to the revised LAS are shorter waiting times, stabilization of the number of group D candidates listed for transplant, and convergence of LAS with lower prevalence of extremely high scores.
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Affiliation(s)
- M Valapour
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - C J Lehr
- Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - M A Skeans
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - J M Smith
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Pediatrics, University of Washington, Seattle, WA
| | - R Carrico
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - K Uccellini
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - R Lehman
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A Robinson
- Organ Procurement and Transplantation Network, Richmond, VA.,United Network for Organ Sharing, Richmond, VA
| | - A K Israni
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
| | - J J Snyder
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - B L Kasiske
- Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN
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49
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Munjal C, Jegga AG, Opoka AM, Stoilov I, Norris RA, Thomas CJ, Smith JM, Mecham RP, Bressan GM, Hinton RB. Inhibition of MAPK-Erk pathway in vivo attenuates aortic valve disease processes in Emilin1-deficient mouse model. Physiol Rep 2017; 5:5/5/e13152. [PMID: 28270590 PMCID: PMC5350168 DOI: 10.14814/phy2.13152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/08/2017] [Indexed: 12/20/2022] Open
Abstract
Aortic valve disease (AVD) is a common condition with a progressive natural history, and presently, there are no pharmacologic treatment strategies. Elastic fiber fragmentation (EFF) is a hallmark of AVD, and increasing evidence implicates developmental elastic fiber assembly defects. Emilin1 is a glycoprotein necessary for elastic fiber assembly that is present in both developing and mature human and mouse aortic valves. The Emilin1‐deficient mouse (Emilin1−/−) is a model of latent AVD, characterized by activated TGFβ/MEK/p‐Erk signaling and upregulated elastase activity. Emilin1−/− aortic valves demonstrate early EFF and aberrant angiogenesis followed by late neovascularization and fibrosis. The objective of this study was to test the effectiveness of three different targeted therapies. Aged (12–14 months) Emilin1−/− mice were treated with refametinib (RDEA‐119, MEK1/2 inhibitor), doxycycline (elastase inhibitor), or G6‐31 (anti‐VEGF‐A mouse antibody) for 4 weeks. Refametinib‐ and doxycycline‐treated Emilin1−/− mice markedly reduced MEK/p‐Erk activation in valve tissue. Furthermore, both refametinib and doxycycline attenuated elastolytic cathepsin K, L, MMP‐2, and MMP‐9 activation, and abrogated macrophage and neutrophil infiltration in Emilin1−/− aortic valves. RNAseq analysis was performed in aortic valve tissue from adult (4 months) and aged (14 months) Emilin1−/− and age‐matched wild‐type control mice, and demonstrated upregulation of genes associated with MAPK/MEK/p‐Erk signaling and elastases at the adult stage and inflammatory pathways at the aged stage controlling for age. These results suggest that Erk1/2 signaling is an important modulator of early elastase activation, and pharmacological inhibition using refametinib may be a promising treatment to halt AVD progression
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Affiliation(s)
- Charu Munjal
- Divisions of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Anil G Jegga
- Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Amy M Opoka
- Divisions of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ivan Stoilov
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Ohio
| | - Russell A Norris
- Department of Cell Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Craig J Thomas
- Division of Pre-Clinical Innovation, National Center for Advancing Translational Sciences National Institutes of Health, Bethesda, Maryland
| | - J Michael Smith
- TriHealth Heart Institute, Cardio-Thoracic Surgery, Cincinnati, Ohio
| | - Robert P Mecham
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Ohio
| | - Giorgio M Bressan
- The Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Robert B Hinton
- Divisions of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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50
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Lehr EJ, Guy TS, Smith RL, Grossi EA, Shemin RJ, Rodriguez E, Ailawadi G, Agnihotri AK, Fayers TM, Hargrove WC, Hummel BW, Khan JH, Malaisrie SC, Mehall JR, Murphy DA, Ryan WH, Salemi A, Segurola RJ, Smith JM, Wolfe JA, Weldner PW, Barnhart GR, Goldman SM, Lewis CTP. Minimally Invasive Mitral Valve Surgery III: Training and Robotic-Assisted Approaches. Innovations (Phila) 2017; 11:260-7. [PMID: 27662478 PMCID: PMC5051529 DOI: 10.1097/imi.0000000000000299] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program.
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Affiliation(s)
- Eric J Lehr
- From the *Swedish Heart and Vascular Institute, Seattle, WA USA; †Temple University, Philadelphia, PA USA; ‡The Heart Hospital Baylor Plano, Plano, TX USA; §New York University School of Medicine, New York, NY USA; ∥David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA; ¶St. Thomas Hospital, Nashville, TN USA; #University of Virginia, Charlottesville, VA USA; **Saint Elizabeth's Medical Center, Brighton, MA USA; ††Holy Spirit Northside Hospital, Chermside, Australia; ‡‡Penn Presbyterian Medical Center, Philadelphia, PA USA; §§Gulf Coast Cardiothoracic & Vascular Surgeons, Ft. Myers, FL USA; ∥∥East Bay Cardiac Surgery Center, Oakland, CA USA; ¶¶Northwestern University, Feinberg School of Medicine, Chicago, IL USA; ##Penrose St. Francis Hospital, Colorado Springs, CO USA; ***Emory St. Joseph's Hospital, Atlanta, GA USA; †††Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY USA; ‡‡‡South Florida Heart & Lung Institute, Doral, FL USA; §§§TriHealth Heart Institute, Cincinnati, OH USA; ∥∥∥Northeast Georgia Physicians Group, Gainesville, GA USA; ¶¶¶Central Maine Heart and Vascular Institute, Lewiston, ME USA; ###Lankenau Medical Center, Wynnewood, PA USA; and ****Department of Cardiothoracic Surgery, Princeton Baptist Hospital, Birmingham, AL USA
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