JHLT: The Podcast ISHLT

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the May issue of The Journal of Heart and Lung Transplantation. Digital Media Editor David Schibilsky, MD, a cardiothoracic surgeon from Freiburg, Germany, hosts this episode.
 
First, Dr. Schibilsky and Digital Media Editor Erika Lease, MD, interview their first guest, Helen A. Hannan, the podcast’s first-ever undergraduate pre-medical guest, from the University of Michigan. Helen was the lead author on the study “Racial and Gender Disparities in Transplantation of Hepatitis C+ Hearts and Lungs.” The study noted that prior research in utilization of kidneys from donors with Hepatitis C had shown disparities due to gender and education—and wanted to see if this was the case in heart and lung donors as well.
 
Drs. Schibilsky and Lease chat with Helen about the findings of the study, including some of the interesting differences shown between heart and lung recipients, and the ramifications for better patient discussions at the clinical level.
 
Next, Dr. Schibilsky and Digital Media Editor Marty Tam, MD, interview their next guest, Lauren Truby, MD, of the University of Texas Southwestern Medical Center in Dallas. Dr. Truby is the podcast’s first return guest, having appeared on the show near the end of 2021. This time, she’s featured as first author on the study “Metabolomic profiling during ex situ normothermic perfusion before heart transplantation defines patterns of substrate utilization and correlates with markers of allograft injury.” The paper explores cardiac metabolism of donor hearts during recovery using an ex situ normothermic perfusion system (NRP).
 
Dr. Truby provides an in depth look at the project’s logistics—which she calls a “labor of love”—its multi-point findings, and what’s next in this line of research.
 
Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.
 
Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.
 
 

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the April issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Erika Lease, MD, a transplant pulmonologist at the University of Washington in Seattle, hosts this episode.
 
First, Dr. Lease and Digital Media Editor Van-Khue Ton, MD interview their first guests, Paul J. Scheel III, MD and Steven Hsu, MD, both of Johns Hopkins University. Dr. Scheel was first author and Dr. Hsu was senior author on the study “Occult right ventricular dysfunction and right ventricular-vascular uncoupling in left ventricular assist device recipients.” The main finding of the study is that LVAD recipients have depressed intrinsic RV contractility and reduced RV compensation.
 
Drs. Scheel and Hsu give an overview of RV pressure-volume loops and their measurements, and discuss the impact of LVAD on intrinsic RV contractility, contractile reserve, and vascular coupling. If you want to know how these findings are important to clinical care, you’ll need to listen to the episode!
 
Next, Dr. Lease and Digital Media Editor David Schibilsky, MD, interview their next guest, Joshua Diamond, MD, of the University of Pennsylvania. Dr. Diamond was first author on the study “Development and validation of primary graft dysfunction predictive algorithm for lung transplant candidates.” The authors of the study set out to develop a clinically useful and generalizable PGD prediction model to aid in clinical decision making.
 
Dr. Diamond discusses the factors they considered in building the model, the model’s strengths over other approaches, and its limitations. Tune in to learn more!
 
Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.
 
Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.
 
 

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the March issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Marty Tam, MD, an advanced heart failure and transplant cardiologist at University of Michigan in Ann Arbor, hosts this episode.
 
First, Dr. Tam and Digital Media Editor David Schibilsky, MD interview their first guests, Fiorella Calabrese, MD and Francesca Lunardi, MD, ScD, PhD, of University of Padova, in Padova Italy. Dr. Lunardi was first author and Dr. Calabrese was senior author on the study “Assessing the role of phosphorylated S6 ribosomal protein in the pathological diagnosis of pulmonary antibody-mediated rejection.” In the conversation, Drs. Calabrese and Lunardi share the main challenges in the current diagnostic algorithm for AMR in lung transplantation, and why this protein expression may be a future mainstay in evaluating patients with this condition.
 
Next, Dr. Tam and Digital Media Editor Van-Khue Ton, MD, interview their next guest, Benjamin Mackie, MD, of Tampa General Hospital. Dr. Mackie was senior author on the study “Relationship between blood and tissue-based rejection-related transcripts in heart transplantation.” In the conversation, Dr. Mackie shares the current state of rejection assessment, including new, non-invasive modalities, and how the relation between these diagnostic methods may inform clinical practice.
 
Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.
 
Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the February issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Van-Khue Ton, MD, a transplant cardiologist at Massachusetts General Hospital, hosts this episode.
 
First, Dr. Ton and Digital Media Editor Erika Lease, MD interview their first guest, David Jenkins, FRCS(Cth), of the Royal Papworth Hospital in Cambridge, UK. Dr. Jenkins was senior author on the study “Perioperative extracorporeal membrane oxygenation support for pulmonary endarterectomy: A 17-year experience from the UK national cohort.” In the conversation, Dr. Jenkins shares the major determinants of mortality in this patient population, differences between survivors and non-survivors, and the CTEPH classification systems involved.
 
Next, Dr. Ton is joined by Digital Media Editor Marty Tam, MD, to interview their next guest, Kevin Chen, a 4th year general surgery resident at Cedars-Sinai Medical Center. Dr. Chen was a first author on the study “Heart transplantation in patients from socioeconomically distressed communities.” Drs. Ton and Tam lead a lively discussion about this important paper, including the methodology behind the indices used to categorize patients, and the million-dollar question: why did patients from distressed communities fare more poorly?
 
Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.
 
Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.

Welcome to 2024! The JHLT Digital Media Editors kick off the new year with a look back at the best of the best from 2023 – specifically, a few of the guidelines and consensus statements from the International Society for Heart and Lung Transplantation that appeared in The Journal of Heart and Lung Transplantation this past year.
 
Digital Media Editor David Schibilsky, MD, a cardiothoracic surgeon from Freiburg, Germany, hosts this episode.
 
First, Digital Media Editor Marty Tam, MD, reviews the updated Heart Transplantation guidelines, published in JHLT at the start of 2023. What’s changed in the decade plus since the 2010 guidelines were published? For starters, there’s more than 200 new or updated recommendations in this document, and Dr. Tam walks you through some of the highlights.
 
Next, Digital Media Editor Erika Lease, MD, shares the new reproductive health guidelines for transplant patients—something that’s relevant to just about everyone working in the cardiothoracic transplantation space. Dr. Lease steps through this much-needed consensus statement and some of its key takeaways.
 
Finally, Dr. Schibilsky joins his fellow Digital Media Editor Van-Khue Ton, MD, for a discussion about the MCS guidelines, another 10 year update on a massive—and massively important—document. Drs. Schibilsky and Ton share their favorite parts of the guideline, and do a little imagining about what might be present in the next major update for MCS.
 
Follow along at www.jhltonline.org/current, or check out all of the ISHLT’s Standards and Guidelines documents at https://ishlt.org/publications-resources/professional-resources/standards-guidelines.
 
Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.
 
 

In our final episode of 2023, the JHLT Digital Media Editors have two manuscripts from the December 2023 issue of The Journal of Heart and Lung Transplantation! Digital Media Editor Erika Lease, MD, transplant pulmonologist at the University of Washington in Seattle, hosts this episode.
 
First, a free-ranging conversation with first author Mark E. Snyder, MD, and senior author John F. McDyer, MD, on their team’s study “Impact of age and telomere length on circulating T cells and rejection risk after lung transplantation for idiopathic pulmonary fibrosis.”
 
A subset of patients with idiopathic pulmonary fibrosis (IPF) have a heritable, age-adjusted short telomere length. Mutations in telomere length can manifest as T-cell dysfunction and immunodeficiency. As T-cells are involved in the development of acute cellular rejection (ACR), the authors hypothesized that the combination of age and telomere length would impact the degree of ACR burden in lung transplant recipients—and indeed, the authors found that lung transplant recipients with IPF and short telomere length had premature “aging” of their circulating T-Cells. There was a significant decline in early ACR burden with increasing age, found only in those with short telomere length.
 
How might these findings impact immunosuppression regimens in clinical practice? What follow-up studies to they have planned? In the discussion, Drs. Snyder and McDyer, both of UPMC in Pittsburgh, discuss all these possibilities, as well as the the work of their collaborator, Jonathan K. Alder, PhD, as inspiration for the study.
 
Next, the editors explored “Early optical coherence tomography evaluation of donor-transmitted atherosclerosis and cardiac allograft vasculopathy: insights from a prospective, single-center study,” in a discussion with senior author Snehal R. Patel, MD, of the Montefiore Medical Center in New York.
 
Cardiac allograft vasculopathy (CAV) remains a major cause of death in heart transplant recipients, and donor-transmitted atherosclerosis (defined as a maximal intimal thickness of >/= 0.5mm on baseline intravascular ultrasound (IVUS) early after transplant) is believed to carry a greater risk for the development of CAV. Dr. Patel’s team, however, hypothesized that optical coherence tomography (OCT) may have advantages over IVUS as an imaging modality due to its higher resolution. In this prospective, observational study, the authors assessed the prognostic role of OCT, and found that transplant recipients whose OCT imaging showed advanced plaque characteristics had a significantly higher event rate after a mean follow up of 3.3 years. OCT was also an independent predictor of clinic events, while maximal intimal thickness of >/= 0.5mm was not.
 
In the episode, Dr. Patel shares the key features of OCT that may make it of clinical use, the three risk categories developed for the study, and what the follow-ups might be.
 
Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation.  Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.