A5009983107- Transplantation: Methods and Outcomes
- Mechanical Circulatory Support Devices
- Cardiac Structural Anomalies and Repair
- Congenital Heart Disease Studies
- Renal Transplantation Outcomes and Treatments
- Cardiac pacing and defibrillation studies
- Cardiovascular Issues in Pregnancy
- Mitochondrial Function and Pathology
- Organ Transplantation Techniques and Outcomes
- Cardiomyopathy and Myosin Studies
- Cardiac Arrhythmias and Treatments
- ATP Synthase and ATPases Research
- Healthcare Policy and Management
- Advanced MRI Techniques and Applications
- Frailty in Older Adults
- Cardiac Imaging and Diagnostics
- Neurogenetic and Muscular Disorders Research
- Genomics and Rare Diseases
- Parvovirus B19 Infection Studies
- Adolescent and Pediatric Healthcare
- Cardiovascular and Diving-Related Complications
- Cardiac Ischemia and Reperfusion
- Cardiac Valve Diseases and Treatments
- Viral Infections and Immunology Research
- Organ and Tissue Transplantation Research
Lurie Children's Hospital
2020-2025
Northwestern University
2021-2024
Children's Hospital of Pittsburgh
2016-2019
Cardiac magnetic resonance with myocardial stress perfusion (stress CMR) is a non-invasive technique that offers assessment of function, perfusion, and viability. Regadenoson selective cardiac adenosine A2 receptor agonist fewer side effects than favorable safety profile in older pediatric heart transplant recipients (PHTR). There are limited studies evaluating the hemodynamic response regadenoson patients under general anesthesia (GA). We reviewed our experience CMR PHTR GA from 2020-2024...
US Pediatric Heart Allocation Policy was recently revised, deprioritizing candidates with cardiomyopathy while maintaining status 1A eligibility for congenital heart disease (CHD) on "high-dose" inotropes. We compared waitlist characteristics and mortality around this change. Status listings decreased (70% to 56%, P < .001) CHD representation increased among (48% vs 64%, .001). Waitlist overall (subdistribution hazard ratio [SHR] 0.96, = .63) (SHR 1.16, .14) were unchanged. trended better...
Abstract Background The relationship between histopathologic and molecular (“MMDx”®) assessments of endomyocardial biopsy (EMB) serum donor‐derived cell‐free DNA (ddcfDNA) in acute rejection (AR) assessment following pediatric heart transplantation (HT) is unknown. Methods EMB sent for MMDx histopathology from November 2021 to September 2022 were reviewed. results compared. DdcfDNA obtained ≤1 week prior compared with results. discrimination ddcfDNA AR was assessed using receiver‐operating...
Despite ubiquitous exposure to sensitizing events, most Fontan PLE patients have low panel reactive antibodies (PRA). To assess whether they are at risk for donor-specific antibody (DSA) memory response following heart transplantation (HT) when their resolves, DSA profiles, incidence of rejection, and graft outcomes in recipients with without were compared.Patient characteristics, appearance newly detected (nDSA), compared between using Wilcoxon rank-sum Chi-squared tests. burden was...
Patients with biallelic mutations in the nuclear-encoded mitochondrial gene C1QBP/p32 have been described syndromic features and autosomal recessive cardiomyopathy. We describe clinical course two siblings who developed cardiomyopathy ventricular fibrillation infancy. provide genomic analysis clinical-pathologic correlation. Both had profound cardiac failure arrhythmia. One child died suddenly. The second sibling survived resuscitation but required extracorporeal cardiopulmonary support...
The US Pediatric Heart Allocation Policy (PHAP) was revised in March 2016, with the goal of reducing waitlist mortality. We evaluated hypothesis that these changes, which increased status exceptions, have worsened racial disparities outcomes.Children Transplant Study database listed for first heart transplant from January 2012 - June 2020 were included and stratified by listing before (Era 1) or after 2) PHAP revision.A total 4,089 children during study period. Compared white (n = 2648),...
Histiocytoid cardiomyopathy (HICMP) is a rare mitochondrial associated with recurrent life-threatening arrhythmias and variable degrees of systolic dysfunction. Successful heart transplantation for HICMP has been described, but there no published experience biventricular assist device (BiVAD) support intractable in HICMP. We report 13 month old girl left ventricular noncompaction preserved function who presented cardiogenic shock secondary to incessant arrhythmias. After failed attempts at...
Abstract Background Early detection of cardiac allograft rejection is crucial for post‐transplant graft survival. Despite the progress made in immunosuppression strategies, acute cellular remains a serious complication during and after first year, there continued lack consensus regarding its treatment, especially pediatric transplant patients. Methods An open request was placed via listserv to membership Pediatric Heart Transplant Society (PHTS). Along with broad literature search, numerous...
Late-onset paroxysmal AVB has been described as a rare complication after HT and associated with AR or CAV. We describe 4 pediatric recipients who developed hours routine cardiac catheterization in the absence of AR, CAV, underlying conduction system disease. Four were >1 year post-transplant had episodes surveillance EMB. Telemetry demonstrated high-grade block, ranging from 2:1 to complete without ventricular escape for several seconds. None patients significant rapidly progressive...
Abstract Background Heterotaxy syndrome (HS) is a defect in lateralization which often results complex intra and extracardiac abnormalities. Orthotropic heart transplantation (OHT) HS involves intricate individualized modifications to surgical technique. Post‐OHT outcomes are worse patients with HS, however, the impact of post‐OHT residual lesions has not yet been characterized. Methods Patients who underwent OHT at Ann & Robert H. Lurie Children's Hospital Chicago between January 2012...
ABSTRACT Background Troponin I is a blood biomarker of cardiac injury and levels measured using high‐sensitivity assay after pediatric heart transplantation (HT) have not been described. We sought to assess the association between troponin (hsTnI) N‐terminal pro‐B‐type natriuretic peptide (NTproBNP) with treated acute rejection (AR) graft loss in transplant recipients. Methods Serum was collected banked from HT recipients prior catheterization. Patients samples drawn within 365 days post‐HT...
Background: Cardiovascular magnetic resonance (CMR) has an emerging role in graft surveillance for pediatric heart transplant recipients (PHTR). Transplanted grafts are susceptible to cardiac allograft vasculopathy, manifested as macrovascular narrowing on angiography, well micro-vessel disease. By CMR, myocardial perfusion abnormalities can be evaluated semi-quantitatively, by calculation of a reserve index (MPRI). However, normal MPRI values have not been established PHTR and prior...
Background: US pediatric heart allocation was revised in March 2016 to more appropriately categorize candidates with the most urgent need for transplantation (HT), including children congenital disease (CHD) listed status 1A on inotropic support. We sought assess impact of these revisions waitlist (WL) characteristics and mortality. Methods: Children (<18 yo) (HT) UNOS database between 12/16/11 11/7/17 were stratified based whether they before (PRE) or after (POST) criteria revision....