Jul 5, 2023
The JHLT Digital Media Editors explore two manuscripts from the July issue of The Journal of Heart and Lung Transplantation—one on heart transplantation and one on lung transplantation. Digital Media Editor Marty C. Tam, MD, Assistant Professor at the University of Michigan, hosts this episode.
First, hear from co-first author Kevin Chen, MD, on his team’s study “Donation after circulatory death heart procurement strategy impacts utilization and outcomes of concurrently procured abdominal organs,” which comes from Cedars-Sinai. The study looks into the results of DCD organ donation depending on the technique used at procurement, mainly comparing ex-situ normothermic organ perfusion with thoracoabdominal normothermic regional perfusion (TA-NRP).
Digital Media Editors David Schibilsky, MD, and Van-Khue Ton, MD, have questions on the relationship between DCD liver and kidney procurement and heart procurement strategies, why TA-NRP livers and kidneys might differ, and the lower incidence of delayed graft function in DCD kidney transplants with TA-NRP. Dr. Chen also shares some thoughts about how this work might be incorporated into clinical practice.
Next, the editors welcome first author Jonathan P. Singer, MD, MS, from UCSF, to discuss the paper “Development of the Lung Transplant Frailty Scale (LT-FS).” Based on previous work, Dr. Singer and his colleagues set out to develop a novel frailty scale specifically for lung transplant candidates with improved performance characteristics over other frailty scales. The authors developed three lung transplant frailty measures and compared the construct and predictive validity to the existing short physical performance battery (SPPB) and the fried frailty phenotype (FFP). Their LT-FS models exhibited superior construct and predictive validity to these measures—and the addition of muscle mass and biomarkers further improved the model’s performance.
Digital Media Editor Erika Lease, MD, digs in with Dr. Singer on the main findings of the study. What’s unique about patients with advanced lung disease that makes them need a more specific frailty scale? How does the LT-FS outshine prior models? And what are the barriers to implementing a new model like this one in a transplant center?
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.