D.S. Esmore

Outcomes Following De Novo CNI‐Free Immunosuppression After Heart Transplantation: A Single‐Center Experience

Renal impairment at the time of heart transplantation complicates the choice of subsequent immunosuppressive therapy. Calcineurin (CNI)‐free regimens utilizing proliferation signal inhibitors (PSI) may mitigate against nephrotoxicity in this group; however, their effectiveness remains unclear.

Surgical management of severe emphysema in Australia: lung transplant and lung volume reduction surgery

Actuarial survival rates at 1 to 5 years were 5867%, 4867%, 4567%, 3967%, and 3168%, respectively. Stepwise logistic regression demonstrated that 6-month survival was influenced by myocardial fibers’ hypertrophy. Cox proportional-harzards analysis showed that preoperative NYHA class IV and high norepinephrine levels were independent predictors of poor longterm survival. When anatomopathological variables were added, myocardial fibers’ diameter (MFD) and existence of apoptotic myocardial cells eliminated those determinants and became independent prognostic factors. Conclusion: PLV associated with mitral insufficiency correction improves LV function and congestive heart failure. Nevertheless, these benefits are restricted by the possibility of LV redilatation. Furthermore, the high mortalities observed at early and longterm follow-up are influenced by patients’ preoperative clinical condition and degree of myocardial fibers compromise, precluding PLV wide application.