D. Schwartz
Temple University
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Publication
Featured researches published by D. Schwartz.
European Journal of Cardio-Thoracic Surgery | 2015
Senthil N. Jayarajan; Sharven Taghavi; Eugene Komaroff; Akira Shiose; D. Schwartz; Eman Hamad; Rene Alvarez; Grayson Wheatley; Thomas Sloane Guy; Yoshiya Toyoda
OBJECTIVES Organ donors with a history of cocaine use are thought to be less favourable for orthotopic heart transplantation (OHT). This study examined long-term survival in OHT using donors with a history of cocaine use. METHODS The United Network for Organ Sharing (UNOS) database was examined for primary, adult heart transplants from 2000 to 2010. Cox proportional hazards analysis using covariates associated with mortality was used to examine survival. RESULTS There were 19 636 total OHTs with 2274 (11.6%) using donors with a history of dependent cocaine use (DCU). Of these, 1008 (44.3%) donors were current cocaine users. Recipients of DCU were more likely to be male (79.0 vs 75.7%, P < 0.001), more likely diabetic (16.5 vs 14.8%, P = 0.003) and were less likely to be sex mismatched (23.0 vs 28.6%, P < 0.001). DCU donors were older (32.5 vs 31.4 years, P < 0.001), more likely male (79.7 vs 69.8%, P < 0.001) and had higher ischaemic times (3.27 vs 3.20 h, P = 0.001). On multivariate analysis, DCU was not associated with mortality [hazard ratio (HR): 0.95, 95% CI: 0.87-1.03, P = 0.22]. Variables associated with mortality included recipient body mass index, sex mismatch, race mismatch, black race, ischaemic time, recipient creatinine, donor age, donor smoking history and mechanical ventilation or extracorporeal membrane oxygen as a bridge to transplantation. On subset analysis, CCU was not associated with mortality (HR: 0.97, 95% CI: 0.89-1.05, P = 0.42). On Kaplan-Meier analysis, median survival was not different when comparing current (3890.0 days), past (3,889.0 days) and non-cocaine using donors (4165.0 days); P = 0.54. CONCLUSIONS Use of carefully selected donors with a history of past and current cocaine use does not result in worse outcomes.
Heart & Lung | 2018
Barbara Riegel; Victoria Vaughan Dickson; Christopher S. Lee; Marguerite Daus; Julia Hill; Elliane Irani; Solim Lee; Joyce Wald; Stephen T. Moelter; Lisa Rathman; Megan Streur; Foster Osei Baah; Linda Ruppert; D. Schwartz; Alfred A. Bove
Background Early heart failure (HF) symptoms are frequently unrecognized for reasons that are unclear. We explored symptom perception in patients with chronic HF. Methods We enrolled 36 HF out‐patients into a longitudinal sequential explanatory mixed methods study. We used objectively measured thoracic fluid accumulation and daily reports of signs and symptoms to evaluate accuracy of detected changes in fluid retention. Patterns of symptom interpretation and response were explored in telephone interviews conducted every 2 weeks for 3‐months. Results In this sample, 44% had a mismatch between objective and subjective fluid retention; younger persons were more likely to have mismatch. In interviews, two patterns were identified: those able to interpret and respond appropriately to symptoms were higher in decision‐making skill and the quality of social support received. Conclusion Many HF patients were poor at interpreting and managing their symptoms. These results suggest a subgroup of patients to target for intervention.
Transplantation | 2015
Sharven Taghavi; Senthil N. Jayarajan; Eugene Komaroff; Akira Shiose; D. Schwartz; Eman Hamad; Rene Alvarez; Grayson Wheatley; Yoshiya Toyoda
Background Although orthotopic heart transplantation (OHT) remains the preferred treatment for end-stage heart failure, there continues to be a critical shortage of organ donors. The goal of this study is to examine outcomes after orthotopic OHT using heavy drinking donors (HDDs) in a large, national database. Methods The United Network for Organ Sharing database was examined for all primary, adult OHT carried out from 2005 to 2012. Results There were 14,928 total OHT performed during the study period with 2,274 (15.2%) using HDD. Recipients of HDD were older (53.4 vs. 51.9 years, P < 0.001), more likely men (80.7 vs 74.4%, P < 0.001), less likely sex mismatched (21.5 vs 27.5%, P < 0.001), more likely race mismatched (57.4 vs 52.4%, P < 0.001), and had less total HLA mismatches (4.55 vs 4.65, P < 0.001). The HDD were older (37.0 vs 30.5 years, P < 0.001), more likely men (82.2 vs 69.9%, P < 0.001), and more likely to have heavy cigarette use (38.1 vs 13.2%, P < 0.001). Length of stay was not different (20.3 vs 19.7 days, P = 0.02). On multivariate analysis, use of HDD was not associated with mortality at 30 days (hazards ratio [HR], 1.12; 95% confidence interval [95% CI], 0.90–1.39; P = 0.30), 1 year (HR, 0.96; 95% CI, 0.83–1.11; P = 0.56), and at 5 years (HR, 1.02; 95% CI, 0.91–1.13; P = 0.79). Variables associated with mortality at 5 years included increasing donor age, prolonged ischemic time, worsening recipient creatinine, recipient black race, sex mismatch, and extracorporeal membrane oxygenation or mechanical ventilation as a bridge to transplantation. Conclusion Heart transplantation can be performed using carefully selected HDDs with good outcomes.
Journal of Heart and Lung Transplantation | 2016
C. Dillane; Alfred A. Bove; H. Cohen; Riyaz Bashir; Brian O’Murchu; Brian P. O’Neill; J. Gomez-Abraham; Akira Shiose; D. Schwartz; Daniel L. Dries; Lynn Punnoose; Yoshiya Toyoda; Rene Alvarez; Eman Hamad
Journal of Cardiac Failure | 2018
Joanna Catalano; Lauren Monaco; John Clark; Xiaofeng Zhao; Meredith A. Brisco; Eman Hamad; D. Schwartz; Rene Alvarez
Journal of Heart and Lung Transplantation | 2017
J. Kumar; C. Dillane; J.D. Plamenac; D. Schwartz
Journal of Heart and Lung Transplantation | 2016
A. Mirza; Farhan Raza; Akira Shiose; D. Schwartz; Yoshiya Toyoda; Rene Alvarez; Eman Hamad
Journal of Cardiac Failure | 2016
Abhishek Singh; Tomo Yoshizumi; Akshay Kumar; J. Gomez-Abraham; Akira Shiose; D. Schwartz; Daniel L. Dries; Lynn Punnoose; Yoshiya Toyoda; Rene Alvarez; Eman Hamad; Alfred A. Bove
Circulation | 2016
Fatima Khan; Ronald Andari Sawaya; Estefania Oliveros; Richard Slobodien; Natalya Iorio; Donald C. Haas; Kevin M Hagan; Divya Aggarwal; Rohinton J. Morris; Mary Naglak; Eman Hamad; Daniel L. Dries; D. Schwartz; Lynn Punnoose; Rene Alvarez
Journal of Heart and Lung Transplantation | 2015
Estefania Oliveros; Farhan Raza; Rene Alvarez; D. Schwartz; Daniel L. Dries; Paul R. Forfia; E. Tsai; Lynn Punnoose; Akira Shiose; Yoshiya Toyoda; Alfred A. Bove; Eman Hamad