Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation
JACC CardioOncol. 2025 Jun;7(4):382-392. doi: 10.1016/j.jaccao.2025.05.002.
ABSTRACT
BACKGROUND: Postural orthostatic tachycardia (POTS) and orthostatic hypotension (OH) commonly occur after hematopoietic stem cell transplantation (HSCT).
OBJECTIVES: This study sought to determine the prevalence of POTS and OH before HSCT and the incidence of new cases after HSCT.
METHODS: In this single-center, prospective study, patients were evaluated 30 days before and 30 and 100 days after HSCT. Blood pressure, heart rate, and plasma norepinephrine levels were measured in the supine position and after a 10-minute active stand test to assess for POTS or OH. After HSCT, adrenergic receptor (AR)-modulating autoantibody activity was measured in 8 subjects with POTS and 8 without.
RESULTS: Among 46 patients, 40 (87.0%) underwent autologous and 6 (13.0%) allogeneic HSCT. Multiple myeloma was the most common indication (67.4%). Before HSCT, the prevalence of both POTS and OH was 4.3%. At 30 days after HSCT, POTS was present in 10 (25.6%) of 39 patients, including 9 (23.1%) new cases, and OH in 6 (15.4%), including 5 (12.8%) new cases. Patients with POTS at 30 days showed a significantly greater increase in norepinephrine levels upon standing (median 231% [Q1-Q3: 179%-343%]) compared with before HSCT (median 100% [Q1-Q3: 62%-183%]) (P = 0.005), which positively correlated with heart rate changes. AR-modulating autoantibody activity was also higher in patients with POTS vs those without and directly correlated with heart rate changes.
CONCLUSIONS: Approximately 1 in 4 patients developed POTS after HSCT, characterized by exaggerated increases in norepinephrine upon standing and elevated AR-modulating autoantibody activity.
PMID:40537187 | DOI:10.1016/j.jaccao.2025.05.002
TIPE2: a novel regulatory factor for cardiovascular-related diseases
J Mol Med (Berl). 2025 Jun 19. doi: 10.1007/s00109-025-02564-7. Online ahead of print.
ABSTRACT
Tumor necrosis factor-α-inducible protein 8-like 2 (TIPE2) is a novel regulatory factor involved in innate and adaptive immunity that negatively regulates the functions of toll-like receptors and T-cell receptors. Its selective expression within the immune system serves to inhibit inflammatory responses and maintain immune homeostasis. Inflammation and immune cell signaling initiate the innate immune response in the cardiovascular system through intricate acute and chronic adaptation processes, resulting in tissue damage and significantly contributing to the onset and progression of cardiovascular diseases. Consequently, TIPE2 presents a potential target for the diagnosis and treatment of various cardiovascular diseases. This paper reviews the structural characteristics and biological functions of TIPE2, as well as its role in the onset and progression of cardiovascular diseases, providing new strategies for prevention and treatment.
PMID:40536707 | DOI:10.1007/s00109-025-02564-7
Human adipose-derived stem cell exosomes alleviate human respiratory system-related cells damaged by exposure to SO<sub>2</sub> derivatives
J Biosci. 2025;50:49.
ABSTRACT
Inhalation burns, especially when combined with thermal burns, can be fatal and significantly increase mortality rate through inhaling hazardous gas. However, there is no specific treatment for inhalation burns except for relieving bronchospasm and cleaning the airways. In particular, inhaled sulfur dioxide (SO2), a major component of inhalation burns, can easily be hydrated in the respiratory tract to produce sulfurous acid, which subsequently dissociates to form bisulfite and sulfite derivatives. In this study, we intend to assess whether human adipose-derived stem cell (ASC) exosomes rescue respiratory system-related cells damaged by exposure to SO2 derivatives. We found that the uptake of ASC exosomes was high in human respiratory systemrelated cells and they rescue decreased proliferation of cells damaged by treatment with SO2 derivatives. In human pulmonary endothelial cells (HPMECs), total tubule length was increased by pre-treatment of ASC exosomes through an in vitro angiogenesis assay. Besides, we confirmed that ASC exosomes alleviate increased expression of inflammation-related genes by treatment of SO2 derivatives in primary respiratory epithelial cells. Taken together, these results suggest that ASC exosomes have potential in regeneration of human respiratory system-related cells damaged by inhalation burns, which currently lack specific treatment methods.
PMID:40536194
Which Donor and Recipient Risk Factors Matter in Heart Transplantation? Results From a Survey of 53 Centers Across Five Countries
Clin Transplant. 2025 Jun;39(6):e70214. doi: 10.1111/ctr.70214.
ABSTRACT
INTRODUCTION: Consensus regarding what defines acceptable heart transplant (HT) donors or recipients is lacking. This survey analyzed how risk factors guide donor and recipient selection, and how practices vary across systems.
METHODS: An online survey was conducted among adult HT centers in the US and Eurotransplant (ET) region. We aimed to represent at least 50% of the total adult HT volumes in both regions. Centers were stratified by their HT volumes. To compensate for non-responders, a safety margin was included, and centers accounting for at least 75% of the total HT volumes were contacted. Centers were queried on relative thresholds and absolute cutoffs for continuous risk factors. For other factors, their influence on donor heart acceptance or the likelihood of listing recipients was assessed.
RESULTS: Fifty-three centers from five countries participated: 39 US (accounting for 51.0% of the US HT volume), and 14 ET centers (65.0%) from four countries. ET centers more liberally considered advanced age donor hearts (threshold 64.5 [60.0-70.0] vs. 50.0 [50.0-55.0] years, p < 0.001), and hearts with abnormal echocardiography or coronary findings. Diabetes, smoking, and hypertension were rated by a quarter to more than half of US and ET centers as moderately or heavily influencing donor heart acceptance. ET centers more liberally listed candidates with chronic kidney disease (GFR 30.0 [21.5-32.5] vs. 35.0 [30.0-40.0] mL/min/1.73m2, p < 0.001). US centers, conversely, allowed for higher candidate ages (71.5 [70.0-74.0] vs. 68.0 [65.0-70.0] years, p < 0.001), and more likely (76.9%) listed candidates on ECMO support (42.9% of ET centers to less likely list, p = 0.022).
CONCLUSION: Selection practices differed distinctly between the US and ET. Further, practices appear to be driven by caution and are more conservative than current guidelines. Strengthening the evidence base to objectify and optimize donor and candidate selection could help alleviate the unmet need for donor hearts.
PMID:40536071 | DOI:10.1111/ctr.70214
Radiation-induced injury and the gut microbiota: insights from a microbial perspective
Therap Adv Gastroenterol. 2025 Jun 16;18:17562848251347347. doi: 10.1177/17562848251347347. eCollection 2025.
ABSTRACT
Although radiotherapy is the second most effective cancer treatment, radiation injuries limit its use. About 80% of abdominal-pelvic radiotherapy patients develop acute radiation enteritis, with 20% discontinuing radiotherapy. The lack of effective mitigation measures restricts its clinical application. Recent studies have proposed gut microbiota as a potential biomarker for radiation injuries. However, the interaction between gut microbiota and radiation injuries remains poorly understood. This review summarizes two forms of interaction between gut microbiota and radiation injuries based on the location of the radiation field. One type of interaction, referred to as "direct interaction," involves changes in the diversity and composition of gut microbiota, alterations in microbiota-derived metabolites, disruption of the intestinal barrier, activation of inflammatory responses within the intestine, and involvement of the host's immune system. The second form, called "indirect interaction," includes the influence of the gut microbiota on various body systems, such as gut microbiota-brain axis, gut microbiota-cardiopulmonary axis, and gut microbiota-oral axis. Additionally, we examine promising interventions aimed at reshaping the gut microbiota, including the use of probiotics, prebiotics, and fecal microbiota transplantation. The interaction between radiation injuries and gut microbiota is more complex than previously understood. Therefore, further clarification of the underlying mechanisms will facilitate the application of gut microbiota in preventing and alleviating radiation injuries.
PMID:40535532 | PMC:PMC12174693 | DOI:10.1177/17562848251347347
COVID-19's impact on heart and lung transplantation: Citation-based analysis of research output
World J Transplant. 2025 Jun 18;15(2):99992. doi: 10.5500/wjt.v15.i2.99992.
ABSTRACT
BACKGROUND: Since being declared as a pandemic on March 11, 2020, coronavirus disease 2019 (COVID-19) has profoundly influenced heart and lung transplant programs, impacting donor availability, patient management, and healthcare resources. This study offers a citation-based review of the research output on this subject, seeking to understand how the transplant community has responded to these challenges. Through a review of literature from the beginning of the pandemic to early 2023, we evaluate the shifts in academic emphasis and the emerging trends in heart and lung transplantation during the COVID-19 period.
AIM: To assess the impact of COVID-19 on heart and lung transplantation research, highlighting key themes, contributions, and trends in the literature during the pandemic.
METHODS: We conducted an extensive search of the Web of Science database on February 9, 2023. We employed the terms "transplant" and "transplantation", as well as organ-specific terms like "heart", "cardiac", and "lung", combined with COVID-19-related terms such as "COVID-19", "coronavirus", and "SARS-CoV-2". The search encompassed publications from March 11, 2020 to February 9, 2023. Data on authors, journals, countries, institutions, and publication types (articles, reviews, conference papers, letters, notes, editorials, brief surveys, book chapters, and errata) were analyzed. The data was visualized and processed with VOSviewer 1.6.18 and Excel.
RESULTS: We included 847 research items. There were 392 articles (46.3%) and 88 reviews (10.3%). The studies included were referenced 7757 times, with an average of 9.17 citations per article. The majority of the publications (n = 317) were conducted by institutes from the United States with highest citations (n = 4948) on this subject, followed by Germany, Italy, and France. The majority of papers (n = 101) were published in the Journal of Heart and Lung Transplantation.
CONCLUSION: To the fullest extent of our knowledge, this is the first bibliometric study of COVID-19's impact on heart and lung transplantation to offer a visual analysis of the literature in order to predict future frontiers and provide an overview of current research hotspots.
PMID:40535501 | PMC:PMC11886284 | DOI:10.5500/wjt.v15.i2.99992
Novel association between graft rejection and post-transplant malignancy in solid organ transplantation
World J Transplant. 2025 Jun 18;15(2):102384. doi: 10.5500/wjt.v15.i2.102384.
ABSTRACT
BACKGROUND: Advancements in immunosuppressive therapies have improved graft survival by enhancing graft tolerance and preventing organ rejection. However, the risk of malignancy associated with prolonged immunosuppression remains a concern, as it can adversely affect recipients' quality of life and survival. While the link between immunosuppression and increased cancer risk is well-documented, the specific interactions between graft rejection and post-transplant malignancy (PTM) remain poorly understood. Addressing this knowledge gap is crucial for devising immunosuppressive strategies that balance rejection prevention with cancer risk reduction.
AIM: To investigate whether immunosuppression in PTM reduces rejection risk, while immune activation during rejection protects against malignancy.
METHODS: We analyzed data from the United Network for Organ Sharing's Organ Procurement and Transplantation Network database (1987-2023) on adult, first-time, single-organ transplant recipients with no prior history of malignancy (in donors or recipients). Landmark analyses at 1, 2, 3, 5, 10, 15, and 20 years post-transplant, Kaplan-Meier analyses, and time-dependent Cox proportional hazards regression models, each incorporating the temporal dimension of outcomes, assessed the association between rejection-induced graft failure (RGF) and PTM. Multivariate models were adjusted for clinical and immunological factors, including immunosuppression regimens.
RESULTS: The cohort included 579905 recipients (kidney: 386878; liver: 108390; heart: 45046; lung: 37643; pancreas: 1948) with a mean follow-up of 7.3 years and a median age of 50.6 ± 13.2 years. RGF was associated with a reduction in PTM risk across all time points [hazard ratio (HR) = 0.07-0.20, P < 0.001], even after excluding mortality cases. Kidney transplant recipients exhibited the most pronounced reduction (HR = 0.22, P < 0.001). Conversely, among recipients with PTM, RGF risk decreased across all time points up to 15 years after excluding mortality cases (HR = 0.49-0.80, P < 0.001). This risk reduction was observed in kidney, liver, heart, and lung transplants (HRs = 0.90, 0.21, 0.21, and 0.18, respectively; P < 0.001) but not in pancreas transplants.
CONCLUSION: RGF reduces PTM risk, particularly in kidney transplants, while PTM decreases RGF risk in kidney, liver, heart, and lung transplants.
PMID:40535498 | PMC:PMC11886299 | DOI:10.5500/wjt.v15.i2.102384
Diagnostic accuracy and cost-effectiveness of the CAR-OLT score in predicting cardiac risk for liver transplantation
World J Transplant. 2025 Jun 18;15(2):99208. doi: 10.5500/wjt.v15.i2.99208.
ABSTRACT
BACKGROUND: The CAR-OLT score predicts major adverse cardiovascular events 1 year after liver transplant (LT).
AIM: To test the hypothesis that the CAR-OLT score may help avoid cardiac stress tests in LT candidates.
METHODS: This retrospective single-center cohort study included all adult patients undergoing elective evaluation for first cadaveric donor orthotopic LT for liver cirrhosis with or without hepatocellular carcinoma at Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricerca e Cura a Carattere Scientifico in Rome, Italy. Cardiac contraindications for LT listing were defined after a center-specific cardiac workup, which included cardiac stress tests for most patients. The diagnostic accuracy of the CAR-OLT score was evaluated using the area under the receiver operating characteristic (AUROC) method.
RESULTS: A total of 342 LT candidates were evaluated between 2015 and 2019, with a moderate cardiovascular risk profile (37% diabetes, 34% hypertension, 22% obesity). Of these, 80 (23%) candidates underwent coronary angiography. Twenty-one (6%) candidates were given cardiac contraindications to LT listing, 48% of which were due to coronary artery disease. The CAR-OLT score predicted cardiac contraindications to LT listing with an AUROC of 0.81. The optimal cut-off for sensitivity was a CAR-OLT score ≤ 23, which showed a 99% negative predictive value for cardiac contraindications to LT listing. A total of 84 (25%) LT candidates with a CAR-OLT score ≤ 23 underwent 87 non-invasive cardiac tests and 13 coronary angiographies pre-listing, with estimated costs of approximately 48000€. The estimated savings per patient was €574.70 for the Italian National Health System.
CONCLUSION: A CAR-OLT score ≤ 23 can identify LT candidates who can be safely listed without the need for cardiac stress tests, providing time and cost savings. These findings require external validation.
PMID:40535490 | PMC:PMC11886293 | DOI:10.5500/wjt.v15.i2.99208
Atrial arrhythmias following lung transplantation: A state of the art review
World J Transplant. 2025 Jun 18;15(2):101005. doi: 10.5500/wjt.v15.i2.101005.
ABSTRACT
Lung transplantation (LT) is now an accepted therapy for end stage lung disease in appropriate patients. Atrial arrhythmias (AA) can occur after LT. Early AA after LT are most often atrial fibrillation, whereas late arrhythmias which occur many months or years after LT are often atrial tachycardia. The causes of AA are multifactorial. The review begins with a brief history of LT and AA. This review further describes the pathophysiology of the AA. The risk factors, incidence, recipient characteristics including intra-operative factors are elaborated on. Since there are no clear and specific guidelines on the management of atrial arrhythmia following LT, the recommended guidelines on the management of AA in general are often extrapolated and used in the setting of post LT arrhythmia. The strategy of rate control vs rhythm control is discussed. The pros and cons of various drug regimen, need for direct current cardioversion and catheter ablation therapies are considered. Possible methods to prevent or reduce the incidence of AA after LT are considered. The impact of AA on the short-term and long-term outcomes following LT is discussed.
PMID:40535489 | PMC:PMC11886302 | DOI:10.5500/wjt.v15.i2.101005
Venous thromboembolism following lung transplantation
World J Transplant. 2025 Jun 18;15(2):99241. doi: 10.5500/wjt.v15.i2.99241.
ABSTRACT
Lung transplantation (LT) is currently a surgical therapy option for end-stage lung disease. Venous thromboembolism (VTE), which can occur after LT, is associated with significant morbidity and mortality. Because of improved outcomes, increasing numbers of patients are receiving LT as treatment. Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms. These factors contribute to a heightened risk of postoperative VTE. Furthermore, patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT. Bleeding and thromboembolism are common in these patients. Pulmonary embolism (PE) in a freshly transplanted lung can have significant effects leading to morbidity and mortality. PE typically leads to impairment of gas exchange and right ventricular strain. In LT, PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction. This article discussed the incidence, clinical features and diagnosis of VTE after LT. Furthermore, the treatment modalities, complications, and outcomes of VTE were reviewed.
PMID:40535488 | PMC:PMC11886300 | DOI:10.5500/wjt.v15.i2.99241
Cardiac transplantation: A review of current status and emerging innovations
World J Transplant. 2025 Jun 18;15(2):100460. doi: 10.5500/wjt.v15.i2.100460.
ABSTRACT
Heart transplantation (HTx) is a life-saving procedure for patients with end-stage heart failure and has undergone remarkable advancements since the first successful transplant in 1967. The introduction of cyclosporine in the 1970s significantly improved patient outcomes, leading to a global increase in transplants, including in India, where the practice has grown despite initial challenges. This review provides an extensive overview of HTx, focusing on current practices, technological advancements, and the ongoing challenges the field faces today. It explores the evolution of surgical techniques, such as minimally invasive and robotic-assisted procedures, and the management of posttransplant rejection through tailored immunosuppressive strategies, including new monoclonal antibodies and personalized therapies. The review also highlights emerging innovations such as mechanical circulatory support devices and xenotransplantation as potential solutions to donor shortages while acknowledging the ethical and logistical challenges these approaches entail. Furthermore, the analysis delves into the implications of using extended-criteria donors and the role of multidisciplinary teams in evaluating absolute and relative contraindications. Despite the progress made, the persistent issues of organ scarcity and ethical concerns underscore the need for ongoing research and innovation to further enhance the efficacy, safety, and accessibility of HTx.
PMID:40535486 | PMC:PMC11886295 | DOI:10.5500/wjt.v15.i2.100460
Successful pediatric heart transplantation with bivalirudin use in a cyanotic single ventricle patient with an intracorporeal continuous flow ventricular assist device and heparin-induced thrombocytopenia
Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):933-936. doi: 10.1007/s12055-024-01892-6. Epub 2025 Jan 7.
ABSTRACT
We describe a case of profound coagulopathy during orthotopic heart transplantation in a cyanotic single ventricle pediatric patient with an intracorporeal continuous flow ventricular assist device performed on bivalirudin for heparin-induced thrombocytopenia. This was successfully managed with central veno-arterial extracorporeal membrane oxygenation and hemofiltration as an adjunct to treat bivalirudin-induced coagulopathy due to lack of a reversal agent for bivalirudin.
PMID:40535220 | PMC:PMC12170461 | DOI:10.1007/s12055-024-01892-6
Ventricular assist devices in functionally univentricular hearts
Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):892-905. doi: 10.1007/s12055-025-01900-3. Epub 2025 Apr 17.
ABSTRACT
The enhanced survival rates of patients with functionally univentricular hearts can be credited to the ongoing development of surgical techniques and improved perioperative care. Hence, the population of single ventricle patients reaching the treating physician is increasing. Many of these patients go on to develop end-stage heart failure and may need a heart transplant. In this subgroup, the scarcity of donors calls for the potential necessity of employing mechanical circulatory support to facilitate heart transplantation. Ventricular assist devices are crucial in supporting the failing myocardium and improving systemic perfusion and tissue oxygenation. However, their implantation poses significant challenges due to the unique intrinsic anatomical and physiological characteristics of these patients. There is mounting evidence bolstering the use of ventricular assist devices in a subset of patients with functionally univentricular hearts. The purpose is to examine the evolution and current role of ventricular assist devices in this spectrum of patients, including its challenges and outcomes.
PMID:40535218 | PMC:PMC12170974 | DOI:10.1007/s12055-025-01900-3
Simultaneous optical recording of action potentials and calcium transients in cardiac single cells differentiated from type 1 CPVT-iPS cells
Front Physiol. 2025 Jun 4;16:1579815. doi: 10.3389/fphys.2025.1579815. eCollection 2025.
ABSTRACT
Numerous reports investigating channelopathies, including Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), have successfully reproduced using cardiomyocytes (CMs) differentiated from human induced pluripotent stem cells (hiPSCs). However, the relationship between action potentials (AP) and calcium transient waveforms-especially after drug treatment-remains unclear. In this study, we simultaneously loaded a membrane potential dye FluoVolt and the new calcium indicator CalbryteTM 590 AM and optimized stimulation and detection of both dyes to successfully obtain a higher signal-to-noise (S/N) ratio than the conventional membrane potential dye-red fluorescence Ca2+ dye combination, thus enabling the simultaneous recording of both AP and calcium transient waveforms in single hiPSC-CMs, which continued even after gradual increases in drug concentration. In drug-loading experiments on CPVT1 (RyR2-I4587V) hiPSC-derived ventricular-like CMs, carvedilol and flecainide demonstrated some effectiveness, while JTV519 at 3 µM exhibited both efficacy and alterations in AP waveforms. The Ca2+/calmodulin-dependent serine-threonine protein kinase II (CaMKII) inhibitor KN-93 at 1 µM was highly effective (93%) at reducing Ca2+ transient abnormalities without altering AP waveforms.
PMID:40534641 | PMC:PMC12175672 | DOI:10.3389/fphys.2025.1579815
Long-Term Survival and Patient-Reported Outcomes After Staged Reconstructive Surgery for Hypoplastic Left Heart Syndrome
J Am Coll Cardiol. 2025 Jun 24;85(24):2386-2398. doi: 10.1016/j.jacc.2025.04.028.
ABSTRACT
BACKGROUND: Survival for hypoplastic left heart syndrome (HLHS) and variants has improved over the past 4 decades; however, survival remains low compared with other forms of congenital heart disease. There is a paucity of data concerning long-term outcomes.
OBJECTIVES: This study aims to: 1) examine long-term survival and the impact of patient factors on survival for newborns with HLHS; and 2) examine functional and health outcomes, including quality-of-life (QOL) in adulthood.
METHODS: The study cohort included patients with HLHS and variants undergoing the Norwood or hybrid procedure between January 1984 and December 2023. Data on patient characteristics and management were abstracted from medical records. Vital status was ascertained by direct subject and family contact, review of the medical record, and publicly available data. Functional outcomes and QOL in adults (≥18 years of age) were assessed by patient reports. The primary outcome was death or cardiac transplantation at last follow-up.
RESULTS: In the study period, 2,012 neonates underwent staged reconstructive surgery for HLHS (Norwood, n = 1,921 and hybrid, n = 91). Transplant-free survival was 31.0% at 35 years. Transplant-free survival improved over time but is not different across recent eras. Most responders reported good to excellent general health.
CONCLUSIONS: In this cohort of newborns undergoing staged reconstructive surgery for HLHS, fewer than one-third are alive without a transplant at 35 years of age. Survival has not improved in recent years. However, there is a group of survivors who report good to excellent outcomes and QOL, consistent with a "high-performing" Fontan phenotype.
PMID:40533128 | DOI:10.1016/j.jacc.2025.04.028
Air toxins disorder the NF-kB Pathway leads to immune disorders and immune diseases in the human health
Ecotoxicol Environ Saf. 2025 Jun 17;302:118474. doi: 10.1016/j.ecoenv.2025.118474. Online ahead of print.
ABSTRACT
Air pollution poses a significant global health threat, largely due to its role in triggering chronic inflammation through molecular pathways. Among these, The NF-κB signaling cascade, comprising nuclear factor kappa-light-chain-enhancer elements in B lymphocytes, serves as a pivotal regulator in orchestrating innate defense mechanisms against anthropogenic contaminants through transcriptional activation processes.This review explores how air pollutants such as particulate matter (PM2.5), heavy metals, NF-κB signaling is activated by exposure to diesel exhaust, triggering the expression of inflammatory mediators including cytokines and chemokines with pro-inflammatory properties.The activation of this pathway involves upstream stimuli including Toll-like receptors (TLRs) and reactive oxygen species (ROS), Modified sentence：These processes serve to amplify pro-inflammatory signaling pathways. Prolonged activation of the NF-κB pathway is implicated in the pathogenesis of pulmonary disorders.cardiovascular conditions, and immune dysfunction. Understanding these mechanisms is crucial for identifying therapeutic targets and designing effective interventions. Strategies including the use of NF-κB inhibitors and public health regulations to reduce exposure are discussed as avenues for mitigating pollutant-induced inflammation and associated diseases.
PMID:40532606 | DOI:10.1016/j.ecoenv.2025.118474
Exploring the Synthesis and Self-Healing Properties of Zwitterionic Hydrogels: Recent Trends and Applications
Chem Biodivers. 2025 Jun 18:e03431. doi: 10.1002/cbdv.202403431. Online ahead of print.
ABSTRACT
Self-healing zwitterionic hydrogels (ZIHs) have sparked widespread attention because of their intriguing properties and potential applications. One of the key features of ZIHs is their inherent antifouling properties, making them appealing for various biomedical applications. A notable characteristic of ZIHs is their self-healing capability, enabling them to mend damage and restore their mechanical properties, hence prolonging their lifespans and enhancing their functionality. Self-healing ZIHs exhibit excellent properties as wound-dressing materials by creating a moist environment that promotes the healing process. In addition to their antifouling, self-healing, wound-healing, and wound-dressing applications, zwitterionic self-healing hydrogels have shown promise in cardiac tissue engineering and cell encapsulation. In cell encapsulation, ZIHs provide promising platforms for the encapsulation and delivery of numerous cell types, including stem cells and therapeutic cells, as well as enable controlled release and protection during transplantation. The self-healing feature of ZIHs provides long-term stability and durability of these materials. This review focuses on state-of-the-art advancements in the synthesis strategies, self-healing mechanisms, and applications of ZIHs, offering an integrated perspective not previously addressed in the literature.
PMID:40531749 | DOI:10.1002/cbdv.202403431
Reply Letter to "Reassessing the Chill: A Critical Perspective on SherpaPak Versus Ice Storage in Heart Transplantation"
ASAIO J. 2025 Jun 18. doi: 10.1097/MAT.0000000000002488. Online ahead of print.
NO ABSTRACT
PMID:40530717 | DOI:10.1097/MAT.0000000000002488
Application and validation of a newly developed lung donor (LUNDON) acceptability score for lung transplantation: a retrospective cohort study
J Thorac Dis. 2025 May 30;17(5):3297-3306. doi: 10.21037/jtd-2025-259. Epub 2025 May 28.
ABSTRACT
BACKGROUND: Organ shortage remains a considerable challenge in the field of lung transplantation. There is an urgent need now for a new standard that can include more donor lungs and expand the donor pool to benefit more patients. To increase lung utilization rates and facilitate the standardization of the lung donor evaluation process, Heiden et al. formulated a novel lung donor (LUNDON) acceptability score. Our study applied data from a Chinese hospital to this model to demonstrate the practicability of the new model and reveal its potential to expand the donor lung pool and improve the efficiency and success rate of lung transplantation.
METHODS: This study was conducted in one of the largest lung transplant centers in China. Our study retrospectively analyzed a cohort of patients who underwent lung transplantation in Wuxi People's Hospital, Jiangsu Province, China, between January 1, 2018 and December 31, 2022, and applied the same exclusion criteria as those described in Heiden et al.'s study. The LUNDON score is an integer score established based on the model. Higher scores correspond to an increased likelihood of lung acceptance.
RESULTS: A total of 553 donor lungs were used for transplantation. According to the LUNDON score, the donors' integer-based score ranged from 9 to 30 points, and the predicted probability of donor lung acceptance was about 6.0% to 95.3%. Utilization of low-LUNDON-score donors increased progressively over the study period. The LUNDON score demonstrated concordance with the lung acceptance rate as designated by the International Society for Heart and Lung Transplantation (ISHLT) standard score. There was a statistically significant difference in the survival rate between donors and recipients with high or low LUNDON scores (P=0.03). The survival rate at 1 year after transplantation was 66.1% for the high-score group and 55.7% for the low-score group. The LUNDON score, as a newly developed practical model, can promote a further understanding of donor lung assessment and has the potential to effectively expand the donor pool.
CONCLUSIONS: This study confirmed the practicability of the newly developed lung donor (LUNDON) scoring model. The LUNDON score was found to be a valuable tool and may revolutionize and optimize the allocation of scarce organ resources. It is possible that the novel model can be applied to various populations, expand the pool of potential available lungs, and enhance the efficiency and success of lung transplantation.
PMID:40529731 | PMC:PMC12170127 | DOI:10.21037/jtd-2025-259
Superior Waitlist Outcomes Among Patients Listed for Donation After Circulatory Death Heart Transplantation
JACC Heart Fail. 2025 Jun 16;13(8):102495. doi: 10.1016/j.jchf.2025.03.039. Online ahead of print.
ABSTRACT
BACKGROUND: Recent advances in heart procurement techniques have facilitated the utilization of hearts obtained after circulatory death. However, discerning the population that stands to benefit most requires an understanding of waitlist outcomes.
OBJECTIVES: The objective of this study was to evaluate waitlist and post-transplant outcomes among patients listed for donation after circulatory death (DCD) hearts in the United States, stratified by listing status.
METHODS: The UNOS (United Network for Organ Sharing) database was queried for all adult patients waitlisted for isolated heart transplantation between October 2018 and June 2024. Patients were stratified by approval for donation after brain death vs DCD hearts. DCD patients were subdivided into those who were DCD candidates at time of listing or later during their waitlist period. Waitlist and post-transplant outcomes were compared using Fine & Gray and Kaplan-Meier analyses.
RESULTS: A total of 24,970 patients were identified; of these, 8,191 (33%) were listed as DCD candidates. DCD status 2, 3, 4, and 6 patients were more likely to be transplanted and less likely to die on the waitlist. There were no differences in post-transplant survival in any group. Receipt of a DCD heart was not predictive of mortality. Patients initially listed as DCD candidates were significantly more likely to be transplanted than those who became DCD candidates later during their waitlist course.
CONCLUSIONS: With exception of status 1, patients waitlisted for DCD hearts experience shorter waitlist duration, improved rates of transplantation, and comparable long-term survival with donation after brain death recipients.
PMID:40527153 | DOI:10.1016/j.jchf.2025.03.039