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Ann Thorac Surg ; 113(6): 1761-1766, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1956088
Clin Transplant ; 36(7): e14697, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1840388


The COVID-19 pandemic initially brought forth considerable challenges to the field of heart transplantation. To prevent the spread of the virus and protect immunocompromised recipients, our center made the following modifications to post-transplant outpatient management: eliminating early coronary angiograms, video visits for postoperative months 7, 9, and 11, and home blood draws for immunosuppression adjustments. To assess if these changes have impacted patient outcomes, the current study examines 1-year outcomes for patients transplanted during the pandemic. Between March and September 2020, we assessed 50 heart transplant patients transplanted during the pandemic. These patients were compared to patients who were transplanted during the same months between 2011 and 2019 (n = 482). Endpoints included subsequent 1-year survival, freedom from cardiac allograft vasculopathy, any-treated rejection, acute cellular rejection, antibody-mediated rejection, nonfatal major adverse cardiac events (NF-MACE), and hospital and ICU length of stay. Patients transplanted during the pandemic had similar 1-year endpoints compared to those of patients transplanted from years prior apart from 1-year freedom from NF-MACE which was significantly higher for patients transplanted during the pandemic. Despite necessary changes being made to outpatient management of heart transplant recipients, heart transplantation continues to be safe and effective with similar 1-year outcomes to years prior.

COVID-19 , Heart Transplantation , COVID-19/epidemiology , Graft Rejection/etiology , Graft Rejection/prevention & control , Humans , Pandemics , Retrospective Studies , Transplant Recipients
Ann Thorac Surg ; 113(5): 1401-1404, 2022 May.
Article in English | MEDLINE | ID: covidwho-1821141
Clin Transplant ; 34(10): e14029, 2020 10.
Article in English | MEDLINE | ID: covidwho-635403


As the SARS-CoV-2-pandemic continues to unfold, the number of heart transplants completed in the United States has been declining steadily. The current case series examines the immediate short-term outcomes of seven heart transplant recipients transplanted during the SARS-CoV-2 pandemic. We hope to illustrate that with proper preparation, planning, and testing, heart transplantation can be continued during a pandemic. We assessed 7 patients transplanted from March 4, 2020, to April 15, 2020. The following endpoints were noted: in-hospital survival, in-hospital freedom from rejection, in-hospital nonfatal major cardiac adverse events (NF-MACE), severe primary graft dysfunction, hospital length of stay, and ICU length of stay. There were no expirations throughout the hospital admission. In addition, there were no patients with NF-MACE or treated rejection, and 1 patient developed severe primary graft dysfunction. Average length of stay was 17.2 days with a standard deviation of 5.9 days. ICU length of stay was 7.7 days with a standard deviation of 2.3 days. Despite the decreasing trend in completed heart transplants due to SARS-CoV-2, heart transplantation appears to be feasible in the immediate short term. Further follow-up is needed, however, to assess the impact of SARS-CoV-2 on post-heart transplant outcomes months after transplantation.

COVID-19/prevention & control , Heart Transplantation/methods , Infection Control/methods , Adult , Aged , COVID-19/epidemiology , COVID-19/etiology , California/epidemiology , Delayed Graft Function/epidemiology , Delayed Graft Function/prevention & control , Feasibility Studies , Female , Graft Rejection/epidemiology , Graft Rejection/prevention & control , Heart Transplantation/mortality , Hospital Mortality , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Outcome Assessment, Health Care , Pandemics , Patient Safety , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Retrospective Studies , Survival Analysis
Ann Thorac Surg ; 110(2): 725-732, 2020 08.
Article in English | MEDLINE | ID: covidwho-277167


Recommendations for the safe and optimized resumption of cardiac surgery care, research, and education during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) era were developed by a cardiovascular research consortium, based in 19 countries and representing a wide spectrum of experience with COVID-19. This guidance document provides a framework for restarting cardiac surgery in the outpatient and inpatient settings, in accordance with the current understanding of SARS-CoV-2, the risks posed by interrupted cardiovascular care, and the available recommendations from major societies.

Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Thoracic Surgery/organization & administration , Betacoronavirus , COVID-19 , Cardiac Surgical Procedures , Humans , Pandemics , SARS-CoV-2