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Incidence of increases in pump power use and associated clinical outcomes with an axial continuous-flow ventricular assist device [Letter]
Steffen, Robert J; Soltesz, Edward G; Miracle, Kimberly; Lee, Sangjin; Mountis, Maria; Moazami, Nader
PMID: 24418736
ISSN: 1557-3117
CID: 2465632
HLA and MICA allosensitization patterns among patients supported by ventricular assist devices
Askar, Medhat; Hsich, Eileen; Reville, Patrick; Nowacki, Amy S; Baldwin, William; Bakdash, Suzanne; Daghstani, Jenna; Zhang, Aiwen; Klingman, Lynne; Smedira, Nicholas; Moazami, Nader; Taylor, David O; Starling, Randall C; Gonzalez-Stawinski, Gonzalo
BACKGROUND: Ventricular assist devices (VADs) are increasingly being used as a bridge to transplantation and have been implicated as a risk factor for allosensitization to human leukocyte antigens (HLA). We investigate the association between VAD and allosensitization to human leukocyte antigens (HLA) and major-histocompatibility-complex (MHC) class I-related Chain A (MICA) antigens. METHODS: We considered all patients who received a VAD at our institution between 2000 and 2009; 89 of them had pre-VAD and post-VAD (=6 months after implant) HLA antibody screening. A control group of non-VAD heart transplant candidates was constructed with at least 2 pre-transplant panel-reactive antibody (PRA) tests within 8 months. Two controls were randomly selected/VAD patient matched for year (n = 178). Patients and controls with available sera from these time-points were tested by Luminex/flow PRA single-antigen beads and by MICA antibody Luminex single-antigen beads. Medical records were reviewed for comparison of pre-transplant immunologic risk factors and post-transplant outcomes between the 2 groups. RESULTS: Compared with controls, VAD patients had greater Class I differences between peak and initial PRA (18% vs. 0%, p < 0.0001) and higher peak PRA (24% vs. 6%, p < 0.0001). The differences between the 2 groups in Class II were less pronounced than in Class I. Of patients who had single-antigen testing, VAD implantation was significantly associated with development of new HLA antibody specificities (Class I and/or Class II) post-VAD with an increase in calculated PRA (cPRA) post-VAD compared with controls (16% vs. 0%, p < 0.0001). This risk was still present after adjusting for age, gender, pre-VAD PRA, transfusion and duration of follow-up in a multivariate analysis (p < 0.0001 and 0.02, respectively). There were no differences in development of MICA antibodies between the 2 groups (14% in both). There was no significant difference in the incidence of pre-transplant positive T-cell crossmatch, pre-transplant donor-specific HLA antibodies, rejection episodes or graft survival between the 2 groups. CONCLUSION: Our results suggest that VAD is associated with significant HLA allosensitization independent of common risk factors.
PMID: 24075503
ISSN: 1557-3117
CID: 2465662
Bivalirudin Bridging to Oral Anticoagulation After Left Ventricular Assist Device Implantation [Meeting Abstract]
Kantorovich, Alexander; Fink, Jodie M; Moazami, Nader; Militello, Michael A
ISI:000332162905337
ISSN: 1524-4539
CID: 2467192
Utility of the Psychosocial Assessment of Candidates for Transplantation (PACT) Scale in Patients Undergoing Mechanical Circulatory Support [Meeting Abstract]
Halkar, Meghana; Nowacki, Amy S; Kendall, Kay; Moazami, Nader; Gorodeski, Eiran Z; Tang, WHWilson; Starling, Randall C; Young, James B; Lee, Sangjin
ISI:000323142500164
ISSN: 1071-9164
CID: 2467182
Recovery of SERCA Protein Following LVAD Support: Heartmate vs Heartmate II [Meeting Abstract]
Sweet, Wendy E; Bennett, Mosi K; Karohl, Kristen L; Moazami, Nader; Starling, Randall C; Moravec, Christine S
ISI:000323142500050
ISSN: 1071-9164
CID: 2467172
Algorithm for the diagnosis and management of suspected pump thrombus
Goldstein, Daniel J; John, Ranjit; Salerno, Christopher; Silvestry, Scott; Moazami, Nader; Horstmanshof, Douglas; Adamson, Robert; Boyle, Andrew; Zucker, Mark; Rogers, Joseph; Russell, Stuart; Long, James; Pagani, Francis; Jorde, Ulrich
Pump thrombosis is a dreaded complication of long-term implantable ventricular assist devices. No guidance exists regarding the diagnosis and management of this entity despite its significant morbidity. After considerable thought and deliberation, a group of leading investigators in the field of mechanical support propose an algorithm for the diagnosis and management of this vexing entity based on clinical symptoms and serologic and imaging studies.
PMID: 23796150
ISSN: 1557-3117
CID: 2465672
Predictive Value of HLA Antibody Characteristics for Progression of Subclinical Antibody Mediated Rejection in Heart Transplant Recipients. [Meeting Abstract]
Askar, M; Rodriguez, E; Reville, P; Gatto, J; Schold, J; Daghstani, J; Zhang, A; Klingman, L; Starling, R; Moazami, N; Taylor, D; Tan, C
ISI:000318240300641
ISSN: 1600-6135
CID: 2467162
LV Unloading with Continuous-Flow Left Ventricular Assist Devices: The Association Between Left Ventricular Size and Late Survival [Meeting Abstract]
Nagpal, AD; Moazami, N; Kalavrouziotis, D; Tong, MZ; Hoercher, KJ; Lee, S
ISI:000316712100474
ISSN: 1053-2498
CID: 2467112
Late Onset Infection in Patients with Ventricular Assist Devices: Etiology, Management and Outcomes [Meeting Abstract]
Tong, MZ; Kalavrouzioutis, D; Nagpal, DA; Chamogeorgakis, T; Soltesz, EG; Smedira, NG; Lee, S; Moazami, N
ISI:000316712100495
ISSN: 1053-2498
CID: 2467132
Has the Incidence of Pump Thrombosis and Stroke in Patients with a HeartMate II Increased over Time? [Meeting Abstract]
Nagpal, AD; Hoercher, KJ; Tong, MZ; Kalavrouziotis, D; Lee, S; Moazami, N
ISI:000316712100059
ISSN: 1053-2498
CID: 2467062