JHLT: The Podcast

The Journal of Heart and Lung Transplantation podcast features editor Daniel Goldstein, MD, in round table talks with the JHLT's digital media editors.

Episode 62: Apixaban Plasma Levels in Patients with HeartMate 3 04/10/2025

Episode 61: Is Sotatercept safe in patients with PAH? 04/02/2025

Episode 60: Riociguat in patients with PAH and Cardiometabolic Comorbidities 03/18/2025

Episode 59: Rewarming Ischemia Time in Lung Transplantation 03/05/2025

Episode 58: Sympathetic Reinnervation 02/20/2025

Episode 57: Trends and Outcomes in EVLP 02/05/2025

Episode 56: The Best Studies of 2024 01/16/2025

Episode 55: Meet the Editors! 01/08/2025

Episode 54: Long-term follow up on the SCHEDULE trial 12/18/2024

Episode 53: Pollution exposure in the first 3 months post-lung transplant 12/04/2024

Episode 52: State of the art review on aortic Insufficiency in durable LVADs 11/20/2024

Episode 51: Can you be pragmatic about tMCS in Acute RV Failure? 11/06/2024

Episode 50: Age matching lung donors and recipients in Europe 10/16/2024

Episode 49: The Evaluation and Care of Cardiac Transplant Candidates 10/02/2024

Episode 48: A Tribute to Daniel R Goldstein 09/13/2024

Episode 47: An Interview with JHLT EIC Joe Rogers 09/04/2024

Episode 46: August 2024 08/14/2024

Episode 45: August 2024 08/07/2024

Episode 44: July 2024 07/03/2024

Episode 44: July 2024 On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the July issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Marty Tam, MD, a transplant cardiologist from the University of Michigan in Ann Arbor, hosts this episode. First, Dr. Tam and Digital Media Editor Erika Lease, MD, FCCP, interview their first guest, Daniel Calabrese, MD, first author on the study “.” The study’s authors sought to tackle challenges behind early detection of chronic lung allograft dysfunction (CLAD) by identifying biomarkers associated with acute lung allograft dysfunction (ALAD) progression to CLAD. To do this, they collected bronchoalveolar lavage (BAL) cells at the time of ALAD diagnosis and performed single cell RNA sequencing to identify significant differences in 26 unique cell populations across groups, with discordant CD8 T cells and macrophages providing the best discrimination between ALAD with decline from ALAD with recovery and controls. Dr. Calabrese discusses how his team identified the diagnostic criteria, why the biomarkers might lead ALAD to progress to CLAD, and how the findings might lead to early targeted therapies. Next, Dr. Tam joins and Digital Media Editor Khue Ton, MD and David Schibilsky, MD, to interview their next guest, David D’Alessandro, MD, the Surgical Director of Cardiac Transplantation and MCS at Massachusetts General Hospital in Boston. Dr. D’Alessandro was the first author on the study “,” which sought to assess the impact of the Paragonix SherpaPak Cardiac Transport System, a device allowing controlled hypothermic preservation, on rates of primary graft dysfunction (PGD) and post-transplant mortality. The key finding was that controlled hypothermic preservation was associated with a lower incidence of severe PGD – 6.6% compared to ice storage at 10.4%. In the conversation, Dr. D’Alessandro answers questions about the need for innovation over traditional ice cold storage, the greatest advantages of controlled hypothermic approaches, and the next steps in this research. Follow along at , or, if you’re an ISHLT member, access your Journal membership at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/31979052

Episode 43: June 2024 06/05/2024

Episode 43: June 2024 On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the June issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Van-Khue Ton, MD, a transplant cardiologist from Massachusetts General Hospital, hosts this episode. First, Dr. Ton and Digital Media Editor Marty Tam, MD, interview their first guests, first author Matthew Carey, MD, MBA, and senior author Justin Fried, MD, both of the Columbia University Irving Medical Center in New York City, on their study “.” This retrospective study of all patients receiving a HeartMate 3 LVAD at a single center between November 2014 and August 2020. The study evaluated findings related to patients with aortic root thrombosis, classified as having at least 1 echocardiogram or contrast-enhanced CT scan with thrombus. In the population of 197 patients, 19 had aortic root thrombus, which was ultimately associated with an increased risk of developing significant aortic regurgitation during the study period. Drs. Carey and Fried discuss whether aortic valve opening is associated with increased risk of aortic root thrombus, how to balance the bleeding-thrombosis scale in patients, and how the study fits in the context of prior generations of LVAD. Next, Dr. Ton joins and Digital Media Editor Erika Lease, MD, FCCP, to interview, Jacqueline DesJardin, MD, a Fellow in the department of medicine at the University of California San Francisco. Dr. DesJardin is first author on the study “.” PHAR is a multicenter US-based registry of patients with PAH, and this study analyzed 1,891 patients from the registry, 1,425 (75%) of whom were female. At baseline, compared to men, women had worse functional status and worse hemodynamics. Women were more likely to be on triple therapy or parenteral prostacyclin therapies at baseline. Interestingly, women had better survival than men, even after adjusting for numerous variables. In the discussion, Dr. DesJardin explains what collider stratification bias is, and how it may illuminate the complex epidemiological system that creates this disparity. She shares the three potential causal models posed in the study, and considers how the study might be followed up. Follow along at , or, if you’re an ISHLT member, access your Journal membership at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/31601037

Episode 42: May 2024 05/01/2024

Episode 41: April 2024 04/03/2024

Episode 40: March 2024 03/06/2024

Episode 39: February 2024 02/07/2024

Episode 38: January 2024 01/03/2024

Episode 37: December 2023 12/06/2023

Episode 37: December 2023 In our final episode of 2023, the JHLT Digital Media Editors have two manuscripts from the December 2023 issue of The Journal of Heart and Lung Transplantation! Digital Media Editor Erika Lease, MD, transplant pulmonologist at the University of Washington in Seattle, hosts this episode. First, a free-ranging conversation with first author Mark E. Snyder, MD, and senior author John F. McDyer, MD, on their team’s study “.” A subset of patients with idiopathic pulmonary fibrosis (IPF) have a heritable, age-adjusted short telomere length. Mutations in telomere length can manifest as T-cell dysfunction and immunodeficiency. As T-cells are involved in the development of acute cellular rejection (ACR), the authors hypothesized that the combination of age and telomere length would impact the degree of ACR burden in lung transplant recipients—and indeed, the authors found that lung transplant recipients with IPF and short telomere length had premature “aging” of their circulating T-Cells. There was a significant decline in early ACR burden with increasing age, found only in those with short telomere length. How might these findings impact immunosuppression regimens in clinical practice? What follow-up studies to they have planned? In the discussion, Drs. Snyder and McDyer, both of UPMC in Pittsburgh, discuss all these possibilities, as well as the the work of their collaborator, Jonathan K. Alder, PhD, as inspiration for the study. Next, the editors explored “,” in a discussion with senior author Snehal R. Patel, MD, of the Montefiore Medical Center in New York. Cardiac allograft vasculopathy (CAV) remains a major cause of death in heart transplant recipients, and donor-transmitted atherosclerosis (defined as a maximal intimal thickness of >/= 0.5mm on baseline intravascular ultrasound (IVUS) early after transplant) is believed to carry a greater risk for the development of CAV. Dr. Patel’s team, however, hypothesized that optical coherence tomography (OCT) may have advantages over IVUS as an imaging modality due to its higher resolution. In this prospective, observational study, the authors assessed the prognostic role of OCT, and found that transplant recipients whose OCT imaging showed advanced plaque characteristics had a significantly higher event rate after a mean follow up of 3.3 years. OCT was also an independent predictor of clinic events, while maximal intimal thickness of >/= 0.5mm was not. In the episode, Dr. Patel shares the key features of OCT that may make it of clinical use, the three risk categories developed for the study, and what the follow-ups might be. Follow along at , or, if you’re an ISHLT member, log in at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/28939878

Episode 36: November 2023 11/01/2023

Episode 36: November 2023 It’s pulmonary hypertension month on JHLT: The Podcast! The JHLT Digital Media Editors explore two PVD-related manuscripts from the November issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Marty Tam, MD, assistant professor in the division of cardiovascular medicine at the University of Michigan, hosts this episode. First, hear from first author Zvonimir Rako, MD, on his team’s study “.” The right ventricle (RV) has a complex contraction pattern. For patients with pulmonary hypertension (PH), right ventricular to pulmonary artery (RV-PA) coupling is important when considering how the RV responds to increases in afterload. Uncoupling occurs with progressive disease and the degree of uncoupling can be derived from pressure–volume loop analysis as the ratio between end-systolic and arterial elastance (Ees/Ea). In this exploratory analysis of the prospective EXERTION study, the authors determined the relationship between RV contraction patterns and RV-PA coupling in patients with PH. They also correlated RV contraction patterns to hemodynamic risk profiles. For details on what the study found about how PH programs can use the results in their practice, listen to the discussion in the episode. Next, the editors explored the study “.” The podcast hosted first author Justin C.Y. Chan, MD, MPhil and senior author Marc de Perrot, MD, MSc, FRCSC. The impact of sex on long-term outcomes after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension (CTEPH) has remained unclear. The authors of this study sought to evaluate the early and long-term outcomes after pulmonary endarterectomy to see if sex had an impact on the risk of residual pulmonary hypertension and need for targeted PH medical therapy. For details on what this retrospective single-center study found, including the mechanics of sex differences and the potential changes to clinical approach, check out the episode. Follow along at , or, if you’re an ISHLT member, log in at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/28461506

Episode 35: October 2023 10/04/2023

Episode 35: October 2023 The JHLT Digital Media Editors explore two manuscripts from the October issue of The Journal of Heart and Lung Transplantation—the first on lung transplantation in patients with stacked risks, and the second on bacterial pathogens found at driveline exit sites in patients with ventricular assist devices. Digital Media Editor Marty Tam, MD, assistant professor in the division of cardiovascular medicine at the University of Michigan, hosts this episode. First, hear from senior author Edward Cantu, MD, MSCE, on his team’s study “.” Lung transplant centers are increasingly evaluating patients with multiple risk factors for adverse post-transplant outcomes, yet there is little data of the effects of these risks as they stack. The authors of the study used the UNOS registry data linked to the National Inpatient Sample (NIS) to create a national encounter-level sample of healthcare data in the United States, then applied a probabilistic matching algorithm using 7 variables and determined associations between mortality, length of stay, total charges, and disposition with the number of comorbidities. For details on what the study found about how these risks affected patient success—based on factors like mortality, length of stay, duration of mechanical ventilation, need for ECMO-salvage, total charges, and discharge to a skilled nursing facility—listen to the discussion in the episode. Next, the editors explored the study “.” While the authors weren’t able to join the episode, editors corresponded with senior author Monika Fürholz, MD, from the Bern University Hospital in Switzerland, before recording, and shared some of her insights. Driveline exit site infections commonly occur in patients with LVADs, and can be a source of recurrent or deeper infections. Bacterial colonization of driveline exit sites has not been well studied, and transition from colonization to infection is also not well understood. The authors of this paper sought to address this by conducting a prospective, observational, single-center cohort study which included systematic and routine collection of driveline exit site skin swabs being taken between June 2019 and December 2021, even in the absence of suspected driveline infection. Bacteria were identified and a subset of the samples underwent whole-genome sequencing. For details on what the study found, including a discussion of how the study findings might impact current practice, check out the episode. Follow along at , or, if you’re an ISHLT member, log in at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/28214246

Episode 34: September 2023 09/06/2023

Episode 34: September 2023 In this special issue of JHLT: The Podcast, the JHLT Digital Media Editors explore just one study—and devote the second half of the episode as a tribute to recently retired Editor-in-Chief, Dr. Daniel R. Goldstein. Digital Media Editor Van-Khue Ton, MD, heart failure and transplant cardiologist at Massachusetts General Hospital, hosts this episode. First, hear from senior author William F. Parker, MD, MS, PhD, on his team’s study “.” Dr. Parker is a pulmonary and critical care physician, health services researcher, and clinical medical ethicist, and he runs a R01 funded lab focusing on the allocation of scarce healthcare resources. In the study, Dr. Parker and colleagues set out to examine the Scientific Registry of Transplant Recipients (SRTR) to compare medical urgency of heart transplant patients listed with exception vs. those listed according to standard guidelines. The study’s main finding: after controlling for status as a time-varying covariate, candidates with an exception had a 45% lower hazard of waitlist mortality compared with standard criteria candidates. The Digital Media Editors want to know all the details and talk with Dr. Parker about the wait-list mortality and post-transplant survival of status 1, 2, 3, and 4 candidates, plus what next steps could be in ensuring a fair allocation system. The episode’s special tribute to Dr. Daniel R. Goldstein features Michelle Kittleson, MD, PhD, Interim Editor-in-Chief of JHLT; Andrew Gelman, PhD, Deputy Editor at JHLT; Andrew Fisher, FRCP, PhD, past president of ISHLT and Chair of the Publications Oversight Committee; Daniel Tyrrell, PhD, a former post-doc of Dr. Goldstein’s; and Judy Chen, PhD, a former immunology PhD student in Dr. Goldstein’s lab. These heartfelt tributes to Dr. Goldstein are worth a listen—and we thank Dr. Goldstein for his vision and leadership at the Journal. Follow along at , or, if you’re an ISHLT member, log in at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . /episode/index/show/thejhlt/id/27944358

Episode 33: August 2023 08/02/2023

Episode 33: August 2023 The JHLT Digital Media Editors explore two manuscripts from the August issue of The Journal of Heart and Lung Transplantation—the first on immunosuppression in pediatric heart transplantation, and the second TA-NRP in DCD lung transplantation. Digital Media Editor Van-Khue Ton, MD, heart failure and transplant cardiologist at Massachusetts General Hospital, hosts this episode. First, hear from senior author Steven C. Greenway, MSc, MD, on his team’s study “.” Dr. Greenway shares his journey from enzyme biochemistry in mollusks, snails, and frogs to pediatric cardiology, then outlines the results of the paper. The study queried the Pediatric Heart Transplant Society’s registry to determine the efficacy and safety of monotherapy immunosuppression. The results showed better graft survival and less coronary allograft vasculopathy in the monotherapy group, even after adjusted for age at transplant, sex, neonatal transplant, infection, PTLD, and etiology of cardiomyopathy. Dr. Greenway and the digital media editors discuss the burning questions that obviously arise from the study’s findings, the limitations of the paper, and what follow-up studies might start generating the answers that might eventually change clinical practice. Next, the editors welcome first author Jad Malas, MD, to discuss the paper “.” This study utilized the United Network of Organ Sharing (UNOS) database to identify DCD donors whose heart was procured in order to evaluate lung utilization rates and early post-lung transplant outcomes. Lung utilization was similar between the groups—14.9% for the NRP group and 13.8% for direct procurement. Post-lung transplant rates of ECMO and mechanical ventilation at 72 hours were not statistically different, and 6-month survival was equivalent. Dr. Malas and the Digital Media Editors discuss the study’s findings and implications, including exploring the background of NRP’s relationship to lung allografts, differences in assessment or procurement techniques, and what might be needed to further evaluate this procurement technique for lung allografts. Follow along at , or, if you’re an ISHLT member, log in at . Don’t already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at for a free subscription, or subscribe today at . This episode of JHLT: The Podcast, but not the studies within, is sponsored by . /episode/index/show/thejhlt/id/27627330

JHLT: The Podcast

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