{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:23:20Z","timestamp":1740137000384,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deutsches Herzzentrum Berlin"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Artif Organs"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Allograft failure secondary to rejection commonly requires a multimodal treatment, ultimately including mechanical circulatory support. A few case reports have demonstrated the use of Impella-devices due to its assumed favorable safety profile in this fragile cohort. However, this treatment option does not play a role in choice of anti-rejective therapy in clinical routine up to date. We summarize our institutional experiences and literature mini-review on Impella-based treatment strategies in allograft rejection after heart transplantation. In all seven cases, three from our institution and four reported in the literature, Impella-based therapies led to hemodynamic stabilization in allograft failure secondary to rejection. Adverse events included hemolysis, non-fatal bleeding and in one patient a relevant aortic valve insufficiency occurred. All patients showed an improvement of allograft function. Two patients died in context of severe immunosuppression or late secondary organ failure. Based on the limited available data, we propose that Impella-mediated mechanical unloading represents a valuable option for hemodynamic stabilization in severe allograft failure due to rejection, enabling an initiation of causal therapy and thereby potentially representing an opportunity to prevent mortality. Furthermore, we hypothesize it might add to the traditional therapeutic approaches by facilitating recovery by decompressing the myocardium in allograft rejection.<\/jats:p>","DOI":"10.1007\/s10047-021-01266-4","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T16:03:33Z","timestamp":1618243413000},"page":"307-311","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanical unloading by miniature axial flow pumps in late cardiac allograft failure due to acute rejection"],"prefix":"10.1007","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-9387","authenticated-orcid":false,"given":"I. A.","family":"Just","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Potapov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Knosalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Schoenrath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"issue":"10","key":"1266_CR1","first-page":"1056","volume":"38","author":"DC Chambers","year":"2019","unstructured":"Chambers DC, Cherikh WS, Harhay MO, et al. The International Thoracic-Organ-Transplant-Registry of the International Society for Heart and Lung Transplantation: thirty-sixth adult heart transplantation report-2019. JHLT. 2019;38(10):1056\u201366.","journal-title":"JHLT"},{"issue":"2","key":"1266_CR2","first-page":"116","volume":"12","author":"C Tschoepe","year":"2019","unstructured":"Tschoepe C, VanLinthout S, Klein O, et al. Mechanical unloading by fulminant myocarditis: LV-IMPELLA, ECMELLA BI-PELLA and PROPELLA concepts. J CardiovascTransl Res. 2019;12(2):116\u201323.","journal-title":"J CardiovascTransl Res"},{"key":"1266_CR3","first-page":"S38","volume":"38","author":"S January","year":"2019","unstructured":"January S, Pottebaum A, Raymer D, et al. Tocilizumab for antibody-mediated rejection in the setting of cardiac allograft vasculopathy. JHLT. 2019;38:S38\u20139.","journal-title":"JHLT"},{"key":"1266_CR4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1177\/2048872619865891","volume":"9","author":"M Karami","year":"2020","unstructured":"Karami M, den Uil CA, Ouweneel DM, et al. Mechanical circulatory support in cardiogenic shock from acute myocardial infarction: Impella CP\/5.0 versus ECMO. Eur Heart J Acute Cardiovasc Care. 2020;9:164\u201372.","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"1266_CR5","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.athoracsur.2008.12.036","volume":"88","author":"G Samoukovic","year":"2009","unstructured":"Samoukovic G, Al-Atassi T, Rosu C, et al. Successful treatment of heart failure due to acute transplant rejection with the Impella LP 5.0. Ann ThoracSurg. 2009;88:271\u20133.","journal-title":"Ann ThoracSurg"},{"key":"1266_CR6","first-page":"E37","volume":"22","author":"AT Beyer","year":"2010","unstructured":"Beyer AT, Hui PY, Haeusslein E. TheImpella 2.5 L for percutaneous mechanical circulatory support in severe humoral allograft rejection. J Invasive Cardiol. 2010;22:E37-39.","journal-title":"J Invasive Cardiol"},{"key":"1266_CR7","first-page":"93","volume":"29","author":"V Rajagopal","year":"2010","unstructured":"Rajagopal V, Steahr G, Wilmer CI, et al. A novel percutaneous mechanical biventricular bridge to recovery in severe cardiac allograft rejection. JHLT. 2010;29:93\u20135.","journal-title":"JHLT"},{"key":"1266_CR8","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/j.1540-8191.2012.01454.x","volume":"27","author":"R Chandola","year":"2012","unstructured":"Chandola R, Cusimano R, Osten M, et al. Severe aortic insufficiency secondary to 5L Impella device placement. J Card Surg. 2012;27:400\u20132.","journal-title":"J Card Surg"},{"key":"1266_CR9","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1097\/MAT.0000000000000732","volume":"64","author":"JJ Lasa","year":"2018","unstructured":"Lasa JJ, Castellanos DA, Denfield SW, et al. Acute biventricular percutaneous Impella ventricular assist device use in pediatric patients. ASAIO J. 2018;64:134\u20137.","journal-title":"ASAIO J"},{"key":"1266_CR10","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1111\/aor.13558","volume":"44","author":"AA Ankola","year":"2020","unstructured":"Ankola AA, McAllister J, Turner ME, et al. Biventricular Impella use in pediatric patients with severe graft dysfunction from acute rejection after heart transplantation. Artif Org. 2020;44:100\u20135.","journal-title":"Artif Org"}],"container-title":["Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10047-021-01266-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10047-021-01266-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10047-021-01266-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T03:26:58Z","timestamp":1629689218000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10047-021-01266-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["1266"],"URL":"https:\/\/doi.org\/10.1007\/s10047-021-01266-4","relation":{},"ISSN":["1434-7229","1619-0904"],"issn-type":[{"type":"print","value":"1434-7229"},{"type":"electronic","value":"1619-0904"}],"subject":[],"published":{"date-parts":[[2021,4,12]]},"assertion":[{"value":"24 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"FS reports non-financial support from Medtronic, grants from Novartis and Abbott and personal fees from Cardiorentis outside of the submitted work. EP reports institutional grants and consulting from Abbott, Medtronic and Abiomed outside of the submitted work. IAJ and CK have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Data resulted from clinical standard of care and was analyzed retrospectively, according to approval by the local ethics committee of Charit\u00e9 Universit\u00e4tsmedizin Berlin (EA2\/016\/20).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Collection and analysis of data were performed in accordance with the data protection act of the local authorities in Berlin.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}