As the number of patients in need of heart or lung transplants continues to exceed the number of donor organs that are viable and available, many patients die while waiting for a transplant. Through the DONATE HCV Trial, a team at Brigham and Women’s Hospital is expanding the donor pool by enabling transplantation from hepatitis C-infected donors.
In a recent publication in the New England Journal of Medicine, a multidisciplinary team of experts from Brigham and Women’s Hospital reported a 100 percent success rate for transplant recipients who received lungs or a heart infected with hepatitis C (HCV).
Six months after transplantation, patients remained hepatitis C free and had functioning transplanted organs. The trial showed that a four-week antiviral treatment regimen started immediately following organ transplantation prevented HCV infection in all patients and led to excellent outcomes. Given the success of the trial, enrollment continues.
The DONATE HCV Trial is the largest clinical trial to date for HCV thoracic organ transplantation. “If even half the other centers in the United States were to adopt the Brigham protocol, we would, in fact, shorten the time to transplantation by nearly half,” says Mandeep Mehra, MD, medical director of the Heart & Vascular Center at Brigham and Women’s Hospital. The team has enrolled 69 participants to date.
In the above video, hear more from the investigators pioneering this trial, including:
- Hilary Goldberg, MD, MPH, Medical Director, Lung Transplant
- Mandeep R. Mehra, MD, Medical Director, Heart & Vascular Center
- Lindsey R. Baden, MD, MSc, Infectious Disease
- Ann E. Woolley, MD, MPH, Infectious Disease
- Hari R. Mallidi, MD, Surgical Director, Heart and Lung Transplant
The PARTNER-3 Continued Access Trial: TAVR in low-risk patients
Brigham and Women’s Hospital is one of two centers in New England currently participating in the PARTNER 3 Continued Access Trial that offers transcatheter aortic valve replacement (TAVR) to low-risk patients undergoing valve replacement for severe aortic stenosis.
All patients who undergo a cardiac procedure at the Aortic Disease Center are placed on a list. After discharge, these patients are systematically followed via a robust post-operative tracking system. Issues that crop up are spotted fast.
Catheter ablation has become an important therapy for patients with ventricular tachycardia (VT). However, it has been a challenge to access arrhythmia sources deep within the heart muscle with the use of conventional approaches.
It’s estimated that approximately 168,000 TAVR procedures will be performed annually in the United States. According to Pinak Bipin Shah, MD, most TAVR programs grew quickly after the FDA decreased the risk-level indication, but many programs have plateaued.
Building on pioneering work performed during the first wave of heart-lung transplantation, Brigham and Women’s Hospital has resumed its heart-lung program and is once again performing the rare procedure.
On November 10, 2018, the American Heart Association (AHA) held its annual Scientific Sessions meeting, featuring the latest advances from major cardiovascular trials with the potential to transform clinical practice. Investigators from the Brigham led some of the most highly anticipated trials and presented their results at the conference.
On October 19th, 2018, the HeartMate 3 Left Ventricular Assist System (LVAD) was approved by the FDA as a destination therapy for patients with advanced heart failure who are not eligible for a heart transplant.
In April 2018, the Brigham and Women’s Hospital (BWH) Heart & Vascular Center became the first in New England to perform their 1,000th transcatheter aortic valve replacement (TAVR) procedure.
The hybrid operating room at the Brigham and Women’s Hospital Heart & Vascular Center now features the state-of-art ARTIS Pheno angiography system. As of March 2018, patients who require hybrid cardiovascular interventions combining intravascular and open surgical procedures are reaping the rewards of this cutting-edge technology.