On the June episode of JHLT: The Podcast, the Digital Media Editors explore two manuscripts from the June issue of The Journal of Heart and Lung Transplantation, with authors from the US and Denmark.

First, hear from senior author Steven R. Hays, MD, on his team's study "Design and implementation of a digital health home spirometry intervention for remote monitoring of lung transplant function," which explores digital health and comes out of UCSF. In the study, the authors developed an automated digital health intervention using Bluetooth-enabled home spirometers to monitor for complications after lung transplantation. Using a chat-based application, patients could perform home spirometry, answer symptom queries, and receive patient education. The program could also alert both the patient and center providers to substantial decreases in FEV1 from baseline—and any other concerning symptoms.

Dr. Hays and Digital Media Editors Erika Lease, MD, and Van-Khue Ton, MD, PhD, discuss how COVID-19 created a serendipitous moment to fund the study, and some of the most valuable lessons from the rollout of the program, including creating efficiencies among the transplant team, proper resourcing, and next steps for perfecting the program.

Next, the editors welcome first author Niels Moeslund, MD, PhD, from Aarhus University in Denmark, to discuss the paper, "Ex-situ oxygenated hypothermic machine perfusion in donation after circulatory death heart transplantation following either direct procurement or in-situ normothermic regional perfusion." In the study, authors set out to explore the use of oxygenated hypothermic machine perfusion as an alternative to in-situ normothermic regional perfusion or ex-situ normothermic machine perfusion of DCD hearts. They used a porcine model to simulate a DCD setting, and performed either normothermic regional perfusion and static cold storage; normothermic regional perfusion with hypothermic machine perfusion with the XVIVO heart preservation system; or direct procurement with hypothermic machine perfusion—all before heart transplantation was performed.

Digital Media Editor David Schibilsky, MD, digs in with Dr. Moeslund on the main findings of the study, in which HMP hearts showed better contractility after transplantation despite significantly lower inotropic support. Why? Dr. Moeslund shares that the hypothermia of HMP keeps metabolic activity low while myocytes are being replenished, creating maximum potential for energy restoration.

Follow along at www.jhltonline.org/current, or, if you're an ISHLT member, log in at ishlt.org/journal-of-heart-lung-transplantation. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.