JHLT: The Podcast

This month, JHLT: The Podcast reissues our September 2023 tribute to former Editor-in-Chief, Dr. Daniel R. Goldstein. Dr. Goldstein stepped down from his role for health reasons in July 2023; he had been diagnosed with an advanced salivary gland malignancy and felt he would be unable to continue serving JHLT and the International Society for Heart and Lung Transplantation (ISHLT) to his characteristically demanding standard.

Sadly, Dr. Goldstein died on 21 May, 2024, at the age of 56, leaving behind his wife, 2 children, an extended family, and a larger universe of colleagues, collaborators, and mentees who greatly benefited from his equanimity, wisdom, and commitment to his passions.

The tribute, recorded in August 2023, features Michelle Kittleson, MD, PhD, then-Interim Editor-in-Chief of JHLT; Andrew Gelman, PhD, Deputy Editor at JHLT; Andrew Fisher, FRCP, PhD, past president of ISHLT and Past 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.

Two funds were created to allow friends and colleagues to memorialize Dr. Goldstein: the Michigan Biology of Cardiovascular Aging Leadership Development Fund at the Frankel Cardiovascular Center (https://giving.umich.edu/give/393178) and the Adenoid Cystic Carcinoma Foundation (https://accrf.org).

The JHLT has also re-published Dr. Goldstein’s farewell message in the September 2024 issue of the Journal. You can read it here: https://www.jhltonline.org/article/S1053-2498(24)01741-8/fulltext

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.

In this special episode of JHLT: The Podcast, the Digital Media Editors connect with Joseph Rogers, MD, the new Editor-in-Chief of JHLT.

In the conversation, Dr. Rogers shares more about his vision for the Journal, how he plans to tackle the challenges and opportunities facing the publication, and a little about his life both inside and outside of medicine.

In addition to being the new Editor-in-Chief, Dr. Rogers is the President and CEO of the Texas Heart Institute in Houston, a past president of the ISHLT, and a prolific contributor to the field of heart and lung transplantation.

For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On the second August episode of JHLT: The Podcast, the Digital Media Editors discuss a paper from the August issue of JHLT, entitled “A modular simulation framework for organ allocation.”The episode is hosted by Digital Media Editor Erika Lease, MD, FCCP, a transplant pulmonologist from the University of Washington.

The guests for this episode are first author Johnie Rose, MD, PhD, of the Center for Community Health Integration at Case Western Reserve University School of Medicine, and lead author Maryam Valapour, MD, MPP, of the Department of Pulmonary Medicine at the Cleveland Clinic.

In the episode, Drs. Rose and Valapour share the findings from their study, and tackle questions about the limitations of simulation models, what makes their COMET model different from past Simulation Allocation Models (SAMs), and why they made the project open-source.

Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors discuss a brand new consensus document from the ISHLT entitled “Strategies to Prevent Hemocompatibility Related Adverse Events in Patients with a Durable, Continuous-Flow Ventricular Assist Device.” The episode is hosted by Digital Media Editor Erika Lease, MD, FCCP, a transplant pulmonologist from the University of Washington.

The consensus document’s lead author, Ian Hollis, PharmD, a heart failure pharmacist and Associate Professor from the University of North Carolina in Chapel Hill, joins the podcast to discuss the document.  During the discussion, he’s reunited with co-author and JHLT Podcast co-host Van-Khue Ton, MD, for a lively discussion of the document’s findings and takeaways.

If you work with heart failure patients with durable VADs, you’ll want to listen to this episode—and check out the complete document at ISHLT.

Stay tuned for a second episode later this month, where we’ll be talking about a modular simulation framework for organ allocation.

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 “Macrophage and CD8 T cell discordance are associated with acute lung allograft dysfunction progression.” 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 “Impact of controlled hypothermic preservation on outcomes following heart transplantation,” 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 www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

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 “Aortic Root Thrombosis in patients with HeartMate 3 left ventricular assist device support.”

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 “Investigating the “sex paradox” in pulmonary arterial hypertension: Results from the Pulmonary Hypertension Association Registry (PHAR).”

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 www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the May issue of The Journal of Heart and Lung Transplantation. Digital Media Editor David Schibilsky, MD, a cardiothoracic surgeon from Freiburg, Germany, hosts this episode.

First, Dr. Schibilsky and Digital Media Editor Erika Lease, MD, interview their first guest, Helen A. Hannan, the podcast’s first-ever undergraduate pre-medical guest, from the University of Michigan. Helen was the lead author on the study “Racial and Gender Disparities in Transplantation of Hepatitis C+ Hearts and Lungs.” The study noted that prior research in utilization of kidneys from donors with Hepatitis C had shown disparities due to gender and education—and wanted to see if this was the case in heart and lung donors as well.

Drs. Schibilsky and Lease chat with Helen about the findings of the study, including some of the interesting differences shown between heart and lung recipients, and the ramifications for better patient discussions at the clinical level.

Next, Dr. Schibilsky and Digital Media Editor Marty Tam, MD, interview their next guest, Lauren Truby, MD, of the University of Texas Southwestern Medical Center in Dallas. Dr. Truby is the podcast’s first return guest, having appeared on the show near the end of 2021. This time, she’s featured as first author on the study “Metabolomic profiling during ex situ normothermic perfusion before heart transplantation defines patterns of substrate utilization and correlates with markers of allograft injury.” The paper explores cardiac metabolism of donor hearts during recovery using an ex situ normothermic perfusion system (NRP).

Dr. Truby provides an in depth look at the project’s logistics—which she calls a “labor of love”—its multi-point findings, and what’s next in this line of research.

Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the April issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Erika Lease, MD, a transplant pulmonologist at the University of Washington in Seattle, hosts this episode.

First, Dr. Lease and Digital Media Editor Van-Khue Ton, MD interview their first guests, Paul J. Scheel III, MD and Steven Hsu, MD, both of Johns Hopkins University. Dr. Scheel was first author and Dr. Hsu was senior author on the study “Occult right ventricular dysfunction and right ventricular-vascular uncoupling in left ventricular assist device recipients.” The main finding of the study is that LVAD recipients have depressed intrinsic RV contractility and reduced RV compensation.

Drs. Scheel and Hsu give an overview of RV pressure-volume loops and their measurements, and discuss the impact of LVAD on intrinsic RV contractility, contractile reserve, and vascular coupling. If you want to know how these findings are important to clinical care, you’ll need to listen to the episode!

Next, Dr. Lease and Digital Media Editor David Schibilsky, MD, interview their next guest, Joshua Diamond, MD, of the University of Pennsylvania. Dr. Diamond was first author on the study “Development and validation of primary graft dysfunction predictive algorithm for lung transplant candidates.” The authors of the study set out to develop a clinically useful and generalizable PGD prediction model to aid in clinical decision making.

Dr. Diamond discusses the factors they considered in building the model, the model’s strengths over other approaches, and its limitations. Tune in to learn more!

Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the March issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Marty Tam, MD, an advanced heart failure and transplant cardiologist at University of Michigan in Ann Arbor, hosts this episode.

First, Dr. Tam and Digital Media Editor David Schibilsky, MD interview their first guests, Fiorella Calabrese, MD and Francesca Lunardi, MD, ScD, PhD, of University of Padova, in Padova Italy. Dr. Lunardi was first author and Dr. Calabrese was senior author on the study “Assessing the role of phosphorylated S6 ribosomal protein in the pathological diagnosis of pulmonary antibody-mediated rejection.” In the conversation, Drs. Calabrese and Lunardi share the main challenges in the current diagnostic algorithm for AMR in lung transplantation, and why this protein expression may be a future mainstay in evaluating patients with this condition.

Next, Dr. Tam and Digital Media Editor Van-Khue Ton, MD, interview their next guest, Benjamin Mackie, MD, of Tampa General Hospital. Dr. Mackie was senior author on the study “Relationship between blood and tissue-based rejection-related transcripts in heart transplantation.” In the conversation, Dr. Mackie shares the current state of rejection assessment, including new, non-invasive modalities, and how the relation between these diagnostic methods may inform clinical practice.

Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.

On this episode of JHLT: The Podcast, the JHLT Digital Media Editors explore two studies from the February issue of The Journal of Heart and Lung Transplantation. Digital Media Editor Van-Khue Ton, MD, a transplant cardiologist at Massachusetts General Hospital, hosts this episode.

First, Dr. Ton and Digital Media Editor Erika Lease, MD interview their first guest, David Jenkins, FRCS(Cth), of the Royal Papworth Hospital in Cambridge, UK. Dr. Jenkins was senior author on the study “Perioperative extracorporeal membrane oxygenation support for pulmonary endarterectomy: A 17-year experience from the UK national cohort.” In the conversation, Dr. Jenkins shares the major determinants of mortality in this patient population, differences between survivors and non-survivors, and the CTEPH classification systems involved.

Next, Dr. Ton is joined by Digital Media Editor Marty Tam, MD, to interview their next guest, Kevin Chen, a 4th year general surgery resident at Cedars-Sinai Medical Center. Dr. Chen was a first author on the study “Heart transplantation in patients from socioeconomically distressed communities.” Drs. Ton and Tam lead a lively discussion about this important paper, including the methodology behind the indices used to categorize patients, and the million-dollar question: why did patients from distressed communities fare more poorly?

Follow along at www.jhltonline.org/current, or, if you’re an ISHLT member, access your Journal membership at www.ishlt.org/jhlt.

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.