HEART AND LUNG FAILURE, TRANSPLANTOLOGY
Meeting Update: International Society for Heart and Lung Transplantation 2014

The 34th annual meeting of the International Society for Heart and Lung Transplantation was convened in San Diego, California, USA on April 10-13, 2014. It was one of the best attended meetings ever with more than 3,000 attendees and the enthusiasm and excitement was palpable in the Manchester Grand Hotel where the meeting was held. This paper will describe a few of the most important contributions from this meeting, recognizing that with so many papers, it is certain that many worthwhile manuscripts will go unmentioned. The topics that will be highlighted are heart transplant trials, non-invasive detection of allograft rejection and vasculopathy, as well as mechanical circulatory support and extracorporeal membrane oxygenation (ECMO).

Heart transplant trials

Ardehali presented the results of the PROCEED II Trial [1]. This was an international, randomized non-inferiority trial to assess the clinical efficacy and safety of the Organ Care System (OCS device). The investigators compared OCS technology which keeps the heart beating in a normothermic fashion to cold storage prior to transplantation. A total of 128 heart transplant recipients were enrolled in the trial. There were no differences between the OCS and ice preservation groups in reference to incidences of cardiac adverse events, rejection and time spent in the ICU. The Proceed II trial also met the primary effectiveness and safety endpoints and success criteria for the Unites States Food and Drug Administration approval process. This is a very exciting trial as it sets the stage for further studies looking at the use of marginal donor hearts or standard criteria hearts which would require long travel times that render then unusable with the conventional ice preservation method.
There were several abstracts on the outcomes of the SCHEDULE trial [2-6]. This was a prospective, randomized multicenter 12-month Scandinavian trial where 115 de novo heart transplant recipients were randomized to everolimus with complete calcineurin inhibitor (CNI) withdrawal (EVE-group) 7-11 weeks after heart transplantation or standard CNI-based immunosuppression (CNI group). Ninety-five (83%) patients had matched intravascular ultrasound examinations (IVUS) at baseline and 12 months and were analyzed to measure change in maximal intimal thickness (MIT). Mean recipient age was 49.9 ± 13.1 years. The EVE group (n = 47) demonstrated significantly reduced cardiac allograft vasculopathy progression as...


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