Journal and News Scan

Patients younger than nineteen years old were included in a study developed to gain a better understanding of pediatric patients supported with ventricular assist devices (VADs). The authors found that illness at VAD implantation, diagnosis, and strategy of support affect survival and differ by device type. The study can act as a predictive tool to help providers make informed decisions.

ECMOSARS registry data was used to describe the characteristics and outcomes of COVID-19 patients undergoing either veno-arterial (VA) or veno-arterial venous (VAV) extracorporeal membrane oxygenation (ECMO). The authors concentrated on forty-seven patients, with a median age of forty-nine years, supported with VA or VAV-ECMO for refractory cardiogenic shock. Fourteen percent had a previous heart failure diagnosis. The two most common causes of cardiogenic shock were acute pulmonary embolism (30 percent) and myocarditis (28 percent). Thirty-eight percent of the patients underwent extracorporeal cardiopulmonary resuscitation (eCPR). In-hospital survival in the whole group was 28 percent (43 percent if eCPR patients were excluded). One day after ECMO cannulation, nonsurvivors had significantly more severe acidosis and higher FiO2. Several other factors were associated with death.
 
The authors concluded that VA-ECMO is a viable rescue therapy in carefully selected patients and suggested that eCPR is not a reasonable indication for ECMO in this group.

This paper looked at the immunotherapy agent Durvalumab used in the perioperative period for resectable NSCLC. A total of 802 patients were enrolled in the study, of which 400 received Durvalumab and the remaining 402 a placebo. The two primary endpoints measured were event-free survival and pathological complete resection. Perioperative Durvalumab plus neoadjuvant chemotherapy, as compared with neoadjuvant chemotherapy alone, was significantly associated with improved results in the two primary endpoints measured. Event-free survival was longer with Durvalumab. The stratified hazard ratio for disease progression, recurrence, or death was 0.68 (p=0.004.) At twelve months, event-free survival was observed with 73.4 percent of Durvalumab patients compared to 64.5 percent of placebo patients. The incidence of pathological complete response was significantly greater with Durvalumab then with placebo (17.2 percent and 4.3 percent respectively, p <0.001). Moreover, a benefit was seen regardless of PD-L1 expression and stage. 

An official press release from the University of Maryland School of Medicine announced the passing of Mr. Lawrence Faucette, the patient with terminal heart failure who received the world’s second genetically modified pig heart transplant. Mr. Faucette lived for nearly six weeks following the surgery and ultimately succumbed on October 30 due to acute organ rejection despite the initial early success and significant progress after surgery. The medical and scientist team in charge of the xenotransplantation program will conduct an extensive analysis to identify factors that can help to improve the outcome in future xenotransplantation.