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This article discusses the incidence and risk factors for malignancies in patients who have undergone heart transplantation at a single center. The study analyzed data from 296 patients who had undergone heart transplantation between September 2010 and August 2023. The overall incidence of malignancy was 8.8%, with skin cancer being the most common type. The study found that the switch to everolimus as part of the immunosuppression therapy did not reduce the incidence of malignancies. Early detection through close follow-up is important for improving the prognosis of these malignancies. [Extracted from the article]

This article discusses the use of temporary mechanical circulatory support (TMCS) as a bridge-to-transplant strategy for patients with cardiogenic shock who require a heart transplant. The study included 296 patients who underwent heart transplant, with 14 of them being on TMCS at the time of transplantation. The TMCS patients had higher rates of postoperative circulatory failure and mortality compared to patients without TMCS. The study highlights the complexity and critical preoperative state of TMCS patients and suggests that while heart transplantation is possible for these patients, their outcomes may be impaired. [Extracted from the article]

It was reported that mRNA-based Covid-19 vaccines rarely cause myocarditis. Although endomyocardial biopsy (EMB) is considered the gold standard for diagnosing myocarditis, no standardized study has been performed after Covid-19 vaccination in humans. Because routine EMB is frequently performed in heart transplant recipients (HTX), we aimed here to investigate effects of Covid-19 vaccination by analyzing myocardial inflammation with state-of-the-art quantitative immunohistochemistry. Consecutive patients after HTX who underwent routine EMB at a median of 167 days before and 136 days after the first Covid 19 vaccination with an mRNA vaccine were included and divided into groups with and without postvaccination inflammatory response, defined as increased CD3+ lymphocyte count >14/ mm2. Patients with evidence of rejection (ISHLT grade >1) or >14 CD3+ lymphocytes/mm2 at baseline were excluded. The final analysis included 46 patients with a mean age of 63 years and a time after HTX of 2.4 years. Thirty-six (78%) patients remained below the threshold of 14 CD3+ lymphocytes/mm2. However, in 10 (22%) recipients, we detected significant leukocyte infiltration by quantitative analysis of EMB after vaccination (4 vs. 33.7 leukocytes/ mm2, p=0.001). The groups did not differ with respect to age (63 vs. 57 years, p=0.21), body mass index (25 vs. 24 kg/m2, p=0.24), NYHA class (≥2 at 19 vs. 10%, p=0.4), NT-ProBNP levels (592 vs. 514 ng/l, p=0.55) or myocardial CD3+ cell count (4.9 vs. 2.6 cells/mm2, p=0.07) before vaccination. Patients with leukocyte infiltration remained clinically inapparent with stable NYHA class (≥2 in 10 vs. 20%, p=0.99) and did not have increased NT-ProBNP levels (514 vs. 478 ng/l, p=0.03). No hospitalizations for suspected myocarditis were reported. For the first time, we report subclinical myocardial leukocyte infiltration after Covid-19 mRNA vaccination in one in five patients without clinical sequelae during the short observation period. [ABSTRACT FROM AUTHOR]