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2. Harmonizing Guidelines and Other Clinical Practice Documents: A Joint Comprehensive Methodology Manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS)

Author

Milojevic, Milan, Freemantle, Nick, Hayanga, J.W. Awori, Kelly, Rosemary F., Myers, Patrick O., Petersen, René Horsleben, Opitz, Isabelle, Sabik, Joseph F., III, and Bakaeen, Faisal G.

Published
2025
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8. Harmonizing guidelines and other clinical practice documents: A joint comprehensive methodology manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic...

Author

Milojevic, Milan, Freemantle, Nick, Hayanga, J.W. Awori, Kelly, Rosemary F., Myers, Patrick O., Petersen, René Horsleben, Opitz, Isabelle, Sabik III, Joseph F., and Bakaeen, Faisal G.

Abstract

[Display omitted] [ABSTRACT FROM AUTHOR]

Published
2025
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10. The 2024 American Association for Thoracic Surgery expert consensus document: Current standards in donor lung procurement and preservation.

Author

Kukreja, Jasleen, Campo-Canaveral de la Cruz, Jose Luis, Van Raemdonck, Dirk, Cantu, Edward, Date, Hiroshi, D'Ovidio, Frank, Hartwig, Matthew, Klapper, Jacob A., Kelly, Rosemary F., Lindstedt, Sandra, Rosso, Lorenzo, Schaheen, Lara, Smith, Michael, Whitson, Bryan, Saddoughi, Sahar A., and Cypel, Marcelo

Abstract

Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure. The objective of the American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC) expert panel was to make evidence-based recommendations for best practices in donor lung procurement and preservation based on review of the existing literature. The AATS CPSC assembled an expert panel of 16 lung transplantation surgeons from 14 centers who developed a consensus document of recommendations. The panel was divided into 7 subgroups covering (1) intraoperative donor assessment, (2) surgical techniques, (3) ex situ static lung preservation methods, (4) hypothermic preservation, (5) normothermic ex vivo lung perfusion (EVLP), (6) donation after circulatory death (DCD) and normothermic regional perfusion, and (7) donor management centers, organ assessment centers, and third-party procurement teams. Following a focused literature review, each subgroup formulated recommendation statements for each subtopic, which were reviewed and further refined using a Delphi process until a 75% consensus was achieved on each final statement by the voting group. The expert panel achieved consensus on 34 recommendations for current best practices in donor lung procurement and preservation both in brain-dead as well as DCD donation. The use of new methods of cold preservation, the role of EVLP, and DCD with and without concomitant heart donation are described in detail. Consistent and best practices in donor lung procurement and preservation are critical to improve both lung transplantation numbers as well as recipient outcomes. The recommendations described here provide guidance for professionals involved in the care of patients with end-stage lung disease considered for transplantation. [ABSTRACT FROM AUTHOR]

Published
2025
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11. Harmonizing guidelines and other clinical practice documents: A joint comprehensive methodology manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS)

Author

Milojevic, Milan, Freemantle, Nick, Hayanga, J W Awori, Kelly, Rosemary F, Myers, Patrick O, Petersen, René Horsleben, Opitz, Isabelle, Sabik, Joseph F, and Bakaeen, Faisal G

Subjects
CLINICAL decision support systems, MEDICAL personnel, EXPRESSED sequence tag (Genetics), CONTRACTS, MEDICAL personnel as patients, THORACIC surgery
Abstract

The article discusses the collaborative effort of the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS) to establish a comprehensive methodology manual for developing clinical practice guidelines (CPGs). The document emphasizes the importance of evidence-based recommendations, rigorous validation, and continuous updates to ensure relevance and trustworthiness. It outlines the process of creating CPGs, including selecting writing committee members, conducting systematic literature reviews, formulating recommendations, achieving consensus through voting, and undergoing external validation before publication. The article also highlights the dissemination and implementation of CPGs, addressing gaps in knowledge, future perspectives, and the need for continuous learning and flexibility in guideline development. [Extracted from the article]

Published
2024
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39. An Adjuvant Stem Cell Patch with Coronary Artery Bypass Graft Surgery Improves Diastolic Recovery in Porcine Hibernating Myocardium.

Author

Aggarwal, Rishav, Potel, Koray N., Shao, Annie, So, Simon W., Swingen, Cory, Reyes, Christina P., Rose, Rebecca, Wright, Christin, Hocum Stone, Laura L., McFalls, Edward O., Butterick, Tammy A., and Kelly, Rosemary F.

Subjects
CORONARY artery bypass, INTERNAL thoracic artery, DIASTOLE (Cardiac cycle), CARDIAC magnetic resonance imaging, STEM cells, MESENCHYMAL stem cells, MYOCARDIUM
Abstract

Diastolic dysfunction persists despite coronary artery bypass graft surgery (CABG) in patients with hibernating myocardium (HIB). We studied whether the adjunctive use of a mesenchymal stem cells (MSCs) patch during CABG improves diastolic function by reducing inflammation and fibrosis. HIB was induced in juvenile swine by placing a constrictor on the left anterior descending (LAD) artery, causing myocardial ischemia without infarction. At 12 weeks, CABG was performed using the left-internal-mammary-artery (LIMA)-to-LAD graft with or without placement of an epicardial vicryl patch embedded with MSCs, followed by four weeks of recovery. The animals underwent cardiac magnetic resonance imaging (MRI) prior to sacrifice, and tissue from septal and LAD regions were collected to assess for fibrosis and analyze mitochondrial and nuclear isolates. During low-dose dobutamine infusion, diastolic function was significantly reduced in HIB compared to the control, with significant improvement after CABG + MSC treatment. In HIB, we observed increased inflammation and fibrosis without transmural scarring, along with decreased peroxisome proliferator-activated receptor-gamma coactivator (PGC1α), which could be a possible mechanism underlying diastolic dysfunction. Improvement in PGC1α and diastolic function was noted with revascularization and MSCs, along with decreased inflammatory signaling and fibrosis. These findings suggest that adjuvant cell-based therapy during CABG may recover diastolic function by reducing oxidant stress–inflammatory signaling and myofibroblast presence in the myocardial tissue. [ABSTRACT FROM AUTHOR]

Published
2023
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48. Novel Therapeutic Approaches Enhance PGC1-alpha to Reduce Oxidant Stress-Inflammatory Signaling and Improve Functional Recovery in Hibernating Myocardium.

Author

Aggarwal, Rishav, Potel, Koray N., McFalls, Edward O., Butterick, Tammy A., and Kelly, Rosemary F.

Subjects
THERAPEUTICS, CORONARY artery bypass, MYOCARDIUM, MYOCARDIAL ischemia, HEART, CORONARY disease
Abstract

Ischemic heart disease affects millions of people around the world. Current treatment options, including coronary artery bypass grafting, do not result in full functional recovery, highlighting the need for novel adjunctive therapeutic approaches. Hibernation describes the myocardial response to prolonged ischemia and involves a set of complex cytoprotective metabolic and functional adaptations. PGC1-alpha, a key regulator of mitochondrial energy metabolism and inhibitor of oxidant-stress-inflammatory signaling, is known to be downregulated in hibernating myocardium. PGC1-alpha is a critical component of cellular stress responses and links cellular metabolism with inflammation in the ischemic heart. While beneficial in the acute setting, a chronic state of hibernation can be associated with self-perpetuating oxidant stress-inflammatory signaling which leads to tissue injury. It is likely that incomplete functional recovery following revascularization of chronically ischemic myocardium is due to persistence of metabolic changes as well as prooxidant and proinflammatory signaling. Enhancement of PGC1-alpha signaling has been proposed as a possible way to improve functional recovery in patients with ischemic heart disease. Adjunctive mesenchymal stem cell therapy has been shown to induce PGC1-alpha signaling in hibernating myocardium and could help improve clinical outcomes for patients undergoing bypass surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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