Brendan W Reichart - Academia.edu (original) (raw)

Uploads

Papers by Brendan W Reichart

Research paper thumbnail of Die Rangfolge psychischer und sozialer Prädiktoren und Kriterien für die Prognose Herztransplantierter — prä- und postoperative Untersuchungen bis zu einem und bis zu drei Jahren nach der Herztransplantation

Zeitschrift für Herz-, Thorax- und Gefäßchirurgie, 1997

Research paper thumbnail of Neurological and neuropsychological examination and outcome after use of an intra-aortic filter device during cardiac surgery

Perfusion, 2003

Cerebral embolization of particles after cardiac surgery is frequently associated with neurologic... more Cerebral embolization of particles after cardiac surgery is frequently associated with neurological deficits. Aortic crossclamp manipulation seems to be the most significant cause of emboli release during cardiac surgery. The goal of this study was to demonstrate whether the use of an intra-aortic filter device has an effect on the magnet resonance imaging (MRI) and functional neurological outcome. Twenty-four patients undergoing cardiosurgical procedures using cardiopulmonary bypass (CPB) were selected: coronary artery bypass graft (CABG) surgery (n = 17), aortic valve replacement (AVR) surgery (n = 4) or combined procedures (n = 3). Patients were evaluated by diffusion weighted MRI of the brain, neurological examination and neuropsychological assessment regarding alertness as well as divided and selective attention before and five to seven days after surgery. The patients were divided into two groups. In group I, 12 patients received a filter through a modified 24 F arterial cannu...

Research paper thumbnail of Calcineurin-inhibitor-free immunosuppression with mycophenolatmofetil and sirolimus after cardiac transplantation is safe and improves renal function significantly

Journal of Heart and Lung Transplantation, 2003

Research paper thumbnail of Calcineurin-Inhibitor-Free Immunosuppression 1WITH Mycophenolate Mofetil and Sirolimus After Cardiac Transplantation is Safe and Improves Renal Function Significantly: 2 Year Follow Up

Research paper thumbnail of Optimalization of Immunosuppression After Pulmonary Transplantation

Research paper thumbnail of Improved Results with the Novacor Lvas Using New Eptfe Inflow Conduits and Intensified Anticoagulation Management

Transplantation Journal, 2004

Research paper thumbnail of Prevention of hyperacute xenograft rejection in orthotopic xenotransplantation of pig hearts into baboons using immunoadsorption of antibodies and complement factors

Transplant International, 2000

To prevent hyperacute xenograft rejection (HXR) caused by preformed natural antibodies (XNAb) aft... more To prevent hyperacute xenograft rejection (HXR) caused by preformed natural antibodies (XNAb) after orthotopic heart xenotransplantation (oXHTx) of landrace pig hearts into baboons, we used immunoadsorption of immunoglobulins IgG, IgM and IgA and complement with the reusable Ig-Therasorb column. In addition to functional data, tissue was sampled for histological, immunohistochemical and electron microscopical analysis. We performed three oXHTx of landrace pig hearts to baboons using extracorporeal circulation (ECC) connected to the imrnunoadsorption unit. Intraoperative treatment consisted of four cycles of immunoabsorption (IA). One oXHTx of a baboon without IA served as a control. A mismatch of donor and recipient heart size was prevented by selecting a 3 W O % lower body weight of donor pigs than recipients. Four cycles of IA removed more than 80 % of IgG, IgM and IgA, 86% of antipig antibodies and 66 % of complement factors C3 and C4 from plasma. The graft of the control animal failed after 29 min. Orthotopic xenotransplantation with IA was selectively terminated after 100 min, 11 h and 21 h, respectively without any histological signs of HXR in light and electron microscopy. After weaning off from ECC these donor xenografts showed sufficient function with normal ECG and excellent cardiac output in echocardiography and invasive measurement (1.93 * 0.035 b i n ) . The myocardium of the control xenograft demonstrated more deposits of Ig and complement components (Q, C4) than in the IA group. Baboons survive HXR after orthotopic pig heart xenotransplantation due to antibody depletion by reusable Ig-Therasorb column treatment. Long-term survival in an orthotopic baboon xenotransplantation model after IA, especially in combination with transgenic pig organs, could be a reliable preclinical trial for future clinical xenotransplantation programs.

Research paper thumbnail of Intragraft events after heart transplantation: an experimental study comparing cytology in coronary sinus blood, peripheral blood, and daily histology

Transplant International, 1994

Acute rejection is a frequent consequence after heart transplantation. To expand our knowledge of... more Acute rejection is a frequent consequence after heart transplantation. To expand our knowledge of the rejection process and to investigate some intragraft events during acute rejection, the following experimental transplantation model was designed. Right cervical heart transplantation was performed in 12 mongrel dogs. Two experimental groups of six animals each received different immunosuppressive regimens. All animals were treated with daily triple drug therapy. In contrast to group 1, the animals in group 2 received high-dose steroids during rejection. The condition of the hearts was examined by daily transmural biopsies, graded according to the Billingham classification. To detect and quantify alterations in the mononuclear cell subsets of the myocardial venous return, blood samples from the coronary sinus blood (CS) and from peripheral blood (PB) were taken simultaneously with the biopsy. The total number of lymphoblasts and activated !ymphocytes was determined and an activation index (AI) was calculated. The data referred to was establishe d from 337 transmural biopsies. The AI of PB (n = 287) correlated well with the different stages of acute rejection (grade B0: AI = 2.2 + 2.1; grade B1 + 2: AI = 6.3 + 1.7; grade B3: AI = 10.0 + 4.7; P < 0.001). The rejection kinetics of both groups, including the rejection-free interval following high-dose steroid administration in group 2, could be expressed accurately by the AI. The time course of the total number of lymphoblasts in CS versus PB demonstrated that the lymphoproliferative response started 4 days prior to the first intramyocardial signs of rejection (2 = 3.8 _+ 0.7; n = 12). The maximum number of lymphoblasts was seen on the day of rejection in group 1 and i day after the onset of histologically proven rejection in group 2 (group 1: n = 6: CS 2 = 40.1 +7.5; PB ~= 12.2 +4.1; P < 0.001; group 2: n = 6: CS = 39.4 + 8.8; PB 2 = 12.9 + 3.7; P < 0.001). Under rejection therapy in group 2 these cells decreased immediately, followed by a short rejection-free interval. In group 1 the total number of lymphoblasts diminished continuously, almost reaching the number in PB at the time of final rejection. In contrast, activated lymphocytes did not render adequate results. Comparison of daily histology and the data of PB proved there is a good correlation between the AI and the different histologic stages of acute rejection. The total number of lymphoblasts in CS during rejection is significantly higher than in PB. Acute rejection seems to be detectable almost 4 days before histology and PB cytology by cytologic evaluation of the CS. Therefore, we speculate that the differentation and proliferation of lymphoblasts during the initial phase of acute rejection takes place within the graft itself.

Research paper thumbnail of Ventral cardiac denervation and age related incidence of atrial fibrillation in patients undergoing CABG surgery compared to patients undergoing aortic valve surgery

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Genetic polymorphisms of p 53 mediated apoptosis predisposing for progression of coronary artery disease after primary CABG

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Up-regulation of cardiovascular Ghrelin-receptor in myocardium of patients suffering from end-stage heart failure

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of First experiences with Levosimendan, a Ca2+-sensitiser, for the treatment of acute graft failure after heart transplantation

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Borderline Hypoplastic Left Heart Malformations: Norwood Palliation or Two-Ventricle Repair?

The Thoracic and Cardiovascular Surgeon, 2002

Patients with hypoplastic left heart syndrome (HLHS) and associated malformations undergo Norwood... more Patients with hypoplastic left heart syndrome (HLHS) and associated malformations undergo Norwood palliation or potentially a two-ventricle repair. Since 8/99, 8 patients with typical HLHS and two with DILV underwent Norwood/Fontan palliation (group I). Three other patients (group II) had two-ventricle repair. Anatomy was: aortic atresia, coarctation, unrestrictive VSD (patient 1), hypoplastic mitral and aortic valve, arch and LV, coarctation (patients 2 and 3). Surgical procedures were Norwood arch reconstruction with either Rastelli operation (patient 1) or ASD-closure (patients 2 and 3). Operative mortality in group I was 1/8 (day 22; RV-failure). Two patients died before Glenn (sepsis, RV-failure). Six patients underwent Glenn procedure successfully. No patient died in group II. Echocardiography after 13 +/- 7.4 months showed mild homograft dysfunction (patient 1) and an LVOT-gradient of 20 mmHg (patient 3). Clinical condition of all survivors in both groups is good. Some anatomical subsets of HLHS with borderline mitral valves and small left ventricles may undergo two-ventricle repair despite severe LVOTO. Mortality and morbidity seem to be lower, but selection criteria are so far not defined.

Research paper thumbnail of Treatment of endothelial cells with ATGs prevents transendothelial migration of leukocytes

The Thoracic and Cardiovascular Surgeon, 2009

Research paper thumbnail of Forty years Starr Edwards aortic prosthesis: A clinical follow-up

The Thoracic and Cardiovascular Surgeon, 2005

Research paper thumbnail of Das Verhalten der pulmonalen Hypertension nach Verschluß von Vorhofseptumdefekten bei Erwachsenen

The Thoracic and Cardiovascular Surgeon, 1975

Research paper thumbnail of Munich single centre experience using different preservation solutions

The Thoracic and Cardiovascular Surgeon, 2008

Research paper thumbnail of A single center study with 258 lung transplantations using different primary immunosuppressive treatments (CYA or FK506)

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of One year experience with the Chronicle® implantable hemodynamic monitor in patients on the heart transplant waiting list

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Assessment of changes of regional blood flow in hyperacutely rejected hDAF transgenic and non-transgenic pig hearts by means of fluorescent microspheres

The Thoracic and Cardiovascular Surgeon, 2005

Research paper thumbnail of Die Rangfolge psychischer und sozialer Prädiktoren und Kriterien für die Prognose Herztransplantierter — prä- und postoperative Untersuchungen bis zu einem und bis zu drei Jahren nach der Herztransplantation

Zeitschrift für Herz-, Thorax- und Gefäßchirurgie, 1997

Research paper thumbnail of Neurological and neuropsychological examination and outcome after use of an intra-aortic filter device during cardiac surgery

Perfusion, 2003

Cerebral embolization of particles after cardiac surgery is frequently associated with neurologic... more Cerebral embolization of particles after cardiac surgery is frequently associated with neurological deficits. Aortic crossclamp manipulation seems to be the most significant cause of emboli release during cardiac surgery. The goal of this study was to demonstrate whether the use of an intra-aortic filter device has an effect on the magnet resonance imaging (MRI) and functional neurological outcome. Twenty-four patients undergoing cardiosurgical procedures using cardiopulmonary bypass (CPB) were selected: coronary artery bypass graft (CABG) surgery (n = 17), aortic valve replacement (AVR) surgery (n = 4) or combined procedures (n = 3). Patients were evaluated by diffusion weighted MRI of the brain, neurological examination and neuropsychological assessment regarding alertness as well as divided and selective attention before and five to seven days after surgery. The patients were divided into two groups. In group I, 12 patients received a filter through a modified 24 F arterial cannu...

Research paper thumbnail of Calcineurin-inhibitor-free immunosuppression with mycophenolatmofetil and sirolimus after cardiac transplantation is safe and improves renal function significantly

Journal of Heart and Lung Transplantation, 2003

Research paper thumbnail of Calcineurin-Inhibitor-Free Immunosuppression 1WITH Mycophenolate Mofetil and Sirolimus After Cardiac Transplantation is Safe and Improves Renal Function Significantly: 2 Year Follow Up

Research paper thumbnail of Optimalization of Immunosuppression After Pulmonary Transplantation

Research paper thumbnail of Improved Results with the Novacor Lvas Using New Eptfe Inflow Conduits and Intensified Anticoagulation Management

Transplantation Journal, 2004

Research paper thumbnail of Prevention of hyperacute xenograft rejection in orthotopic xenotransplantation of pig hearts into baboons using immunoadsorption of antibodies and complement factors

Transplant International, 2000

To prevent hyperacute xenograft rejection (HXR) caused by preformed natural antibodies (XNAb) aft... more To prevent hyperacute xenograft rejection (HXR) caused by preformed natural antibodies (XNAb) after orthotopic heart xenotransplantation (oXHTx) of landrace pig hearts into baboons, we used immunoadsorption of immunoglobulins IgG, IgM and IgA and complement with the reusable Ig-Therasorb column. In addition to functional data, tissue was sampled for histological, immunohistochemical and electron microscopical analysis. We performed three oXHTx of landrace pig hearts to baboons using extracorporeal circulation (ECC) connected to the imrnunoadsorption unit. Intraoperative treatment consisted of four cycles of immunoabsorption (IA). One oXHTx of a baboon without IA served as a control. A mismatch of donor and recipient heart size was prevented by selecting a 3 W O % lower body weight of donor pigs than recipients. Four cycles of IA removed more than 80 % of IgG, IgM and IgA, 86% of antipig antibodies and 66 % of complement factors C3 and C4 from plasma. The graft of the control animal failed after 29 min. Orthotopic xenotransplantation with IA was selectively terminated after 100 min, 11 h and 21 h, respectively without any histological signs of HXR in light and electron microscopy. After weaning off from ECC these donor xenografts showed sufficient function with normal ECG and excellent cardiac output in echocardiography and invasive measurement (1.93 * 0.035 b i n ) . The myocardium of the control xenograft demonstrated more deposits of Ig and complement components (Q, C4) than in the IA group. Baboons survive HXR after orthotopic pig heart xenotransplantation due to antibody depletion by reusable Ig-Therasorb column treatment. Long-term survival in an orthotopic baboon xenotransplantation model after IA, especially in combination with transgenic pig organs, could be a reliable preclinical trial for future clinical xenotransplantation programs.

Research paper thumbnail of Intragraft events after heart transplantation: an experimental study comparing cytology in coronary sinus blood, peripheral blood, and daily histology

Transplant International, 1994

Acute rejection is a frequent consequence after heart transplantation. To expand our knowledge of... more Acute rejection is a frequent consequence after heart transplantation. To expand our knowledge of the rejection process and to investigate some intragraft events during acute rejection, the following experimental transplantation model was designed. Right cervical heart transplantation was performed in 12 mongrel dogs. Two experimental groups of six animals each received different immunosuppressive regimens. All animals were treated with daily triple drug therapy. In contrast to group 1, the animals in group 2 received high-dose steroids during rejection. The condition of the hearts was examined by daily transmural biopsies, graded according to the Billingham classification. To detect and quantify alterations in the mononuclear cell subsets of the myocardial venous return, blood samples from the coronary sinus blood (CS) and from peripheral blood (PB) were taken simultaneously with the biopsy. The total number of lymphoblasts and activated !ymphocytes was determined and an activation index (AI) was calculated. The data referred to was establishe d from 337 transmural biopsies. The AI of PB (n = 287) correlated well with the different stages of acute rejection (grade B0: AI = 2.2 + 2.1; grade B1 + 2: AI = 6.3 + 1.7; grade B3: AI = 10.0 + 4.7; P < 0.001). The rejection kinetics of both groups, including the rejection-free interval following high-dose steroid administration in group 2, could be expressed accurately by the AI. The time course of the total number of lymphoblasts in CS versus PB demonstrated that the lymphoproliferative response started 4 days prior to the first intramyocardial signs of rejection (2 = 3.8 _+ 0.7; n = 12). The maximum number of lymphoblasts was seen on the day of rejection in group 1 and i day after the onset of histologically proven rejection in group 2 (group 1: n = 6: CS 2 = 40.1 +7.5; PB ~= 12.2 +4.1; P < 0.001; group 2: n = 6: CS = 39.4 + 8.8; PB 2 = 12.9 + 3.7; P < 0.001). Under rejection therapy in group 2 these cells decreased immediately, followed by a short rejection-free interval. In group 1 the total number of lymphoblasts diminished continuously, almost reaching the number in PB at the time of final rejection. In contrast, activated lymphocytes did not render adequate results. Comparison of daily histology and the data of PB proved there is a good correlation between the AI and the different histologic stages of acute rejection. The total number of lymphoblasts in CS during rejection is significantly higher than in PB. Acute rejection seems to be detectable almost 4 days before histology and PB cytology by cytologic evaluation of the CS. Therefore, we speculate that the differentation and proliferation of lymphoblasts during the initial phase of acute rejection takes place within the graft itself.

Research paper thumbnail of Ventral cardiac denervation and age related incidence of atrial fibrillation in patients undergoing CABG surgery compared to patients undergoing aortic valve surgery

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Genetic polymorphisms of p 53 mediated apoptosis predisposing for progression of coronary artery disease after primary CABG

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Up-regulation of cardiovascular Ghrelin-receptor in myocardium of patients suffering from end-stage heart failure

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of First experiences with Levosimendan, a Ca2+-sensitiser, for the treatment of acute graft failure after heart transplantation

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Borderline Hypoplastic Left Heart Malformations: Norwood Palliation or Two-Ventricle Repair?

The Thoracic and Cardiovascular Surgeon, 2002

Patients with hypoplastic left heart syndrome (HLHS) and associated malformations undergo Norwood... more Patients with hypoplastic left heart syndrome (HLHS) and associated malformations undergo Norwood palliation or potentially a two-ventricle repair. Since 8/99, 8 patients with typical HLHS and two with DILV underwent Norwood/Fontan palliation (group I). Three other patients (group II) had two-ventricle repair. Anatomy was: aortic atresia, coarctation, unrestrictive VSD (patient 1), hypoplastic mitral and aortic valve, arch and LV, coarctation (patients 2 and 3). Surgical procedures were Norwood arch reconstruction with either Rastelli operation (patient 1) or ASD-closure (patients 2 and 3). Operative mortality in group I was 1/8 (day 22; RV-failure). Two patients died before Glenn (sepsis, RV-failure). Six patients underwent Glenn procedure successfully. No patient died in group II. Echocardiography after 13 +/- 7.4 months showed mild homograft dysfunction (patient 1) and an LVOT-gradient of 20 mmHg (patient 3). Clinical condition of all survivors in both groups is good. Some anatomical subsets of HLHS with borderline mitral valves and small left ventricles may undergo two-ventricle repair despite severe LVOTO. Mortality and morbidity seem to be lower, but selection criteria are so far not defined.

Research paper thumbnail of Treatment of endothelial cells with ATGs prevents transendothelial migration of leukocytes

The Thoracic and Cardiovascular Surgeon, 2009

Research paper thumbnail of Forty years Starr Edwards aortic prosthesis: A clinical follow-up

The Thoracic and Cardiovascular Surgeon, 2005

Research paper thumbnail of Das Verhalten der pulmonalen Hypertension nach Verschluß von Vorhofseptumdefekten bei Erwachsenen

The Thoracic and Cardiovascular Surgeon, 1975

Research paper thumbnail of Munich single centre experience using different preservation solutions

The Thoracic and Cardiovascular Surgeon, 2008

Research paper thumbnail of A single center study with 258 lung transplantations using different primary immunosuppressive treatments (CYA or FK506)

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of One year experience with the Chronicle® implantable hemodynamic monitor in patients on the heart transplant waiting list

The Thoracic and Cardiovascular Surgeon, 2007

Research paper thumbnail of Assessment of changes of regional blood flow in hyperacutely rejected hDAF transgenic and non-transgenic pig hearts by means of fluorescent microspheres

The Thoracic and Cardiovascular Surgeon, 2005