Heart transplantation and durable ventricular assist devices (VAD) are effective treatment options for patients with advanced heart failure. The Transplant and Pumps (TAPS) Innovation Cluster aims to forward the advanced heart failure field through the development of novel tailored management approaches for heart transplant and VAD patients. Solving the unique challenges in this patient population requires unraveling key disease mechanisms including understanding adaptation of alloimmunity after transplant and changes in cardiac bio-physiology after mechanical assist device.
Goals of the Cluster
The TAPS Cluster will address the following five major research objectives:
- Develop effective management strategies for allosensitization and antibody mediated rejection (AMR)
The accurate detection and characterization of HLA antibodies as well as the development of effective management strategies to desensitize patients pre-transplant, and effectively manage HLA antibodies and AMR post-transplant, is imperative to improving outcomes for transplant patients.
- Improve early detection of Cardiac Allograft Vasculopathy (CAV)
CAV is a key factor limiting long-term success of heart transplantation. Early identification of patients at risk of development CAV offers the greatest opportunity for intervention. Understanding CAV disease mechanisms can direct appropriate timing and optimal intervention.
- Improve peri-operative risk modification in patients undergoing advanced heart failure therapies
Refine clinical tools for patient risk stratification and selection as well as cardiac rehabilitation interventions to improve outcomes post transplant and long term mechanical circulatory support.
- Develop a histological and serological bio-bank
Blood and cardiac tissue archiving will aid evaluation of new discoveries in immunology and heart failure.
- Improve management of Mechanical Circulatory Support (MCS)
Improving understanding and management of MCS challenges including right ventricular dysfunction and bleeding/thrombosis will lead to improved outcomes.
Innovation Cluster Scientists
Team members at the University of Ottawa Heart Institute:
Munir Boodhwani, MD, Vincent Chan, MD, Aun-Yeong Chong, MD, Ross Davies, MD, Alexander Dick, MD, Haissam Haddad, MD, Peter Liu, MD, Lisa Mielniczuk, MD, Jennifer Reed, PhD, Marc Ruel, MD, Derek So, MD, Ellamae Stadnick, MD, Louise Sun, MD, Heather Tulloch, PhD
Other Team members:
Harold Atkins, MD, Ottawa Hospital Research Institute
Greg Knoll, MD, Ottawa Hospital Research Institute
Jianping Li, MD, The Ottawa Hospital
Heather Ross, MD, University Health Network (Toronto), Peter Munk Cardiac Centre
Kathryn Tinckam, MD, University Health Network (Toronto), Canadian Blood Services
Selected Innovation Cluster Publications
Alba AC, Tinckam K, Foroutan F, Nelson LM, Gustafsson F, Sander K, Bruunsgaard H, Chih S, Hayes H, Rao V, Delgado D, Ross HJ. Factors associated with anti-human leukocyte antigen antibodies in patients supported with continuous-flow devices and effect on probability of transplant and post-transplant outcomes. J Heart Lung Transplant. 2015 May;34(5):685-92.
Chih S, Ross HJ, McDonald MA, Isaac DL. Highly sensitized patients in cardiac transplantation: early outcomes from the Canadian Prioritized Organ Sharing Program. J Heart Lung Transplant. 2012 Jul;31(7):780-2.
Chih S, Tinckam KJ, Ross HJ. A survey of current practice for antibody-mediated rejection in heart transplantation. Am J Transplant. 2013 Apr;13(4):1069-74.
Hall AB, Ziadi MC, Leech J, Chen S-Y, Burwash I, Renaud J, deKemp R, Haddad H, Mielniczuk L, Yoshinaga K, DaSilva J, Walter O, Guo A, Chen L, Garrard L, Floras J, Beanlands RB. Effects of Short-Term Continuous Positive Airway Pressure on Myocardial Sympathetic Nerve Function and Energetics in Patients with Heart Failure and Obstructive Sleep Apnea. Circulation. 2014 Sep 9;130(11):892-901.
Une D, Kulik A, Voisine P, Le May M, Ruel M.Correlates of saphenous vein graft hyperplasia and occlusion 1 year after coronary artery bypass grafting: analysis from the CASCADE randomized trial. Circulation. 2013 Sep 10;128(11 Suppl 1):S213-8.
Molnar AO, Fergusson D, Tsampalieros AK, Bennett A, Fergusson N, Ramsay T, Knoll GA. Generic immunosuppression in solid organ transplantation: systematic review and meta-analysis. BMJ. 2015 Jun 22;350:h3163.
Konvalinka A, Tinckam K. Utility of HLA Antibody Testing in Kidney Transplantation. J Am Soc Nephrol. 2015 Mar 24.