Evidence map›Paper›PMID 41964020›Full record

ArticleJournal of cardiothoracic surgery2026

Biventricular impella support in acute antibody-mediated cardiac allograft rejection with severe hemodynamic compromise.

Ye In Christopher Kwon, Kelli Fox, Jay Patel, Richard Cooke, Hamang Patel, Inna F Tchoukina, Krishnasree Rao, Melissa Smallfield, Keyur B Shah, Vigneshwar Kasirajan and 2 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ye In Christopher KwonDivision of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 W. Broad St. 15th Floor, East Wing Richmond, Richmond, 23298, VA, US. kwonyc@vcu.edu.
Kelli FoxDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Jay PatelDivision of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 W. Broad St. 15th Floor, East Wing Richmond, Richmond, 23298, VA, US.
Richard CookeDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Hamang PatelDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Inna F TchoukinaDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Krishnasree RaoDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Melissa SmallfieldDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Keyur B ShahDivision of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, US.
Vigneshwar KasirajanDivision of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 W. Broad St. 15th Floor, East Wing Richmond, Richmond, 23298, VA, US.
Zubair A HashmiDivision of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 W. Broad St. 15th Floor, East Wing Richmond, Richmond, 23298, VA, US.
Josue CheryDivision of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, 1200 W. Broad St. 15th Floor, East Wing Richmond, Richmond, 23298, VA, US.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute antibody-mediated cardiac allograft rejection (AMR) can lead to SCAI Stage D cardiogenic shock, frequently necessitating escalation to extracorporeal membrane oxygenation support. However, biventricular Impella (BiPella), configured with Impella 5.5 and Impella RP Flex, may offer an alternative, less invasive cardiac unloading and support. CASE PRESENTATION: We present a 28-year-old male nine-months post-heart transplantation who developed refractory shock from AMR after immunosuppression nonadherence. Hemodynamic instability and elevated filling pressures prompted emergent initiation of simultaneous Impella 5.5 and Impella RP Flex support. Over two weeks, cardiac function improved significantly for BiPella removal and discharge.

conclusionsIn select patients, BiPella may serve as a less invasive alternative to venoarterial extracorporeal membrane oxygenation support in rejection-associated biventricular failure, with potential advantages for substantial ventricular unloading, early mobilization, and bridging to recovery.

Indexed as

Graft RejectionHeart-Assist DevicesHeart TransplantationHemodynamicsShock, CardiogenicAdultHumansMaleAntibody-mediated rejectionBiPellaHeart transplantationImpellaMechanical circulatory supportVentricular assist device

Identifiers

PMID41964020
PMCPMC13214182

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.