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Hübbert, Laila
Alternative names
Publications (10 of 21) Show all publications
Sundbom, P., Hübbert, L. & Serrander, L. (2017). Progressive multifocal leukoencephalopathy after heart transplantation: 4 years of clinically stable infection on low-dose immunosuppressive therapy. Oxford Medical Case Reports, 2017(2), 15-17
Open this publication in new window or tab >>Progressive multifocal leukoencephalopathy after heart transplantation: 4 years of clinically stable infection on low-dose immunosuppressive therapy
2017 (English)In: Oxford Medical Case Reports, E-ISSN 2053-8855, Vol. 2017, no 2, p. 15-17Article in journal (Refereed) Published
Abstract [en]

Progressive multifocal leukoencephalopathy (PML), caused by reactivation of JC-virus is a relatively rare complication seen in patients with compromised immune system. There are no evidence-based treatment available and prognosis is poor. Withdrawal of immunosuppressant can result in further neurological deterioration and for patients with solid organ transplantations, fatal graft rejection. We report a 52-year-old women that presented with seizures within 1 month after heart transplantation. Initial diagnosis was vascular disease. After clinical deterioration 10 months after transplantation, further examinations led to the diagnosis. Minimizing tacrolimus, to a concentration of 2 ng/ml, and extensive physical therapy has improved the physical capacity of the patient. The patient has now been clinically stable for 4 years and extended survival for 5 years. This case adds to the limited adult cases of PML within the population of heart transplant recipients and the need for increased awareness to minimize diagnosis delay.

Place, publisher, year, edition, pages
Oxford Academic, 2017
National Category
Surgery Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-145288 (URN)10.1093/omcr/omx003 (DOI)28473916 (PubMedID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-07-30Bibliographically approved
Hubbert, L., Sundbom, P., Loebe, M., Peterzén, B., Granfeldt, H. & Ahn, H. (2014). Acoustic Analysis of a Mechanical Circulatory Support. Artificial Organs, 38(7), 593-598
Open this publication in new window or tab >>Acoustic Analysis of a Mechanical Circulatory Support
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2014 (English)In: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 38, no 7, p. 593-598Article in journal (Refereed) Published
Abstract [en]

Mechanical circulatory support technology is continually improving. However, adverse complications do occur with devastating consequences, for example, pump thrombosis that may develop in several parts of the pump system. The aim of this study was to design an experimental clot/thrombosis model to register and analyze acoustic signals from the left ventricular assist device (LVAD) HeartMate II (HMII) (Thoratec Corporation, Inc., Pleasanton, CA, USA) and detect changes in sound signals correlating to clots in the inflow, outflow, and pump housing. Using modern telecom techniques, it was possible to register and analyze the HMII pump-specific acoustic fingerprint in an experimental model of LVAD support using a mock loop. Increase in pump speed significantly (P less than 0.005) changed the acoustic fingerprint at certain frequency (0-23 000 Hz) intervals (regions: R1-3 and peaks: P1,3-4). When the ball valves connected to the tubing were narrowed sequentially by similar to 50% of the inner diameter (to mimic clot in the out-and inflow tubing), the frequency spectrum changed significantly (P less than 0.005) in P1 and P2 and R1 when the outflow tubing was narrowed. This change was not seen to the same extent when the lumen of the ball valve connected to the inflow tube was narrowed by similar to 50%. More significant (P less than 0.005) acoustic changes were detected in P1 and P2 and R1 and R3, with the largest dB figs. in the lower frequency ranges in R1 and P2, when artificial clots and blood clots passed through the pump system. At higher frequencies, a significant change in dB figs. in R3 and P4 was detected when clots passed through the pump system. Acoustic monitoring of pump sounds may become a valuable tool in LVAD surveillance.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
Mechanical circulatory support; Frequency analysis; Thrombosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-112071 (URN)10.1111/aor.12244 (DOI)000343223400001 ()24372095 (PubMedID)
Available from: 2014-11-14 Created: 2014-11-13 Last updated: 2017-12-05Bibliographically approved
Hübbert, L., Baranowski, J., Delshad, B. & Ahn, H. (2014). First implantation in human of a wireless miniaturized intracardiac pressure sensor in a patient with a heartmate IItm. In: : . Paper presented at The Journal of Heart and Lung Transplantation.
Open this publication in new window or tab >>First implantation in human of a wireless miniaturized intracardiac pressure sensor in a patient with a heartmate IItm
2014 (English)Conference paper, Published paper (Refereed)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-113423 (URN)
Conference
The Journal of Heart and Lung Transplantation
Available from: 2015-01-19 Created: 2015-01-19 Last updated: 2015-03-31
Lund, L., Holmg-Jung, M., Gustafsson, F., Dellgren, G., Fiane, A., Lemström, K., . . . Nilsson, J. (2014). Long-term outcomes of left ventricular assist device therapy in Scandinavia. In: : . Paper presented at The Journal of Heart and Lung Transplantation (pp. s216). , 33(4)
Open this publication in new window or tab >>Long-term outcomes of left ventricular assist device therapy in Scandinavia
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2014 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Purpose

The purpose was to assess outcomes with durable continuous-flow left ventricular assist device (LVAD) in Scandinavia.

Methods

Since 1993, 497 durable LVADs have been implanted among 9 centers in Scandinavia. Of those, 273 were 2nd and 3rd generation LVAD, 80% as bridge to transplant. We performed a retrospective analysis of 252 patients with complete data. Postoperative complications and survival, with censorship at transplantation, were compared between groups and Cox proportion hazard regression analysis was used to identify factors associated with reduced long-term survival.

Results

The actuarial survival rate was 71%, 64% and 62% at 1 year, 3 years and 5 years respectively and similar for 2nd and 3rd generation LVADs (Figure). The most common complication were drive line infection (24%), right heart failure (24%), gastrointestinal bleeding (11%), pump thrombosis (9%) and thromboembolic events (8%) (Table), again similar for 2nd and 3rd generations LVADs. Univariable predictors of mortality were higher age, creatinine, bilirubin and lower platelet count and pulmonary vascular resistance.

Conclusion

Prognosis after continuous flow LVAD in Scandinavia is modest. Careful selection considering markers of renal insufficiency and liver congestion as well as previously reported risk markers may improve the risk / benefit ratio.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114087 (URN)10.1016/j.healun.2014.01.558 (DOI)
Conference
The Journal of Heart and Lung Transplantation
Available from: 2015-02-07 Created: 2015-02-07 Last updated: 2019-01-11Bibliographically approved
Sundbom, P., Hübbert, L., Armeryd, T., Karlsson, M., Lindén, M. & Anderson, C. (2014). The place of skin cancer screening in heart transplant recipient follow-up protocols: a case series. Paper presented at Enliven: Surgery and Transplantation. Enliven: Surgery and Transplantation, 1(1)
Open this publication in new window or tab >>The place of skin cancer screening in heart transplant recipient follow-up protocols: a case series
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2014 (English)In: Enliven: Surgery and Transplantation, ISSN 2379-5719, Vol. 1, no 1Article in journal (Refereed) Published
Abstract [en]

ObjectivesFor solid organ transplant recipients the risk of skin cancer is markedly increased due to immunosuppression. Many studies propose an annual, or morefrequent, skin screening program by a dermatologist. As the number of transplant recipients increases and survival times improve, the need for screeningand rapid response (as required) access is increasing.

DesignIn a quality control study we retrospectively examined the medical records of patients participating in an annual screening program between 1997 and2012. A total of 69 medical records were studied and we here describe the program and present the findings.

ResultsWe found malignant melanoma in 3 cases. Cutaneous squamous cell carcinoma occurred in 16 patients and basal cell carcinoma in 12 patients. Themost frequent skin lesions were actinic keratoses, reported in 20 patients.

ConclusionsIncidence rates for all diagnoses were elevated compared to the general population. Awareness of the increased risk for skin malignancies is of importanceto those involved in the care of solid organ transplant recipients. Routines for early discovery of skin tumors are needed both in the form of screening,which can also establish risk group status and give preventive education, and as rapid response access for skin lesion diagnosis and treatment.

Place, publisher, year, edition, pages
Enliven Archive, 2014
Keywords
Cutanous squamous cell carcinoma; Heart transplant; Screening; Skin cancer
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114002 (URN)
Conference
Enliven: Surgery and Transplantation
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2019-01-31
Sundbom, P., Hedayati, E., Peterzén, B., Granfeldt, H., Casimir Ahn, H. & Hübbert, L. (2014). Young Woman With Breast Cancer and Cardiotoxicity With Severe Heart Failure Treated With a HeartMate II (TM) for Nearly 6 Years Before Heart Transplantation. ASAIO journal (1992), 60(6), E3-E4
Open this publication in new window or tab >>Young Woman With Breast Cancer and Cardiotoxicity With Severe Heart Failure Treated With a HeartMate II (TM) for Nearly 6 Years Before Heart Transplantation
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2014 (English)In: ASAIO journal (1992), ISSN 1058-2916, E-ISSN 1538-943X, Vol. 60, no 6, p. E3-E4Article in journal (Refereed) Published
Abstract [en]

Cardiotoxicity is a multifactorial problem, which has emerged with the improvement of cancer therapies and survival. Heart transplantation is relatively contraindicated in patients with breast cancer, until at least 5 years after complete remission. We present a case where a young woman who in 2001, at the age of 31, was diagnosed with breast cancer. She was considered cured, but 4 years later she suffered a relapse. During her second treatment, in 2006, she suffered from severe heart failure. She received a HeartMate II, as a long-term bridge to transplantation and 6 years later she was successfully transplanted. In this case report we discuss the use of mechanical circulatory support in cancer patients with drug-induced heart failure.

Place, publisher, year, edition, pages
Lippincott, Williams andamp; Wilkins, 2014
Keywords
breast cancer; cardiotoxicity; heart failure; mechanical circulatory support; heart transplantation
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-113018 (URN)10.1097/MAT.0000000000000138 (DOI)000345299200001 ()25232773 (PubMedID)
Available from: 2015-01-12 Created: 2015-01-08 Last updated: 2017-12-05
Sundbom, P., Hedayati, E., Peterzén, B., Granfeldt, H., Ahn, H. & Hübbert, L. (2013). Kardiotoxicitet med terminal hjärtsvikt och nästan sex år med Heartmate II i väntan på hjärttransplantation. In: : . Paper presented at Thoraxmötet 2013, 17-18 oktober, Linköping.
Open this publication in new window or tab >>Kardiotoxicitet med terminal hjärtsvikt och nästan sex år med Heartmate II i väntan på hjärttransplantation
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2013 (Swedish)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104988 (URN)
Conference
Thoraxmötet 2013, 17-18 oktober, Linköping
Available from: 2014-03-05 Created: 2014-03-05 Last updated: 2015-11-09Bibliographically approved
Casimir Ahn, H., Granfeldt, H., Hübbert, L. & Peterzén, B. (2013). Long-term left ventricular support in patients with a mechanical aortic valve. Scandinavian Cardiovascular Journal, 47(4), 236-239
Open this publication in new window or tab >>Long-term left ventricular support in patients with a mechanical aortic valve
2013 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 47, no 4, p. 236-239Article in journal (Refereed) Published
Abstract [en]

Objectives. The presence of a mechanical prosthesis has been regarded as an increased risk of thromboembolic complications and as a relative contraindication for a left ventricular assist device (LVAD). Five patients in our center had a mechanical aortic valve at the time of device implantation and were studied regarding thromboembolic complications. Design. Five patients operated upon with an LVAD (1 HeartMate I (TM), 4 HeartMate II (TM)) between 2002 and 2011 had a mechanical aortic valve at the time of implantation. The first patient had a patch closure of the aortic valve. In four patients, the prosthesis was left in place. Anticoagulants included aspirin, warfarin, and clopidogrel. Results. The average and accumulated treatment times were 150 and 752 days, respectively. Three of the five patients showed early signs of valve thrombosis on echo with concomitant valve dysfunction. Four patients were transplanted without thromboembolic events during pump treatment. One patient died from a hemorrhagic stroke after 90 days on the LVAD. Conclusions. The strategy of leaving a mechanical heart valve in place at the time of LVAD implantation in five patients led to valvular thrombosis in three but did not provoke embolic events. It increased the complexity of postoperative anticoagulation.

Place, publisher, year, edition, pages
INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND, 2013
Keywords
aortic valve, left ventricular support, mechanical valve
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96976 (URN)10.3109/14017431.2013.795655 (DOI)000322607700007 ()
Available from: 2013-09-05 Created: 2013-09-02 Last updated: 2017-12-06
Hübbert, L., Jorde, U. P., Peterzén, B., Granfeldt, H., Kornhall, B., Morrison, K. & Ahn, H. C. (2012). Early Results from the SoundMate Study. Acoustic Analysis of a Thromboembolic Event in a Patient Treated with HeartMate II (TM), Mechanical Circulatory Support. Paper presented at 32nd Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation/Meeting of the ISHLT Academy - Core Competencies in Mechanical Circulatory Support, APR 17-21, 2012, Prague, CZECH REPUBLIC. The Journal of Heart and Lung Transplantation, 31(4 Suppl.), S134-S135
Open this publication in new window or tab >>Early Results from the SoundMate Study. Acoustic Analysis of a Thromboembolic Event in a Patient Treated with HeartMate II (TM), Mechanical Circulatory Support
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2012 (English)In: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, E-ISSN 1557-3117, Vol. 31, no 4 Suppl., p. S134-S135Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76942 (URN)10.1016/j.healun.2012.01.388 (DOI)000302207900379 ()
Conference
32nd Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation/Meeting of the ISHLT Academy - Core Competencies in Mechanical Circulatory Support, APR 17-21, 2012, Prague, CZECH REPUBLIC
Available from: 2012-05-02 Created: 2012-04-27 Last updated: 2017-12-07
Kornhall, B., Nilsson, J., Sigurdardottir, V., Dellgren, G., Hagerman, I. & Hübbert, L. (2012). Fler hjärttransplantationer än någonsin. Läkartidningen, 109(39), 1743-1744
Open this publication in new window or tab >>Fler hjärttransplantationer än någonsin
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2012 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 39, p. 1743-1744Article in journal (Refereed) Published
Abstract [sv]

Under de senaste tre åren har antalet hjärttransplantationer i Sverige legat runt 50 per år jämfört med kring 30 årligen under tidigare decennier.

Majoriteten av patienterna är mellan 40 och 60 år, många behandlas med mekaniskt cirkulationsunderstöd före transplantationen, och me­dianväntetiden är ca 3 månader.

Prognosen är god vid internationell jämförelse.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86469 (URN)
Available from: 2012-12-17 Created: 2012-12-17 Last updated: 2017-12-06
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