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Lung transplant, intensive care

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https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#1
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28797053/the-epidemiology-of-medically-attended-respiratory-syncytial-virus-in-older-adults-in-the-united-states-a-systematic-review
#2
Ann D Colosia, Jin Yang, Eric Hillson, Josephine Mauskopf, Catherine Copley-Merriman, Vivek Shinde, Jeffrey Stoddard
OBJECTIVE: This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. DESIGN: A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. METHODS: A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years...
2017: PloS One
https://www.readbyqxmd.com/read/28790293/-critical-care-managements-after-lung-transplantation
#3
Masaki Anraku
Lung transplantation is a viable treatment option for patients with end-stage lung diseases such as interstitial pneumonia/pulmonary fibrosis, emphysema, pulmonary hypertension, and so on. Collecting available clinical, physiological, serological, and surgical information of both donor and recipient is vital when planning relevant postoperative managements. The goal of the managements is to keep the transplanted lung (s) functional while preventing/treating infection, rejection, and ischemiareperfusion lung injury...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28708843/prevalence-of-respiratory-viruses-among-adults-by-season-age-respiratory-tract-region-and-type-of-medical-unit-in-paris-france-from-2011-to-2016
#4
Benoit Visseaux, Charles Burdet, Guillaume Voiriot, François-Xavier Lescure, Taous Chougar, Olivier Brugière, Bruno Crestani, Enrique Casalino, Charlotte Charpentier, Diane Descamps, Jean-François Timsit, Yazdan Yazdanpanah, Nadhira Houhou-Fidouh
BACKGROUND: Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. METHODS: All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units)...
2017: PloS One
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#5
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28691772/successful-liver-transplantation-despite-donor-transmitted-esbl-producing-klebsiella-pneumoniae-infection-case-report-and-review-of-the-literature
#6
Laura Escolà-Vergé, Ibal Los-Arcos, Junajo González, Mayli Lung, Itxarone Bilbao, Mercè Farré, Teresa Pont, Alberto Sandiumenge, Joan Gavalda, Oscar Len
Donor-derived bacterial infection is a recognized complication of solid organ transplantation. Patients admitted to the intensive care unit are increasingly exposed to infection with multidrug-resistant microorganisms. However, no specific recommendations are available about their suitability as donors. We report a case of donor-transmitted extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a liver recipient, and review the related literature. This article is protected by copyright...
July 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28640022/brain-dead-donors-on-extracorporeal-membrane-oxygenation
#7
Régis Bronchard, Louise Durand, Camille Legeai, Johana Cohen, Patrice Guerrini, Olivier Bastien
OBJECTIVES: To describe donors after brain death with ongoing extracorporeal membrane oxygenation and to analyze the outcome of organs transplanted from these donors. DESIGN: Retrospective analysis of the national information system run by the French Biomedicine Agency (CRISTAL database). SETTING: National registry data of all donors after brain death in France and their organ recipients between 2007 and 2013. PATIENTS: Donors after brain death and their organ recipients...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#8
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#9
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
July 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28596083/organ-donation-in-cardiac-arrest-patients-treated-with-extracorporeal-cpr-a-single-centre-observational-study
#10
Maria Chiara Casadio, Anna Coppo, Alessia Vargiolu, Jacopo Villa, Matteo Rota, Leonello Avalli, Giuseppe Citerio
AIM OF THE STUDY: In a consecutive cohort of cardiac arrest (CA) treated with extracorporeal cardiopulmonary resuscitation (eCPR), we describe the incidence of brain death (BD), the eligibility for organ donation and the short-term follow-up of the transplanted organs. METHODS: All refractory in- and out-of-hospital CA admitted to our Cardiac Intensive Care Unit between January 2011 and September 2016 treated with eCPR were enrolled in the study. RESULTS: 112 CA patients received eCPR...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28552627/perioperative-statin-use-is-associated-with-decreased-incidence-of-primary-graft-dysfunction-after-lung-transplantation
#11
Jacob Raphael, Stephen R Collins, Xin-Qun Wang, David C Scalzo, Priyanka Singla, Christine L Lau, Benjamin D Kozower, Marcel E Durieux, Randal S Blank
BACKGROUND: Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. METHODS: We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System...
May 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28527964/impact-of-high-priority-allocation-on-lung-and-heart-lung-transplantation-for-pulmonary-hypertension
#12
Laurent Savale, Jérôme Le Pavec, Olaf Mercier, Sacha Mussot, Xavier Jaïs, Dominique Fabre, Caroline O'Connell, David Montani, François Stephan, Olivier Sitbon, Gérald Simonneau, Philippe Dartevelle, Marc Humbert, Elie Fadel
BACKGROUND: Since 2006 and 2007, patients in France with severe pulmonary hypertension (PH) who are at imminent risk of death, despite optimal treatment in the intensive care unit, are placed on a high-priority list (HPL) for heart-lung transplantation (HLT) or double-lung transplantation (DLT). We assessed the effect of this approach on the waiting list and outcomes after transplantation. METHODS: We conducted a single-center, retrospective, before-and-after study of consecutive patients with severe group 1, 1', or 4 PH listed for DLT or HLT between 2000 and 2013 (ie, 6 years before and 6 years after HPL implementation)...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28457373/optimizing-the-use-of-available-lungs
#13
D Peritore, L Rizzato, S Trapani, V Morabito, P Fiaschetti, A Cacciotti, A Montemurro, E Del Sordo, A Ricci, A Nanni Costa
BACKGROUND: Organ transplantation, the treatment of choice in organ failure, is penalized by the lack of organs. Because the increase in the number of donors is not proportional throughout the different age groups, there is no increase in lung transplantations. The aim of this work was to analyze the use of available lungs and evaluate strategies that may help increase transplantations. METHODS: We analyzed the activity of lung transplantation in 2015, divided into various allocation programs...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28455097/severity-of-acute-kidney-injury-in-the-post-lung-transplant-patient-is-associated-with-higher-healthcare-resources-and-cost
#14
Albert P Nguyen, Rodney A Gabriel, Eugene Golts, Erik B Kistler, Ulrich Schmidt
OBJECTIVE: Perioperative risk factors and the clinical impact of acute kidney injury (AKI) and failure after lung transplantation are not well described. The incidences of AKI and acute renal failure (ARF), potential perioperative contributors to their development, and postdischarge healthcare needs were evaluated. DESIGN: Retrospective. SETTING: University hospital. PARTICIPANTS: Patients undergoing lung transplantation between January 1, 2011 and December 31, 2015...
February 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#15
Vera Spatenkova, Eva Pokorna, Petr Suchomel
OBJECTIVES: Efficient intensive care donor management can help alleviate the shortage of organs for transplant. The aim of this study was to investigate the efficiency of management of donors after brain death from our neurointensive care unit. MATERIALS AND METHODS: We conducted a prospective observational 5-year follow-up on 29 transplanted organs from 14 brain-dead donors after acute stroke (7 subarachnoid and 4 intracerebral hemorrhages, 3 ischemic strokes)...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28390643/a-46-year-old-man-with-dyspnea-hypoxemia-and-radiographic-asymmetry-after-redo-bilateral-lung-transplantation
#16
Sofya Tokman, Michael A Smith, A Samad Hashimi, Ashraf Omar
A 46-year-old man underwent redo bilateral sequential lung transplantation for rapidly progressive bronchiolitis obliterans syndrome that developed 3.5 years after initial transplantation. In the operating room, he was sedated and intubated with a dual lumen endotracheal tube with subsequent single right-lung ventilation and left allograft implantation. His pulmonary arterial pressure became elevated with reperfusion of the newly implanted left lung, which required initiation of cardiopulmonary bypass to facilitate implantation of the right lung...
April 2017: Chest
https://www.readbyqxmd.com/read/28366682/indications-for-lung-resection-surgery-and-lung-transplant-in-south-american-children-with-cystic-fibrosis
#17
REVIEW
Fabíola Villac Adde, Sílvia Vidal Campos, Ricardo Henrique de Oliveira Braga Teixeira, Joaquim Carlos Rodrigues
The current available literature evaluating lung resection surgery and lung transplantation in children with cystic fibrosis (CF) was reviewed through a PubMed search and references from selected studies were additionally included. Pulmonary resections, i.e. lobectomy, segmentectomy, and pneumonectomy, are seldom performed in CF. The main indications, in patients with a forced expiratory volume in 1second (FEV1) that is greater than 30% predicted, are localized bronchiectasis/atelectasis, severe hemoptysis, and bronchopleural fistula refractory to medical management...
February 16, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28364392/burkholderia-cepacia-complex-in-cystic-fibrosis-in-the-post-epidemic-period-multilocus-sequence-typing-based-approach
#18
Libor Fila, Pavel Dřevínek
Cystic fibrosis (CF) patients in the Czech Republic suffered in the late 1990s from an epidemic with ST32 strain of Burkholderia cepacia complex (Bcc). Cohort segregation of Bcc and of ST32 positive patients was introduced in 1999 and 2002, respectively. We performed a study to evaluate the molecular epidemiology of Bcc infection after implementation of these infection control measures. Patients attending the Prague CF adult Centre from 2000 to 2015 were included in the present study. Demographic data and microbial statuses were collected from patient records...
March 31, 2017: Folia Microbiologica
https://www.readbyqxmd.com/read/28340839/incidence-of-early-acute-kidney-injury-in-lung-transplant-patients-a-single-center-experience
#19
M K Balci, M Vayvada, C Salturk, C A Kutlu, E Ari
BACKGROUND: Acute kidney injury (AKI) is a common complication in the early period of lung transplantation (LTx). We aimed to describe the incidence and perioperative risk factors associated with AKI following LTx. METHODS: Clinical data of 30 patients who underwent LTx were retrospectively reviewed. Primary outcomes were development of AKI and patient mortality within 30 postoperative days. Postoperative AKI is determined based on creatinine criteria from Acute Kidney Injury Network (AKIN) classification...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28314503/standard-donor-lung-procurement-with-normothermic-ex-vivo-lung-perfusion-a-prospective-randomized-clinical-trial
#20
Alexis Slama, Lukas Schillab, Maximilian Barta, Aris Benedek, Andreas Mitterbauer, Konrad Hoetzenecker, Shahrokh Taghavi, Gyoergy Lang, Jose Matilla, Hendrik Ankersmit, Helmut Hager, Georg Roth, Walter Klepetko, Clemens Aigner
BACKGROUND: Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (Tx)...
February 20, 2017: Journal of Heart and Lung Transplantation
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