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https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#1
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29620796/recent-alcohol-use-prolongs-hospital-length-of-stay-following-lung-transplant
#2
Erin M Lowery, Meagan Yong, Arala Cohen, Cara Joyce, Elizabeth J Kovacs
Little is known about the alcohol habits of people with advanced lung disease. Following lung transplantation patients are asked to abstain from or minimize alcohol use. The aim of this investigation is to assess alcohol use in a cohort of patients with advanced lung disease undergoing evaluation for lung transplant. This is a prospective observational investigation comparing patient self-report of alcohol use with their responses on the Alcohol Use Disorder and Identification Test, and alcohol biomarkers collected at the time of transplant...
April 5, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#3
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#4
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29579767/donation-after-brain-death-versus-donation-after-circulatory-death-lung-donor-management-issues
#5
Gregory I Snell, Bronwyn J Levvey, Kovi Levin, Miranda Paraskeva, Glen Westall
Lung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#6
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29552956/intensive-care-of-pulmonary-complications-following-liver-transplantation
#7
Justin K Lui, Lidia Spaho, Erik Holzwanger, Rosa Bui, Jennifer S Daly, Adel Bozorgzadeh, Scott E Kopec
Chronic liver disease has been associated with pulmonary dysfunction both before and after liver transplantation. Post-liver transplantation pulmonary complications can affect both morbidity and mortality often necessitating intensive care during the immediate postoperative period. The major pulmonary complications include pneumonia, pleural effusions, pulmonary edema, and atelectasis. Poor clinical outcomes have been known to be associated with age, severity of liver dysfunction, and preexisting lung disease as well as perioperative events related to fluid balance, particularly transfusion and fluid volumes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29550627/microbiologic-diagnostic-workup-of-acute-respiratory-failure-with-pulmonary-infiltrates-after-allogeneic-hematopoietic-stem-cell-transplantation-findings-in-the-era-of-molecular-and-biomarker-based-assays
#8
Philipp Wohlfarth, Amin T Turki, Joerg Steinmann, Melanie Fiedler, Nina K Steckel, Dietrich W Beelen, Tobias Liebregts
Allogeneic hematopoietic stem cell transplantation (HSCT) recipients frequently develop acute respiratory failure (ARF) with pulmonary infiltrates. Molecular- and biomarker-based assays enhance pathogen detection, but data on their yield in this population are scarce. This was a retrospective single-center study of 156 consecutive HSCT recipients admitted to the intensive care unit (ICU) between May 2013 and July 2017. Findings from a microbiologic diagnostic workup using currently available methods on bronchoalveolar lavage (BAL) and blood samples from 66 patients (age, 58 years [range, 45 to 64]; HSCT to ICU, 176 days [range, 85 to 407]) with ARF and pulmonary infiltrates were analyzed...
March 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29531748/randomised-clinical-trial-of-an-early-palliative-care-intervention-support-for-patients-with-idiopathic-pulmonary-fibrosis-ipf-and-their-caregivers-protocol-and-key-design-considerations
#9
Kathleen Oare Lindell, Mehdi Nouraie, Melinda J Klesen, Sara Klein, Kevin F Gibson, Daniel J Kass, Margaret Quinn Rosenzweig
Introduction: Idiopathic pulmonary fibrosis (IPF), a progressive life-limiting lung disease affects approximately 128 000 newly diagnosed individuals in the USA annually. IPF, a disease of ageing associated with intense medical and financial burden, is expected to grow in incidence globally. Median survival from diagnosis is 3.8 years, and many of these patients succumb to a rapid death within 6 months. Despite the fatal prognosis, we have found that patients and caregivers often fail to understand the poor prognosis as the disease relentlessly progresses...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29430425/clinical-outcomes-of-lung-transplantation-experience-at-asan-medical-center
#10
Yong Ho Jeong, Sehoon Choi, Seung-Il Park, Dong Kwan Kim
Background: Lung transplantation is a life-saving procedure in patients with end-stage lung disease, and is increasingly performed in Korea. Methods: We retrospectively evaluated the outcomes of patients who received a lung transplant at Asan Medical Center between January 2008 and December 2016. Thirteen of 54 patients experienced multiorgan transplantation; the remaining 41 who received only lung grafts were included. Results: The mean age of the lung transplant recipients was 44...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29398281/neurocognitive-outcomes-after-heart-transplantation-in-early-childhood
#11
Simon Urschel, Gwen Y Bond, Irina A Dinu, Fahime Moradi, Jennifer Conway, Gonzalo Garcia-Guerra, Bryan V Acton, Ari R Joffe, Mohammed AlAklabi, Ivan M Rebeyka, Charlene M T Robertson
BACKGROUND: Children requiring heart transplantation (HTx) for congenital heart disease (CHD) or failing anatomically normal hearts (CMP) face different challenges pre-HTx. We compared the neurocognitive capabilities in pre-school-age children receiving HTx for CHD vs CMP and determined factors predicting outcomes. METHODS: Data were collected within a prospective multi-provincial project from children who underwent HTx ≤4 years of age between 1999 and 2011. At age 54 ± 3 months, we obtained scores from the Wechsler Preschool and Primary Scales of Intelligence for full-scale intelligence quotient (FSIQ) verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ), and from the Beery-Buktenica Developmental Test for visual-motor integration (VMI)...
December 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29393584/complications-and-risk-factors-in-pediatric-bronchoscopy-in-a-tertiary-pediatric-respiratory-center
#12
Julia Carlens, Jan Fuge, Timothy Price, David S DeLuca, Mareike Price, Gesine Hansen, Nicolaus Schwerk
Bronchoscopy is an established procedure routinely used by pediatric pulmonologists. Despite its frequent application, data on complications and specific risk factors are scarce and sometimes conflicting. AIM: The aim of this study was to evaluate frequency and severity of clearly defined complications of bronchoscopy in children that occur both during and after the procedure, and to identify potential risk factors. METHOD: A retrospective single-center analysis of 670 elective bronchoscopies in 522 children aged 0-17 years during the time period of 2008-2012 was performed...
February 2, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#13
Whitney D Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina M Patel, Daniel Brodie, Matthew Bacchetta, Matthew R Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of patients with interstitial lung disease (ILD) with acute respiratory failure, and to identify those at lower vs higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an ICU for respiratory failure at a tertiary care hospital between 2010 and 2014 and who did not undergo lung transplantation during their hospitalization...
January 17, 2018: Chest
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#14
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29203299/evaluation-of-cardiac-index-and-extravascular-lung-water-after-single-lung-transplantation-using-the-transpulmonary-thermodilution-technique-by-the-picco2-device
#15
Alexy Tran-Dinh, Pascal Augustin, Guillaume Dufour, Sigismond Lasocki, Nicolas Allou, Gabriel Thabut, Yves Castier, Philippe Montravers, Mathieu Desmard
OBJECTIVES: First evaluation of the transpulmonary thermodilution technique by the PiCCO2 device to assess cardiac index and pulmonary edema during the postoperative course after single-lung transplantation. DESIGN: Prospective observational study. SETTINGS: Intensive care unit, university hospital (single center). PARTICIPANTS: Single-lung transplant patients. INTERVENTIONS: The authors compared cardiac index measured by PiCCO2 and pulmonary artery catheter and assessed pulmonary edema using extravascular lung water index and pulmonary vascular permeability index measured by PiCCO2...
December 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#16
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29112904/procalcitonin-accurately-predicts-lung-transplant-adults-with-low-risk-of-pulmonary-graft-dysfunction-and-intensive-care-mortality
#17
Cristopher Mazo, Bárbara Borgatta, Teresa Pont, Alberto Sandiumenge, Silvia Moyano, Antonio Roman, Jordi Rello
PURPOSE: We evaluated the association of procalcitonin (PCT), IL-6-8-10 plasma levels during the first 72h after lung transplantation (LT) with ICU-mortality, oxygenation, primary graft dysfunction (PGD), and one-year graft function after LT. MATERIAL AND METHODS: Prospective, observational study. PCT and IL-6-8-10 plasma levels were measured at 24h, 48h and 72h after LT from 100 lung transplant recipients (LTr). Patients were followed until one year after LT. End-points were ICU survival, grade 3 PGD at 72h and one-year graft function...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29055604/treatment-of-primary-graft-dysfunction-after-lung-transplantation-with-orally-inhaled-ap301-a-prospective-randomized-pilot-study
#18
Clemens Aigner, Alexis Slama, Maximilian Barta, Andreas Mitterbauer, Gyoergy Lang, Shahrokh Taghavi, Jose Matilla, Roman Ullrich, Katharina Krenn, Peter Jaksch, Klaus Markstaller, Walter Klepetko
BACKGROUND: Primary graft dysfunction (PGD) after lung transplantation (LTx) carries significant morbidity and mortality in the early post-operative period and is associated with the development of chronic lung allograft dysfunction. AP301, an activator of epithelial sodium channel-mediated Na+ uptake represents a new concept for prevention and treatment of pulmonary edema and has shown promising results in the pre-clinical setting. This pilot study investigated the clinical effect of inhaled AP301 on patients with development of PGD > 1 according to International Society of Heart and Lung Transplantation criteria after primary LTx in a high-volume center and was conducted as a randomized, placebo-controlled, single-center pilot-study including 20 patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29048510/donor-derived-mycoplasma-hominis-and-an-apparent-cluster-of-m-hominis-cases-in-solid-organ-transplant-recipients
#19
Olivia C Smibert, Heather L Wilson, Asma Sohail, Shanti Narayanasamy, Mark B Schultz, Susan A Ballard, Jason C Kwong, Jim de Boer, C Orla Morrissey, Anton Y Peleg, Greg I Snell, Miranda A Paraskeva, Adam W J Jenney
Background: Invasive and disseminated Mycoplasma hominis infections are well recognized but uncommon complications in solid organ transplant recipients. In a single center, a cluster of M. hominis infections were identified in lung transplant recipients from the same thoracic intensive care unit (ICU). We sought to determine the source(s) of these infections. Methods: Medical records of the donor and infected transplant recipients were reviewed for clinical characteristics...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29019812/venous-thromboembolism-after-adult-lung-transplantation-a-frequent-event-associated-with-lower-survival
#20
Manuel L Ribeiro Neto, Marie Budev, Daniel A Culver, C Randall Lane, Marcelo Gomes, Xiao-Feng Wang, Paulo Novis Rocha, Mitchell A Olman
BACKGROUND: The incidence of venous thromboembolism (VTE) after lung transplantation (LTX) varies significantly across studies. Two studies have suggested that these thrombotic events are associated with a lower posttransplant survival. Herein, we sought to determine the incidence, predictors, and impact of VTE on survival after LTX at a quaternary referral center. METHODS: This was a large cohort study of LTX recipients. Key outcome parameters were time to VTE after transplant and survival...
April 2018: Transplantation
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