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Lung transplantation technology

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https://www.readbyqxmd.com/read/30054767/a-new-way-of-monitoring-mechanical-ventilation-by-measurement-of-particle-flow-from-the-airways-using-pexa-method-in-vivo-and-during-ex-vivo-lung-perfusion-in-dcd-lung-transplantation
#1
Ellen Broberg, Martiné Wlosinska, Lars Algotsson, Anna-Carin Olin, Darcy Wagner, Leif Pierre, Sandra Lindstedt
BACKGROUND: Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation before changes in the tissue can be observed. We hypothesized that by analyzing the particle flow, we could understand the impact of different ventilation parameters. METHODS: Particle flow was monitored in vivo, post mortem, and in ex vivo lung perfusion (EVLP) in six porcines with the Pexa (particles in exhaled air) instrument...
July 27, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/30054193/applications-of-out-of-body-lung-perfusion
#2
Bing Zhu, Yoshikazu Suzuki, Thomas DiSanto, Samantha Rubin, Zachary Penfil, Ralph A Pietrofesa, Shampa Chatterjee, Melpo Christofidou-Solomidou, Edward Cantu
RATIONALE AND OBJECTIVES: Out of body organ perfusion is a concept that has been around for a long time. As technology has evolved, so have the systems available for out of body perfusion making whole organ preservation for extended evaluation, resuscitation, and discovery routine. MATERIALS AND METHODS: Clinical use of ex vivo lung perfusion (EVLP) systems has continued to expand as evidence has accumulated to suggest EVLP transplants experience similar mortality, ICU length of stay, length of mechanical ventilation, hospital length of stay, and rates of primary graft dysfunction as conventional lung transplants...
July 24, 2018: Academic Radiology
https://www.readbyqxmd.com/read/30023164/near-fatal-mucormycosis-post-double-lung-transplant-presenting-as-uncontrolled-upper-gastrointestinal-haemorrhage
#3
Ciara O'Connor, Ciaran Farrell, Aurelie Fabre, Donna Eaton, Karen Redmond, David G McSharry, John B Conneely, Conor J Shields, Jim J Egan, Margaret M Hannan
Invasive fungal infections in immunosuppressed transplant patients are associated with significant morbidity and mortality. We present a case of splenic mucormycosis post-double lung transplant, presenting as uncontrolled near-fatal upper gastrointestinal haemorrhage, to remind clinicians of the need to consider pre-transplant invasive fungal infection risk factors if an unexpected fungal infection arises in the post-transplant period. This case also highlights the valuable contribution of molecular technology for fungal identification but also the need for clinical correlation...
September 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29879861/blood-products-transfusion-and-mid-term-outcomes-of-lung-transplanted-patients-under-extracorporeal-membrane-oxygenation-support
#4
Tommaso Pettenuzzo, Giulio Faggi, Guido Di Gregorio, Marco Schiavon, Giuseppe Marulli, Dario Gregori, Federico Rea, Carlo Ori, Paolo Feltracco
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is considered a reliable technique in lung transplantation requiring cardiorespiratory support. However, the impact of this technology on blood product transfusion rate and outcomes compared to off-pump lung transplantation has been rarely investigated. METHODS: Between January 2012 and June 2015, 52 elective adult lung transplants were performed at our institution. Of these, 15 recipients required intraoperative venoarterial extracorporeal support and 37 did not...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29744218/machine-perfusion-of-thoracic-organs
#5
REVIEW
Dirk Van Raemdonck, Filip Rega, Steffen Rex, Arne Neyrinck
This article summarizes recent knowledge and clinical advances in machine perfusion (MP) of thoracic organs. MP of thoracic organs has gained much attention during the last decade. Clinical studies are investigating the role of MP to preserve, resuscitate, and assess heart and lungs prior to transplantation. Currently, MP of the cardiac allograft is essential in all type DCD heart transplantation while MP of the pulmonary allograft is mandatory in uncontrolled DCD lung transplantation. MP of thoracic organs also offers an exciting platform to further investigate downregulation of the innate and adaptive immunity prior to reperfusion of the allograft in recipients...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29742287/a-mobile-health-technology-enabled-home-based-intervention-to-treat-frailty-in-adult-lung-transplant-candidates-a-pilot-study
#6
Jonathan P Singer, Allison Soong, Allan Bruun, Ayana Bracha, Greg Chin, Steven R Hays, Jasleen Kukreja, Julia Rigler, Jeff A Golden, John R Greenland, Chris Garvey
BACKGROUND: Frailty is prevalent in lung transplant candidates (LTC) and is associated with waitlist delisting or death. We performed a pilot study to assess the safety and feasibility of a home-based, mobile health technology-facilitated intervention to treat frailty in LTC. METHODS: We performed an 8-week, nonrandomized, home-based exercise and nutrition intervention in LTC with Short Physical Performance Battery (SPPB) frailty scores of ≤11. The intervention utilized a customized, mobile device application ("app") enabling monitoring and progression of the intervention in real time...
June 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29734152/cell-sheet-engineering-and-kidney-diseases
#7
Masatoshi Oka, Yoei Miyabe, Naoko Sugiura, Kosaku Nitta
Treatment using the cell sheet technology has been applied to various organs, including the cornea, heart, esophagus, periodontium, cartilage, middle ear, and lungs. It has been shown that the therapeutic efficacy of cell sheet transplantation involves 2 aspects, supplementation of cells and provision of cytokines to the affected organ. In addition, cell sheet transplantation also promotes repair of damage through the paracrine effects of cytokines derived from the transplanted cells. It is known that in cases of cell transplantation by injection, the transplanted cells are less likely to differentiate into renal tissue to supply cells, but repair is promoted by the actions of the transplanted cell-derived renotropic factors...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29702179/state-of-the-art-in-pediatric-lung-transplantation
#8
Timothy S Lancaster, Pirooz Eghtesady
Pediatric lung transplantation is a highly specialized therapy for end-stage pulmonary disease in children, and is performed in only a handful of transplant centers around the world. Advancement in the field has been made on many fronts in recent years, including in public policy and organ allocation strategies, donor selection and management, emerging technologies for donor lung rehabilitation and bridge-to-transplant support of listed candidates, and ongoing refinement of surgical techniques. Despite this progress, children continue to suffer discrepant waitlist mortality and longer waiting times than their adult counterparts, and face special challenges of donor availability and size matching...
2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29695251/efficacy-and-mechanism-of-steep-pulse-irreversible-electroporation-technology-on-xenograft-model-of-nude-mice-a-preclinical-study
#9
Zuoqing Song, Xiaohong Xu, Minghui Liu, Jinghao Liu, Jun Chen, Chengxiang Li, Chenguo Yao, Qinghua Zhou
BACKGROUND: Steep pulse therapy can irreversible electrically brackdown of tumor membrance and cause cell death. In previous studies, we investigated the effect of steep pulsed electroporation on the killing of large cell lung cancer cell line L981- in vitro, and determined the best parameters for killing lung cancer cells by steep pulse technology. But the optimal parameters and the mechanisms of steep pulse irreversible electroporation technology on nude mouse tumor model are unclear...
April 25, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29590671/primary-graft-dysfunction-pgd-following-lung-transplantation
#10
Rupal J Shah, Joshua M Diamond
Primary graft dysfunction (PGD) is a form of acute lung injury that results from ischemia reperfusion injury (IRI) and is the major cause of early posttransplant morbidity and mortality. Patients who survive PGD have decreased quality of life, an increased risk of chronic lung allograft dysfunction, specifically bronchiolitis obliterans syndrome, and a significantly increased risk of death. In 2017, the International Society for Heart and Lung Transplantation released updated consensus statements on the PGD definition, most up-to-date PGD risk factors, mechanisms of PGD development, and the state-of-the-art for PGD therapeutics...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29423554/performance-of-a-second-generation-pulmonary-capnotracking-system-for-continuous-monitoring-of-cardiac-output
#11
Philip J Peyton, Monique Kozub
Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO2 elimination (VCO2 ) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO2 and end-tidal CO2 concentration with each breath. A baseline measurement of non-shunt cardiac output was made during a brief oscillating change in ventilator rate, according to the differential CO2 Fick approach and repeated at 5-10 min intervals...
February 8, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29376452/devices-for-ex-vivo-heart-and-lung-perfusion
#12
Dean P Schraufnagel, Robert J Steffen, Patrick R Vargo, Tamer Attia, Haytham Elgharably, Saad M Hasan, Alejandro Bribriesco, Per Wierup
The number of organs available for heart and lung transplantation is far short of the number that is needed to meet demand. Perfusion and ventilation of donor organs after procurement has led to exciting advances in the field of cardiothoracic transplantation. The clinical implications of this technology allows for techniques to evaluate the quality of an organ, active rehabilitation of organs after procurement and prior to implantation, and increased time between organ procurement and implantation. This ex-vivo perfusion technique has also been referred to in the lay press as the 'heart in a box' or 'lung in a box...
March 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29346562/scaffold-free-trachea-regeneration-by-tissue-engineering-with-bio-3d-printing
#13
Daisuke Taniguchi, Keitaro Matsumoto, Tomoshi Tsuchiya, Ryusuke Machino, Yosuke Takeoka, Abdelmotagaly Elgalad, Kiyofumi Gunge, Katsunori Takagi, Yasuaki Taura, Go Hatachi, Naoto Matsuo, Naoya Yamasaki, Koichi Nakayama, Takeshi Nagayasu
OBJECTIVES: Currently, most of the artificial airway organs still require scaffolds; however, such scaffolds exhibit several limitations. Alternatively, the use of an autologous artificial trachea without foreign materials and immunosuppressants may solve these issues and constitute a preferred tool. The rationale of this study was to develop a new scaffold-free approach for an artificial trachea using bio-3D printing technology. Here, we assessed the circumferential tracheal replacement using scaffold-free trachea-like grafts generated from isolated cells in an inbred animal model...
May 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29266272/a-decrease-in-hypoxic-pulmonary-vasoconstriction-correlates-with-increased-inflammation-during-extended-normothermic-ex-vivo-lung-perfusion
#14
Sayed Himmat, Almothana Alzamil, Nader Aboelnazar, Sanaz Hatami, Christopher White, Peter Dromparis, Michael Mengel, Darren Freed, Jayan Nagendran
Normothermic ex vivo lung perfusion (EVLP) is an evolving technology to evaluate function of donor lungs to determine suitability for transplantation. We hypothesize that hypoxic pulmonary vasoconstriction (HPV) during EVLP will provide a more sensitive parameter of lung function to determine donor lung quality for lung transplantation. Eight porcine lungs were procured, and subsequently underwent EVLP with autologous blood and STEEN solution for 10 h. Standard physiologic parameters including dynamic compliance, peak airway pressure, and pulmonary vascular resistance (PVR) remained stable (P = 0...
March 2018: Artificial Organs
https://www.readbyqxmd.com/read/29250755/extracorporeal-lung-support-for-advanced-lung-failure-a-new-era-in-thoracic-surgery-and-translational-science
#15
REVIEW
Norihisa Shigemura
For the patients with progressively decompensating acute or acute-on-chronic respiratory failure, the first-choice treatment remains as mechanical ventilation. Despite the consistent value of mechanical ventilation, the majority of lung specialists are aware of its limitations, in particular for the patients with advanced lung failure, and inherent drawbacks that augment disease progression. More recently, the concept of allowing the lungs to 'rest and recover' has been supported by quite a few clinical studies...
March 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29193654/technology-experience-of-solid-organ-transplant-patients-and-their-overall-willingness-to-use-interactive-health-technology
#16
Jasper M M Vanhoof, Bert Vandenberghe, David Geerts, Pieter Philippaerts, Patrick De Mazière, Annette DeVito Dabbs, Sabina De Geest, Fabienne Dobbels
BACKGROUND: The use of interactive health technology (IHT) is a promising pathway to tackle self-management problems experienced by many chronically ill patients, including solid organ transplant (Tx) patients. Yet, to ensure that the IHT is accepted and used, a human-centered design process is needed, actively involving end users in all steps of the development process. A first critical, predevelopment step involves understanding end users' characteristics. This study therefore aims to (a) select an IHT platform to deliver a self-management support intervention most closely related to Tx patients' current use of information and communication technologies (ICTs), (b) understand Tx patients' overall willingness to use IHT for self-management support, and investigate associations with relevant technology acceptance variables, and (c) explore Tx patients' views on potential IHT features...
March 2018: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/29190645/cd105-mesenchymal-stem-cells-migrate-into-osteoarthritis-joint-an-animal-model
#17
Pablo Fernandez-Pernas, Iván Rodríguez-Lesende, Alexandre de la Fuente, Jesús Mateos, Isaac Fuentes, Javier De Toro, Fco J Blanco, M C Arufe
Mesenchymal stem cells are being the focus of connective tissue technology and regenerative medicine, presenting a good choice cell source for improving old and well recognized techniques of cartilage defect repair. For instance, the autologous chondrocyte transplantation using new concepts of regenerative medicine. The present study investigated the risk of xenogenicity of human synovial membrane-derived MSCs, injected into the monkeys using intravenous and intra-articular administration. The animal models used were adult monkeys Rhesus which had been injured into the left knee to create an Osteoarthritis (OA) animal model...
2017: PloS One
https://www.readbyqxmd.com/read/29128016/extracorporeal-life-support-in-lung-transplantation
#18
REVIEW
Darryl Abrams, Daniel Brodie, Selim M Arcasoy
Extracorporeal life support in lung transplantation has been associated with poor posttransplant outcomes. However, recent advances have resulted in more favorable posttransplant outcomes. The increased use of this technology must be weighed against the risks inherent in its use, especially when complications arising in extracorporeal membrane oxygenation (ECMO)-dependent patients result in loss of transplant candidacy, leaving them with no viable alternative for long-term support. Existing and emerging data support the judicious use of this technology in carefully selected patients at high-volume transplant and ECMO centers that prioritize minimization of sedation, avoidance of endotracheal intubation, and early mobilization...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29110798/intraoperative-anesthetic-management-of-lung-transplantation-patients
#19
REVIEW
Bessie Kachulis, Ludmil Mitrev, Desmond Jordan
Lung transplantation is a high-risk procedure that requires a highly trained cardiothoracic anesthesiologist and a considerable degree of vigilance. In the 50 years since the first lung transplantation, improvements in immunosuppression, preservation solutions, and surgical techniques and technologies have led to increased survival rates. The development of the extracorporeal circulatory membrane oxygenation allowed for bridge to transplantation and for donor organ recovery from primary graft dysfunction post transplantation [1]...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29043965/japanese-encephalitis-virus-transmitted-via-blood-transfusion-hong-kong-china
#20
Vincent C C Cheng, Siddharth Sridhar, Shuk-Ching Wong, Sally C Y Wong, Jasper F W Chan, Cyril C Y Yip, Chi-Hung Chau, Timmy W K Au, Yu-Yan Hwang, Carol S W Yau, Janice Y C Lo, Cheuk-Kwong Lee, Kwok-Yung Yuen
Japanese encephalitis virus (JEV) is a mosquitoborne virus endemic to China and Southeast Asia that causes severe encephalitis in <1% of infected persons. Transmission of JEV via blood transfusion has not been reported. We report transmission of JEV via blood donation products from an asymptomatic viremic donor to 2 immunocompromised recipients. One recipient on high-dose immunosuppressive drugs received JEV-positive packed red blood cells after a double lung transplant; severe encephalitis and a poor clinical outcome resulted...
January 2018: Emerging Infectious Diseases
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