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Lung transplantation technology

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https://www.readbyqxmd.com/read/30507676/extravascular-lung-water-monitoring-for-thoracic-and-lung-transplant-surgeries
#1
Sherif Assaad, Wolf B Kratzert, Albert C Perrino
PURPOSE OF REVIEW: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates...
November 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/30391025/the-utility-of-complement-assays-in-clinical-immunology-a-comprehensive-review
#2
REVIEW
Thomas Lung, Lorenz Risch, Martin Risch, Benjamin Sakem, Reinhard Würzner, Urs Nydegger
The multi-tasking organ liver, which is the major synthesis site of most serum proteins, supplies humoral components of the innate, - including proteins of the complement system; and, less intensely, also of the acquired immune system. In addition to hepatocyte origins, C1q, factor D, C3, C7 and other protein components of the complement system are produced at various body locations by monocytes/macrophages, lymphocytes, adipocytes, endometrium, enterocytes, keratinocytes and epithelial cells; but the contribution of these alternate sites to the total serum concentrations is slight...
October 31, 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/30286447/the-gut-microbiota-and-hematopoietic-stem-cell-transplantation-challenges-and-potentials
#3
REVIEW
Fozia Noor, Anne Kaysen, Paul Wilmes, Jochen G Schneider
The human gut microbiota gained tremendous importance in the last decade as next-generation technologies of sequencing and multiomics analyses linked the role of the microbial communities to host physiology and pathophysiology. A growing number of human pathologies and diseases are linked to the gut microbiota. One of the main mechanisms by which the microbiota influences the host is through its interactions with the host immune system. These interactions with both innate and adaptive host intestinal and extraintestinal immunity, although usually commensalistic even mutualistic with the host, in some cases lead to serious health effects...
October 4, 2018: Journal of Innate Immunity
https://www.readbyqxmd.com/read/30261966/artificial-lungs-for-lung-failure-jacc-technology-corner
#4
REVIEW
Noritsugu Naito, Keith Cook, Yoshiya Toyoda, Norihisa Shigemura
Although lung transplantation is an effective treatment for end-stage lung failure, its limitations have led to renewed interest in artificial lung support for patients with lung failure. The use of ventricular assist devices has significantly improved the quality of life and survival of patients with end-stage heart failure. In contrast, there are no devices that can be used long term as destination therapy for end-stage lung failure, and there is a strong need for them. Extracorporeal membrane oxygenation is widely used as a temporary treatment for acute lung failure and as a bridge to lung transplant...
October 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/30253872/trends-in-mortality-and-resource-utilization-for-extracorporeal-membrane-oxygenation-in-the-united-states-2008-2014
#5
Yas Sanaiha, Katherine Bailey, Peter Downey, Young-Ji Seo, Esteban Aguayo, Vishal Dobaria, Richard J Shemin, Peyman Benharash
BACKGROUND: Extracorporeal membrane oxygenation is used as a life-sustaining measure in patients with acute or end-stage cardiac or respiratory failure. We analyzed national trends in extracorporeal membrane oxygenation use and outcomes and assessed the influence of hospital demographics. METHODS: Adult extracorporeal membrane oxygenation patients in the 2008-2014 National Inpatient Sample were evaluated. Patient and hospital characteristics, extracorporeal membrane oxygenation indication, mortality, and hospital costs were analyzed...
September 22, 2018: Surgery
https://www.readbyqxmd.com/read/30233890/extracorporeal-support-during-and-after-lung-transplantation-the-history-of-an-idea
#6
REVIEW
Fabio Ius, Igor Tudorache, Gregor Warnecke
During recent years, continuous technological innovation has provoked an increase of extracorporeal life support (ECLS) use for perioperative cardiopulmonary support in lung transplantation. Initial results were disappointing, due to ECLS-specific complications and high surgical risk of the supported patients. However, the combination of improved patient management, multidisciplinary team work and standardization of ECLS protocols has recently yielded excellent results in several case series from high-volume transplant centres...
August 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/30214443/xenogeneic-graft-versus-host-disease-in-humanized-nsg-and-nsg-hla-a2-hhd-mice
#7
Grégory Ehx, Joan Somja, Hans-Jörg Warnatz, Caroline Ritacco, Muriel Hannon, Loïc Delens, Gilles Fransolet, Philippe Delvenne, Joséphine Muller, Yves Beguin, Hans Lehrach, Ludovic Belle, Stéphanie Humblet-Baron, Frédéric Baron
Despite the increasing use of humanized mouse models to study new approaches of graft-versus-host disease (GVHD) prevention, the pathogenesis of xenogeneic GVHD (xGVHD) in these models remains misunderstood. The aim of this study is to describe this pathogenesis in NOD/LtSz-Prkdcscid IL2rγtm1Wjl (NSG) mice infused with human PBMCs and to assess the impact of the expression of HLA-A0201 by NSG mice cells (NSG-HLA-A2/HHD mice) on xGVHD and graft-versus-leukemia (GvL) effects, by taking advantage of next-generation technologies...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/30171860/the-future-of-lung-transplantation
#8
Katherine A Young, Daniel F Dilling
The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overcome several stumbling blocks, including donor shortage, proper selection of candidates, primary graft dysfunction, and chronic lung allograft dysfunction. The advances and developments surrounding these factors will have a significant impact on shaping the field within the coming years...
August 29, 2018: Chest
https://www.readbyqxmd.com/read/30166412/extracorporeal-lung-support-for-hypercapnic-ventilatory-failure
#9
Lara Pisani, Massimiliano Polastri, Angela Maria Grazia Pacilli, Stefano Nava
Extracorporeal lung support can be achieved using extracorporeal membrane oxygenation (ECMO) and extracorporeal CO2 removal. The ECMO systems allow a total lung support, providing both blood oxygenation and CO2 removal. Unlike ECMO, extracorporeal CO2 removal refers to an extracorporeal circuit that provides a partial lung support and selectively extracts CO2 from blood. The concept of partial extracorporeal lung support by removing only CO2 without effect on oxygenation was first proposed in 1977 by Kolobow and Gattinoni, with the aim to reduce breathing frequency, ventilator tidal volumes, and inspiratory pressures, facilitating lung-protective ventilation...
September 2018: Respiratory Care
https://www.readbyqxmd.com/read/30166411/technical-advances-in-the-field-of-ecmo
#10
Peter Betit
Although the fundamentals of extracorporeal membrane oxygenation (ECMO) have not changed in 3 decades, the technical elements continue to improve and have evolved from an assemblage of individual components to more integrated systems with added features, enhanced safety, and improved maneuverability. The introduction of polymethylpentene (PMP) fiber technology has expanded the development of artificial membranes that have low resistance, are more biocompatible, and can be used for extended durations. Extracorporeal carbon dioxide removal techniques continue to be enhanced as stand alone technology and modified renal dialysis systems are introduced...
September 2018: Respiratory Care
https://www.readbyqxmd.com/read/30123573/artificial-lung
#11
REVIEW
Francesco Petrella, Lorenzo Spaggiari
Lung transplantation remains the definitive curative treatment for end-stage lung disease. However, future applications of tissue bioengineering could overcome the donor organ shortage and the need for immunosuppression. The final goal of lung tissue engineering is to recreate the whole spectrum of specialized lung tissues and thereby provide physiologic functions through bioengineered conducting airways, vasculature and gas exchange tissue. This review focuses on ongoing research in artificial lung development, open questions, achievements to date and how tissue engineering and stem cell technology may further contribute to the clinical application of bioartificial lungs...
July 2018: Journal of Thoracic Disease
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
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
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