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Primary graft dysfunction

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https://www.readbyqxmd.com/read/29136325/primary-graft-dysfunction-after-heart-transplantation-incidence-trends-and-associated-risk-factors
#1
Alina Nicoara, David Ruffin, Mary Cooter, Chetan B Patel, Annemarie Thompson, Jacob Schroeder, Mani A Daneshmand, Adrian F Hernandez, Joseph G Rogers, Mihai V Podgoreanu, Madhav Swaminathan, Adam Kretzer, Mark Stafford-Smith, Carmelo A Milano, Raquel R Bartz
Changes in heart transplant (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutive adult patients who underwent HT between January 2009 and December 2014 at our institution. Patients were categorized as having PGD using the International Society of Heart and Lung Transplantation defined criteria. Variables, including clinical and demographic characteristics of donors and recipients, were selected to assess their independent association with PGD...
November 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29136255/loss-of-internal-tibial-rotation-after-anterior-cruciate-ligament-reconstruction
#2
Shawn R Brandenburg, Thomas M Matelic
The flexion angle of the knee and the position of the tibia need to be considered during tensioning of the anterior cruciate ligament (ACL) graft to avoid overconstraining the knee. The purpose of this report was to describe 2 cases of loss of tibial internal rotation after single-bundle anatomic ACL reconstruction with graft tensioning in flexion. Retrospective review of each patient's operative chart revealed that the graft was tensioned in flexion and placed in an anatomic position in the femoral tunnel at the time of the index operation...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29128047/use-of-lung-allografts-from-donation-after-cardiac-death-donors-a-single-center-experience
#3
Joseph Costa, Lori Shah, Hilary Robbins, Kashif Raza, Sowmya Sreekandth, Selim Arcasoy, Joshua R Sonett, Frank D'Ovidio
BACKGROUND: Lung transplantation remains the only treatment for end-stage lung disease. Availability of suitable lungs does not parallel this growing trend. Centers using donation after cardiac death (DCD) donor lungs report comparable outcomes with those from brain-dead donors. Donor assessment protocols and consistent surgical teams have been advocated when considering using the use of DCD donors. We present our experience using lungs from Maastricht category III DCD donors. METHODS: Starting 2007 to July 2016, 73 DCD donors were assessed, 44 provided suitable lungs that resulted in 46 transplants...
November 8, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29128015/primary-graft-dysfunction-after-lung-transplantation
#4
REVIEW
Mary K Porteous, James C Lee
Primary graft dysfunction is a form of acute injury after lung transplantation that is associated with significant short- and long-term morbidity and mortality. Multiple mechanisms contribute to the pathogenesis of primary graft dysfunction, including ischemia reperfusion injury, epithelial cell death, endothelial cell dysfunction, innate immune activation, oxidative stress, and release of inflammatory cytokines and chemokines. This article reviews the epidemiology, pathogenesis, risk factors, prevention, and treatment of primary graft dysfunction...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29112904/procalcitonin-accurately-predicts-lung-transplant-adults-with-low-risk-of-pulmonary-graft-dysfunction-and-intensive-care-mortality
#5
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/29110799/acute-postoperative-management-after-lung-transplantation
#6
REVIEW
Christopher Potestio, Desmond Jordan, Bessie Kachulis
Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29110798/intraoperative-anesthetic-management-of-lung-transplantation-patients
#7
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/29110796/long-term-outcomes-and-management-of-the-heart-transplant-recipient
#8
REVIEW
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29110793/postoperative-management-of-heart-transplantation-patients
#9
REVIEW
Eleanor Vega, Jacob Schroder, Alina Nicoara
Heart transplant recipients are at risk for a number of post-transplantation complications such as graft dysfunction, rejection, and infection. The rates of many complications are decreasing over time, and prognosis is improving. However, these patients continue to experience significant morbidity and mortality. This review focuses on the optimal management of heart transplant recipients in the postoperative period, based on current knowledge. More information is needed about the best ways to predict, prevent, and treat primary graft dysfunction, right ventricular failure, and cellular and antibody-mediated rejection...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29106711/interventions-for-treating-central-venous-haemodialysis-catheter-malfunction
#10
REVIEW
Alice L Kennard, Giles D Walters, Simon H Jiang, Girish S Talaulikar
BACKGROUND: Adequate haemodialysis (HD) in people with end-stage kidney disease (ESKD) is reliant upon establishment of vascular access, which may consist of arteriovenous fistula, arteriovenous graft, or central venous catheters (CVC). Although discouraged due to high rates of infectious and thrombotic complications as well as technical issues that limit their life span, CVC have the significant advantage of being immediately usable and are the only means of vascular access in a significant number of patients...
October 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29100649/lung-retransplantation-for-chronic-rejection-a-single-center-experience
#11
Sreeja Biswas Roy, Roshan Panchanathan, Rajat Walia, Katherine E Varsch, Paul Kang, Jasmine Huang, A Samad Hashimi, Thalachallour Mohanakumar, Ross M Bremner, Michael A Smith
BACKGROUND: Chronic lung allograft dysfunction (CLAD) is nonreversible and remains the biggest obstacle to long-term survival after lung transplantation (LTx). Retransplantation is the sole definitive therapeutic option for CLAD. We analyzed our single-center experience with retransplantation as a treatment option for CLAD. METHODS: From March 1, 2010, to May 31, 2016, 419 consecutive patients underwent LTx at our institution; 29 of these procedures were retransplantations for CLAD...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29096937/primary-graft-dysfunction-after-heart-transplantation-what-are-we-fighting-for
#12
EDITORIAL
Michael Zakliczynski
No abstract text is available yet for this article.
September 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29096622/tissue-engineered-smooth-muscle-cell-and-endothelial-progenitor-cell-bi-level-cell-sheets-prevent-progression-of-cardiac-dysfunction-microvascular-dysfunction-and-interstitial-fibrosis-in-a-rodent-model-of-type-1-diabetes-induced-cardiomyopathy
#13
Masashi Kawamura, Michael J Paulsen, Andrew B Goldstone, Yasuhiro Shudo, Hanjay Wang, Amanda N Steele, Lyndsay M Stapleton, Bryan B Edwards, Anahita Eskandari, Vi N Truong, Kevin J Jaatinen, Arnar B Ingason, Shigeru Miyagawa, Yoshiki Sawa, Y Joseph Woo
BACKGROUND: Diabetes mellitus is a risk factor for coronary artery disease and diabetic cardiomyopathy, and adversely impacts outcomes following coronary artery bypass grafting. Current treatments focus on macro-revascularization and neglect the microvascular disease typical of diabetes mellitus-induced cardiomyopathy (DMCM). We hypothesized that engineered smooth muscle cell (SMC)-endothelial progenitor cell (EPC) bi-level cell sheets could improve ventricular dysfunction in DMCM. METHODS: Primary mesenchymal stem cells (MSCs) and EPCs were isolated from the bone marrow of Wistar rats, and MSCs were differentiated into SMCs by culturing on a fibronectin-coated dish...
November 2, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29074873/regulatory-compliant-tissue-engineered-human-corneal-endothelial-grafts-restore-corneal-function-of-rabbits-with-bullous-keratopathy
#14
Gary S L Peh, Heng-Pei Ang, Chan N Lwin, Khadijah Adnan, Benjamin L George, Xin-Yi Seah, Shu-Jun Lin, Maninder Bhogal, Yu-Chi Liu, Donald T Tan, Jodhbir S Mehta
Corneal transplantation is the only treatment available to restore vision for individuals with blindness due to corneal endothelial dysfunction. However, severe shortage of available donor corneas remains a global challenge. Functional regulatory compliant tissue-engineered corneal endothelial graft substitute can alleviate this reliance on cadaveric corneal graft material. Here, isolated primary human corneal endothelial cells (CEnCs) propagated using a dual media approach refined towards regulatory compliance showed expression of markers indicative of the human corneal endothelium, and can be tissue-engineered onto thin corneal stromal carriers...
October 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29056228/comparison-of-clinical-characteristics-complications-and-outcomes-in-recipients-having-heart-transplants-65-years-of-age-versus-%C3%A2-65-years-of-age
#15
Aayla Jamil, Huanying Qin, Joost Felius, Giovanna Saracino, Aldo E Rafael, Juan C MacHannaford, Gonzalo V Gonzalez-Stawinski, Brian Lima
Advanced recipient age remains a limiting factor for heart transplant candidacy, with many centers reluctant to transplant older patients. Here, we report our experience with recipients aged ≥65 years compared with younger recipients in terms of baseline characteristics, intraoperative and immediate postoperative experiences, and post-transplant morbidity and survival. The main study outcome was primary graft dysfunction (PGD), which has not been widely studied in this population. Donor and recipient data from 255 heart transplantations performed between 2012 and 2016 were reviewed...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29055604/treatment-of-primary-graft-dysfunction-after-lung-transplantation-with-orally-inhaled-ap301-a-prospective-randomized-pilot-study
#16
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/29048930/how-would-you-grade-our-progress-in-primary-graft-dysfunction-after-lung-transplantation
#17
Arne Neyrinck, Geert M Verleden
No abstract text is available yet for this article.
October 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29042051/extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation-a-single-center-experience-in-the-present-era
#18
Emily M Todd, Sreeja Biswas Roy, A Samad Hashimi, Rosemarie Serrone, Roshan Panchanathan, Paul Kang, Katherine E Varsch, Barry E Steinbock, Jasmine Huang, Ashraf Omar, Vipul Patel, Rajat Walia, Michael A Smith, Ross M Bremner
OBJECTIVE: Extracorporeal membrane oxygenation has been used as a bridge to lung transplantation in patients with rapid pulmonary function deterioration. The reported success of this modality and perioperative and functional outcomes are varied. METHODS: We retrospectively reviewed all patients who underwent lung transplantation at our institution over 1 year (January 1, 2015, to December 31, 2015). Patients were divided into 2 groups depending on whether they required extracorporeal membrane oxygenation support as a bridge to transplant; preoperative characteristics, lung transplantation outcomes, and survival were compared between groups...
November 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29018070/hypothermic-oxygenated-machine-perfusion-hope-for-orthotopic-liver-transplantation-of-human-liver-allografts-from-extended-criteria-donors-ecd-in-donation-after-brain-death-dbd-a-prospective-multicentre-randomised-controlled-trial-hope-ecd-dbd
#19
Zoltan Czigany, Wenzel Schöning, Tom Florian Ulmer, Jan Bednarsch, Iakovos Amygdalos, Thorsten Cramer, Xavier Rogiers, Irinel Popescu, Florin Botea, Jiří Froněk, Daniela Kroy, Alexander Koch, Frank Tacke, Christian Trautwein, Rene H Tolba, Marc Hein, Ger H Koek, Cornelis H C Dejong, Ulf Peter Neumann, Georg Lurje
INTRODUCTION: Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28988183/neurological-outcome-after-minimal-invasive-coronary-artery-surgery-nomics-protocol-for-an-observational-prospective-cohort-study
#20
Kristof Nijs, Jeroen Vandenbrande, Fidel Vaqueriza, Jean-Paul Ory, Alaaddin Yilmaz, Pascal Starinieri, Jasperina Dubois, Luc Jamaer, Ingrid Arijs, Björn Stessel
INTRODUCTION: Adverse neurocognitive outcomes are still an important cause of morbidity and mortality after cardiac surgery. The most common neurocognitive disorders after conventional cardiac surgery are postoperative cognitive dysfunction (POCD), stroke and delirium. Minimal invasive cardiac procedures have recently been introduced into practice. Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimal invasive cardiac procedure based on the conventional CABG procedure. Neurocognitive outcome after minimal invasive cardiac surgery, including Endo-CABG, has never been studied...
October 6, 2017: BMJ Open
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