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Primary graft dysfunction

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https://www.readbyqxmd.com/read/28739402/graft-detachment-and-re-bubbling-rate-in-descemet-membrane-endothelial-keratoplasty
#1
REVIEW
Mohit Parekh, Pia Leon, Alessandro Ruzza, Davide Borroni, Stefano Ferrari, Diego Ponzin, Vito Romano
Descemet Membrane Endothelial Keratoplasty (DMEK) is a selective replacement of dysfunctional endothelium with healthy donor Descemet's membrane and endothelium. Although the donor preparation and surgical methods still remain a challenge, DMEK is gaining popularity in terms of early rehabilitation and visual outcomes. New and improved donor preparation techniques like pre-stripped DMEK tissues are taken up rapidly due to less manipulation that is required in the surgical theatre. Donor graft delivery in the recipient eye has also been improved due to new products like pre-stripped and pre-loaded membranes...
July 21, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28736024/effects-of-sildenafil-and-tadalafil-on-edema-and-reactive-oxygen-species-production-in-an-experimental-model-of-lung-ischemia-reperfusion-injury
#2
J R Guerra-Mora, E Perales-Caldera, D Aguilar-León, C Nava-Sanchez, A Díaz-Cruz, N E Díaz-Martínez, P Santillán-Doherty, G Torres-Villalobos, C C Bravo-Reyna
BACKGROUND: Lung ischemia-reperfusion injury is characterized by formation of reactive oxygen species and cellular swelling leading to pulmonary edema and primary graft dysfunction. Phosphodiesterase 5 inhibitors could ameliorate lung ischemia-reperfusion injury by interfering in many molecular pathways. The aim of this work was to evaluate and compare the effects of sildenafil and tadalafil on edema and reactive oxygen species formation in an ex vivo nonhuman animal model of lung ischemia-reperfusion injury...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734446/successful-lung-transplantation-using-a-deceased-donor-mechanically-ventilated-for-ten-months
#3
Shin Tanaka, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Takahiro Oto
A successful outcome after lung transplant was achieved using lungs donated from a teenage boy who underwent prolonged mechanical ventilation. The donor experienced hypoxic brain damage and was declared brain dead 324 days after tracheal intubation. At the time of referral, the donor's lungs revealed diffuse radiologic infiltration and atelectasis but excellent function, with a PaO2/FiO2 ratio of 450. The lungs were transplanted to a 10-year-old girl with bronchiolitis obliterans. She developed grade 2 primary graft dysfunction, but recovered quickly...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28733186/easix-in-patients-with-acute-graft-versus-host-disease-a-retrospective-cohort-analysis
#4
Thomas Luft, Axel Benner, Sonata Jodele, Christopher E Dandoy, Rainer Storb, Ted Gooley, Brenda M Sandmaier, Natalia Becker, Aleksandar Radujkovic, Peter Dreger, Olaf Penack
BACKGROUND: Endothelial dysfunction links thrombotic microangiopathy to steroid-refractory graft-versus-host disease (GVHD) after allogeneic stem-cell transplantation. We aimed to assess if the simple formula-lactate dehydrogenase (U/L) × creatinine (mg/dL)/thrombocytes (10(9) cells per L)-termed the Endothelial Activation and Stress Index (EASIX), might be valuable for the prediction of death in patients with acute GVHD after allogeneic stem-cell transplantation. METHODS: For this retrospective analysis, we analysed a training cohort (in Germany) and three validation cohorts (in Germany and the USA) of patients with acute GVHD who had received consecutive allogeneic stem-cell transplantation...
July 18, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28719755/clinical-risk-factors-and-prognostic-model-for-primary-graft-dysfunction-after-lung-transplantation-in-patients-with-pulmonary-hypertension
#5
Mary K Porteous, James C Lee, David J Lederer, Scott M Palmer, Edward Cantu, Rupal J Shah, Scarlett L Bellamy, Vibha N Lama, Sangeeta M Bhorade, Maria M Crespo, John F McDyer, Keith M Wille, A Russell Localio, Jonathan B Orens, Pali D Shah, Ann B Weinacker, Selim Arcasoy, David S Wilkes, Lorraine B Ware, Jason D Christie, Steven M Kawut, Joshua M Diamond
RATIONALE: Pulmonary hypertension from pulmonary arterial hypertension or parenchymal lung disease is associated with an increased risk of primary graft dysfunction after lung transplantation. OBJECTIVE: We evaluated the clinical determinants of severe primary graft dysfunction in pulmonary hypertension and developed and validated a prognostic model. METHODS: We conducted a retrospective cohort study of patients in the multi-center Lung Transplant Outcomes Group with pulmonary hypertension at transplant listing...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28712587/clinical-implications-of-donor-age-a-single-institution-analysis-spanning-3%C3%A2-decades
#6
Christopher T Holley, Rosemary F Kelly, Sara J Shumway, Roland Z Brown, Marshall I Hertz, Kyle D Rudser, Coco W Quinlan, Irena Cich, Gabriel Loor
BACKGROUND: We sought to clarify the effect of donor age as a continuous variable on morbidity and mortality in a single-institution experience. METHODS: From 1986 to 2016, 882 adult lung transplants were performed, including 396 in the lung allocation score era. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the association of donor age with overall survival and bronchiolitis obliterans syndrome (BOS) score ≥1-free survival. Logistic regression was used to evaluate the association with primary graft dysfunction grade 3...
June 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28704503/role-of-biomarkers-in-early-infectious-complications-after-lung-transplantation
#7
Borja Suberviola, Luzdivina Rellan, Jordi Riera, Reyes Iranzo, Ascension Garcia Campos, Juan Carlos Robles, Rosario Vicente, Eduardo Miñambres, Miguel Santibanez
BACKGROUND: Infections and primary graft dysfunction are devastating complications in the immediate postoperative period following lung transplantation. Nowadays, reliable diagnostic tools are not available. Biomarkers could improve early infection diagnosis. METHODS: Multicentre prospective observational study that included all centres authorized to perform lung transplantation in Spain. Lung infection and/or primary graft dysfunction presentation during study period (first postoperative week) was determined...
2017: PloS One
https://www.readbyqxmd.com/read/28698347/carbon-dioxide-surgical-field-flooding-and-aortic-no-touch-off-pump-coronary-artery-bypass-grafting-to-reduce-neurological-injuries-after-surgical-coronary-revascularisation-canon-protocol-for-a-randomised-controlled-investigator-and-patient-blinded-single
#8
Szwed Krzysztof, Pawliszak Wojciech, Serafin Zbigniew, Kowalewski Mariusz, Tomczyk Remigiusz, Perlinski Damian, Szwed Magdalena, Tomaszewska Marta, Anisimowicz Lech, Borkowska Alina
INTRODUCTION: Neurological injuries remain a major concern following coronary artery bypass grafting (CABG) that offsets survival benefit of CABG over percutaneous coronary interventions. Among numerous efforts to combat this issue is the development of off-pump CABG (OPCABG) that obviates the need for extracorporeal circulation and is associated with improved neurological outcomes. The objective of this study is to examine whether the neuroprotective effect of OPCABG can be further pronounced by the use of two state-of-the-art operating techniques...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#9
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/28689646/higher-m30-and-high-mobility-group-box-1-protein-levels-in-ex-vivo-lung-perfusate-are-associated-with-primary-graft-dysfunction-after-human-lung-transplantation
#10
Kohei Hashimoto, Marcelo Cypel, Stephen Juvet, Tomohito Saito, Ricardo Zamel, Tiago N Machuca, Michael Hsin, Hyunhee Kim, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
BACKGROUND: Ex vivo lung perfusion (EVLP) enables assessment of marginal donor lungs for transplantation, with similar clinical outcomes to conventional lung transplantation. We investigated whether cell death-related proteins in the EVLP perfusate could predict primary graft dysfunction (PGD) after transplantation. METHODS: M30 (indicating epithelial apoptosis), M65 (indicating total epithelial cell death), and high mobility group box 1 (HMGB-1, related to cell death and inflammation) protein levels in EVLP perfusate were measured by enzyme-linked immunosorbent assay and correlated with clinical outcomes...
June 21, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28676074/immunoregulatory-effects-of-multipotent-adult-progenitor-cells-in-a-porcine-ex-vivo-lung-perfusion-model
#11
An Martens, Sofie Ordies, Bart M Vanaudenaerde, Stijn E Verleden, Robin Vos, Dirk E Van Raemdonck, Geert M Verleden, Valerie D Roobrouck, Sandra Claes, Dominique Schols, Eric Verbeken, Catherine M Verfaillie, Arne P Neyrinck
BACKGROUND: Primary graft dysfunction (PGD) is considered to be the end result of an inflammatory response targeting the new lung allograft after transplant. Previous research has indicated that MAPC cell therapy might attenuate this injury by its paracrine effects on the pro-/anti-inflammatory balance. This study aims to investigate the immunoregulatory capacities of MAPC cells in PGD when administered in the airways. METHODS: Lungs of domestic pigs (n = 6/group) were subjected to 90 minutes of warm ischemia...
July 5, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28675791/olprinone-protects-liver-from-ischemia-reperfusion-injury-through-oxidative-stress-prevention-and-protein-kinase-akt-activation
#12
Mohamed Bejaoui, Mohamed Amine Zaouali, Rim Sakly, Hassen Ben Abdennebi
Liver ischemia reperfusion (IR) injury is inevitable in surgical procedures such as hepatic resection and liver transplantation. It represents a leading cause of liver graft dysfunction and primary non function after transplantation. Phosphodiesterase (PDE) inhibitors are emerging as effective drugs able to reduce IR damage. The aim of this study was to investigate the effect of selective PDE-3 inhibitor olprinone (Olp) against liver IR injury. Male Wistar rats were subjected to one hour of partial warm ischemia (70%) followed by six hours of reperfusion...
July 4, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28675360/four-years-of-hepatic-transplantation-in-the-republic-of-moldova
#13
Vladimir Hotineanu, Adrian Hotineanu, Serghei Burgoci, Grigore Ivancov, Natalia Taran, Angela Peltec, Dumitru Cazacu, Vitalie Sîrghi
Ever since the first liver transplant in the Republic of Moldova in 2013 we have performed 30 liver transplantations, the first having been performed in collaboration with the surgical team from Romania, led by Professor Irinel Popescu. The serious deficit of available cadaveric organs has forced us to begin with right hemi-liver transplantation from a living donor. In one third of liver transplantations we used right hemi-liver graft from a living donor, and in 2/3 of cases whole liver graft was harvested from brain-dead donors...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28650593/hhv-6-in-liver-transplantation-a-literature-review
#14
REVIEW
Tuan L Phan, Irmeli Lautenschlager, Raymund R Razonable, Flor M Munoz
Human herpesvirus 6 (HHV-6A and HHV-6B) can cause primary infection or reactivate from latency in liver transplant recipients, which can result in a variety of clinical syndromes, including fever, hepatitis, encephalitis, and higher rates of graft dysfunction as well as indirect effects including increased risks of mortality, CMV disease, hepatitis C progression and greater fibrosis scores. Although HHV-6 infection is currently diagnosed by quantifying viral DNA in plasma or blood, biopsy to demonstrate histopathologic effects of HHV-6 remains the gold standard for diagnosis of end-organ disease...
June 26, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28641354/-acute-liver-failure-acute-on-chronic-liver-failure-hepatorenal-syndrome-hepatopulmonary-syndrome-and-portopulmonary-hypertension-artificial-liver-support-on-the-icu
#15
Uwe Lodes, David Jacob, Frank Meyer
Background Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. Aim This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Method Narrative review with a selective literature review and representative case studies...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28636211/resolution-of-donor-non-alcoholic-fatty-liver-disease-following-liver-transplantation
#16
Andrew D Posner, Samuel T Sultan, Norann A Zaghloul, William S Twaddell, David A Bruno, Steven I Hanish, William R Hutson, Laci Hebert, Rolf N Barth, John C LaMattina
INTRODUCTION: Transplant surgeons conventionally select against livers displaying high degrees (>30%) of macrosteatosis (MaS), out of concern for primary non-function or severe graft dysfunction. As such, there is relatively limited experience with such livers, and the natural history remains incompletely characterized. We present our experience of transplanted livers with high degrees of MaS and microsteatosis (MiS), with a focus on the histopathologic and clinical outcomes. METHODS: 29 cases were identified with liver biopsies available from both the donor and the corresponding liver transplant recipient...
June 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28625949/discussion-on-the-risk-factors-of-developing-cardiovascular-diseases-cvd-after-the-kidney-transplantation
#17
Kai Wang, Qing-Shan Qu, Shu-Zhai Miao, Yanxuan Zhang, Xin Jing
To discuss the risk factors of developing cardiovascular disease (CVD) after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28624055/sevoflurane-preconditioning-protects-from-posttransplant-injury-in-mouse-lung-transplantation
#18
Yoshito Yamada, Isabelle Laube, Jae-Hwi Jang, John M Bonvini, Ilhan Inci, Walter Weder, Beatrice Beck Schimmer, Wolfgang Jungraithmayr
BACKGROUND: Although sevoflurane (Sevo) had been shown to ameliorate posttransplant injury in various organs, data available are inconsistent, particularly in the context of lung transplantation (Tx). We here investigated if preconditioning by Sevo can protect from posttransplant injury regarding both, primary graft dysfunction (PGD) and acute rejection (AR) after experimental lung Tx, thereby focusing on two important clinical outcome parameters. MATERIALS AND METHODS: Three experimental approaches were used: (1) BALB/c mice were preconditioned for 2 h with Sevo or a fentanyl cocktail (Control; n = 10); (2) syngeneic (Syn) mouse lung Tx (C57BL/6) with a Sevo-preconditioned graft followed by 18 h storage to mimic PGD (Syn-Tx, n = 12) versus controls (fentanyl cocktail); and (3) allogeneic (Allo) Tx (BALB/c, donor; C57BL/6, recipient) to mimic AR (Allo-Tx, n = 12) versus controls (fentanyl cocktail)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28620643/activin-biology-after-lung-transplantation
#19
Glen P Westall, Gregory I Snell, Monika Loskot, Bronwyn Levvey, Robyn O'Hehir, Mark P Hedger, David M de Kretser
BACKGROUND: Activins A and B, members of the TGF-β superfamily, are produced as part of the physiological response to tissue damage and the resulting proinflammatory response. Given that lung allograft reperfusion results in an inflammatory response, it is likely that the activins and their binding protein follistatin will form part of the regulatory response. There is a need to document the response of these proteins to allograft reperfusion to determine if there is a role for the use of follistatin to control the biological actions of the activins because some of these are potentially damaging...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620154/influence-of-donor-lung-surfactant-a-and-b-protein-expression-on-the-development-of-primary-graft-dysfunction-after-lung-transplantation-a-pilot-study
#20
Asmae Belhaj, Carine Boven, Laurence Dewachter, Maria Ruiz Patino, Youri Sokolow, Benoît Rondelet
BACKGROUND Primary graft dysfunction (PGD) is responsible of high early mortality in lung transplanted patients. We measured the rate of surfactant proteins in the organ donor, and we observed the occurrence of lung PGD in the recipient. The co-relation between these two parameters was evaluated. MATERIAL AND METHODS In this pilot study, we prospectively collected blood samples and lung biopsies in thirteen donors at the time of recovery of organs before preservation. Gene expression of SP-A, SP-B, SP-D, and CC16 was evaluated by real-time quantitative PCR...
June 16, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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