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Pre operative lung transplant

A Avriel, A H Klement, S R Johnson, M de Perrot, J Granton
Diastolic dysfunction may influence perioperative outcome, early graft function, and long-term survival. We compared the outcomes of double lung transplantation (DLTx) for patients with pulmonary arterial hypertension (PAH) with preoperative left ventricular (LV) diastolic dysfunction with the outcomes of patients without diastolic dysfunction. Of 116 consecutive patients with PAH (who underwent transplantation between January 1995 and December 2013), 44 met our inclusion and exclusion criteria. Fourteen (31...
May 16, 2017: American Journal of Transplantation
Michael Eberlein, Robert M Reed, Mayy Chahla, Servet Bolukbas, Amy Blevins, Dirk Van Raemdonck, Alessia Stanzi, Ilhan Inci, Silvana Marasco, Norihisa Shigemura, Clemens Aigner, Tobias Deuse
AIM: To systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio. METHODS: We set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley (CDSR), Database of Abstracts of Reviews of Effects via Wiley (DARE), Cochrane Central Register of Controlled Trials via Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx...
February 24, 2017: World Journal of Transplantation
Cheng-Chih Chang, Ying-Ju Chen, Tzu-Hao Huang, Chun-Han Chen, Fang-Ying Kuo, Hock-Liew Eng, Chee-Chien Yong, Yueh-Wei Liu, Ting-Lung Lin, Wei-Feng Li, Yu-Hung Lin, Chih-Che Lin, Chih-Chi Wang, Chao-Long Chen
BACKGROUND Because the outcome of liver transplantation for cholangiocarcinoma is often poor, cholangiocarcinoma is a contraindication for liver transplantation in most centers. Combined hepatocellular carcinoma and cholangiocarcinoma is a rare type of primary hepatic malignancy containing features of hepatocellular carcinoma and cholangiocarcinoma. Diagnosing combined hepatocellular carcinoma and cholangiocarcinoma pre-operatively is difficult. Because of sparse research presentations worldwide, we report our experience with living donor liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma...
February 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Wiebke Sommer, Gwen Buechler, Katharina Jansson, Murat Avsar, Ann-Kathrin Knöfel, Jawad Salman, Klaus Hoeffler, Thierry Siemeni, Jens Gottlieb, Johann H Karstens, Danny Jonigk, Ansgar Reising, Axel Haverich, Martin Strüber, Gregor Warnecke
Solid organs may differ in their potential to induce and maintain a state of donor-specific tolerance. Previously, we induced stable immunological tolerance in a lung transplantation model in miniature swine. Here, we wished to transfer this established protocol into a heart transplantation model in miniature swine. Heterotopic heart transplantation (HTX) was performed in four and left-sided lung transplantation (LTX) in seven minipigs from gender- and SLA-mismatched donors. All recipients received nonmyeloablative irradiation, donor splenocyte infusion and intravenous pharmacologic immunosuppression for 28 postoperative days...
January 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
Zheyi Liew, Santosh Mallikarjuna, Asif Hasan, F Kate Gould, Su Bunn, Matthew F Thomas, Jim L Lordan, Christopher O'Brien, Malcolm Brodlie
BACKGROUND: Cystic fibrosis lung disease is generally a diffuse process however rarely one lung may become particularly damaged through chronic collapse and consolidation resulting in end-stage bronchiectasis with relative sparing of the contralateral lung. This clinical situation is sometimes referred to as "destroyed lung". Lung resection surgery is seldom indicated in cystic fibrosis and the associated medical literature is relatively sparse. CASE PRESENTATION: A 14 year old boy was referred to our centre for lung transplantation assessment...
January 13, 2017: BMC Pulmonary Medicine
K Takeda, Y Sawada, T Kumamoto, K Tanaka, I Endo
BACKGROUND: The post-operative mortality and morbidity rates associated with living-donor liver transplantation (LDLT) are still relatively high. Several papers have reported the risk factors associated with post-operative infectious complications, but few have analyzed the risk factors with respect to the severity of sepsis. The aim of this study was to clarify the risk factors that affect severe sepsis after LDLT. METHODS: For 63 LDLT patients at our institute, we compared peri-operative characteristics in 29 patients who developed sepsis after surgery and 34 patients who did not...
July 2016: Transplantation Proceedings
Baruch Vainshelboim, Mordechai Reuven Kramer, Shimon Izhakian, Ricardo M Lima, Jose Oliveira
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that manifests in hypoxemia, inactivity, and poor prognosis. This study aimed to assess the prognostic role of physical activity (PA) and exertional desaturation (ED) with mortality in IPF. At baseline, 34 IPF patients (68 (50-81) years) were interviewed using the International Physical Activity Questionnaire (IPAQ), and SpO₂ was assessed pre to post 6-min walking test (∆SpO₂). Patients were prospectively followed up for 40 months. Receiver operating characteristics curve analysis determined cut-off points associated with mortality, and Cox proportional hazard ratio (HR) were conducted...
August 18, 2016: Journal of Clinical Medicine
S E Verleden, R Vos, E Vandermeulen, D Ruttens, H Bellon, T Heigl, D E Van Raemdonck, G M Verleden, V Lama, B D Ross, C J Galbán, B M Vanaudenaerde
Bronchiolitis obliterans syndrome (BOS) remains a major complication after lung transplantation. Air trapping and mosaic attenuation are typical radiological features of BOS; however, quantitative evaluation remains troublesome. We evaluated parametric response mapping (PRM, voxel-to-voxel comparison of inspiratory and expiratory computed tomography [CT] scans) in lung transplant recipients diagnosed with BOS (n = 20) and time-matched stable lung transplant recipients (n = 20). Serial PRM measurements were performed prediagnosis, at time of BOS diagnosis, and postdiagnosis (Tpre , T0 , and Tpost , respectively), or at a postoperatively matched time in stable patients...
November 2016: American Journal of Transplantation
Marijan Koprivanac, Marie M Budev, James J Yun, Marta Kelava, Gösta B Pettersson, Kenneth R McCurry, Douglas R Johnston, Abeel A Mangi, Penny L Houghtaling, Eugene H Blackstone, Sudish C Murthy
BACKGROUND: Coronary artery disease (CAD) remains a relative contraindication for lung transplantation, but should it be if amenable to effective palliation? METHODS: From January 2005 to July 2010, 356 adults undergoing primary lung transplantation had no significant (<50%) coronary arterial stenosis and 70 had significant (≥50%) CAD requiring prior or concomitant revascularization. Propensity matching on 38 pre-transplant patient characteristics identified 61 well-matched pairs (87% of possible matches) and 295 no-CAD unmatched patients to compare post-operative morbidity, graft function, and time-related pulmonary function and survival...
December 2016: Journal of Heart and Lung Transplantation
Kimberly N Hong, Aurelie Merlo, Dhaval Chauhan, Ryan R Davies, Alexander Iribarne, Elizabeth Johnson, Val Jeevanandam, Mark J Russo
BACKGROUND: This study was conducted to determine whether survival after orthotopic heart transplant (OHT) is associated with pre-transplant estimated glomerular filtration rate (eGFR) and to define ranges of pre-OHT eGFR associated with differences in post-transplant survival. The 2006 International Society for Heart and Lung Transplantation revised listing criteria for OHT stated that chronic kidney disease, defined by an eGFR <40 ml/min is a relative contraindication for OHT alone...
July 2016: Journal of Heart and Lung Transplantation
Conall T Morgan, Cedric Manlhiot, Brian W McCrindle, Anne I Dipchand
BACKGROUND: In the registry of the International Society for Heart and Lung Transplantation (ISHLT), cerebrovascular accidents are the fifth most common cause for mortality after pediatric heart transplantation (PHTx), but details are lacking in the literature. The purpose of this analysis of the ISHLT registry was to determine the prevalence, risk factors and outcomes of stroke after PHTx. METHODS: Data from the ISHLT registry (1998 to 2010) were used to identify all patients whose primary transplantation was performed at <18 years of age...
May 2016: Journal of Heart and Lung Transplantation
Kohei Hashimoto, Rickvinder Besla, Ricardo Zamel, Stephen Juvet, Hyunhee Kim, Sassan Azad, Thomas K Waddell, Marcelo Cypel, Mingyao Liu, Shaf Keshavjee
RATIONALE: Immediate graft performance after lung transplantation is associated with short- and long-term clinical outcomes. However, the biologic mechanism that determines outcomes is not fully understood. OBJECTIVES: To investigate the impact of cell death signals at 24 and 48 hours after lung transplantation on short- and long-term clinical outcomes. METHODS: Plasma samples were collected pretransplantation and at 24 and 48 hours after transplant from 60 bilateral lung transplant recipients...
July 1, 2016: American Journal of Respiratory and Critical Care Medicine
Prashant N Mohite, Anton Sabashnikov, Nikhil P Patil, Diana Garcia-Saez, Bartlomeij Zych, Mohamed Zeriouh, Rosalba Romano, Simona Soresi, Anna Reed, Martin Carby, Fabio De Robertis, Toufan Bahrami, Mohamed Amrani, Nandor Marczin, Andre R Simon, Aron-Frederik Popov
BACKGROUND: The risk-benefit for utilizing cardio-pulmonary bypass (CPB) in lung transplantation (LTx) remains debatable. This study compares outcomes after LTx utilizing different CPB strategies - elective CPB vs. off-pump vs. off-pump with unplanned conversion to CPB. METHODS: A total of 302 LTx performed over seven yr were divided into three groups: "off-pump" group (n = 86), "elective on-pump" group (n = 162), and "conversion" group (n = 54). The preoperative donor and recipient demographics and baseline characteristics and the postoperative outcomes were analyzed; 1:1 propensity score matching was used to identify patients operated upon using elective CPB who had risk profiles similar to those operated upon off-pump (propensity-matching 1) as well as those emergently converted from off-pump to CPB (propensity-matching 2)...
March 2016: Clinical Transplantation
Helen Marie Stone, Ross Gareth Edgar, Richard Damian Thompson, Robert Andrew Stockley
BACKGROUND: Lung transplantation is a therapeutic option for patients with end-stage lung disease and a survival benefit has been described in patients with alpha-1-antitrypsin deficiency (A1ATD). The aims of the current study were to determine the survival and health benefits of lung transplantation in UK patients with A1ATD compared to carefully matched non-transplant patients. METHODS: Patients with the PiZZ (alpha-1-antitrypsin deficiency) genotype who had undergone lung transplantation between 1996 and 2011 were identified from the UK A1ATD registry...
2016: COPD
Kongkiat Chaikriangkrai, Soma Jyothula, Hye Yeon Jhun, Jerry Estep, Matthias Loebe, Scott Scheinin, Guillermo Torre-Amione
BACKGROUND: This study examined the correlation between pre-operative coronary artery disease (CAD) and post-operative cardiovascular events in lung transplant recipients. METHODS: Consecutive isolated lung transplant recipients from 2007 to 2013 in our institution were identified and categorized as having significant CAD (≥ 50% coronary stenosis in at least 1 artery or history of coronary revascularization) or no-mild CAD. Patient records and death index data were analyzed for a median of 2 years for death or cardiovascular events, including coronary, cerebrovascular, and peripheral artery events...
January 2016: Journal of Heart and Lung Transplantation
Wai-Kit Lo, Robert Burakoff, Hilary J Goldberg, Natan Feldman, Walter W Chan
AIM: To evaluate pre-lung transplant acid reflux on pH-testing vs corresponding bolus reflux on multichannel intraluminal impedance (MII) to predict early allograft injury. METHODS: This was a retrospective cohort study of lung transplant recipients who underwent pre-transplant combined MII-pH-testing at a tertiary care center from January 2007 to November 2012. Patients with pre-transplant fundoplication were excluded. Time-to-event analysis was performed using a Cox proportional hazards model to assess associations between measures of reflux on MII-pH testing and early allograft injury...
August 14, 2015: World Journal of Gastroenterology: WJG
Joshua C Grimm, Vicente Valero, J Trent Magruder, Arman Kilic, Samuel P Dungan, Leann L Silhan, Pali D Shah, Bo S Kim, Christian A Merlo, Christopher M Sciortino, Ashish S Shah
BACKGROUND: In this study we sought to construct a novel scoring system to pre-operatively stratify a patient's risk of 1-year mortality after lung transplantation (LTx) based on recipient- and donor-specific characteristics. METHODS: The UNOS database was queried for adult (≥18 years) patients undergoing LTx between May 1, 2005 and December 31, 2012. The population was randomly divided in a 4:1 fashion into derivation and validation cohorts. A multivariable logistic regression model for 1-year mortality was constructed within the derivation cohort...
November 2015: Journal of Heart and Lung Transplantation
Purificación Pérez-Terán, Oriol Roca, José Rodríguez-Palomares, Judit Sacanell, Sandra Leal, Joan Solé, María I Rochera, Antonio Román, Juan C Ruiz-Rodríguez, Joaquim Gea, Arturo Evangelista, Joan R Masclans
BACKGROUND: Primary graft dysfunction (PGD) remains a significant cause of lung transplant postoperative morbidity and mortality. The underlying mechanisms of PGD development are not completely understood. This study analyzed the effect of right ventricular function (RVF) on PGD development. METHODS: A retrospective analysis of a prospectively assessed cohort was performed at a single institution between July 2010 and June 2013. The primary outcome was development of PGD grade 3 (PGD3)...
November 2015: Journal of Heart and Lung Transplantation
Hamza Salim, Jose Melendez, Harish Seethamraju
INTRODUCTION: Platypnea-orthodeoxia is a relatively uncommon but striking clinical syndrome characterized by dyspnea and deoxygenation accompanying a change to sitting or standing from a recumbent position. Hypoxemia early after lung transplant can have multiple etiologies. We report a rare case of persistent hypoxemia and platypnea-orthodeoxia after left single-lung transplantation, as a result of right-to-left interatrial shunt through a patent foramen ovale, with subsequent resolution of hypoxemia after percutaneous closure of the patent foramen ovale...
June 12, 2015: Journal of Medical Case Reports
S E Verleden, J L Todd, M Sato, S M Palmer, T Martinu, E N Pavlisko, R Vos, A Neyrinck, D Van Raemdonck, T Saito, H Oishi, S Keshavjee, M Greer, G Warnecke, J Gottlieb, A Haverich
Chronic lung allograft dysfunction (CLAD) remains a major problem after lung transplantation with no definitive treatment except redo lung transplantation (re-LTx) in selected candidates. However, CLAD is not a homogeneous entity and different phenotypes exist. Therefore, we aimed to evaluate the effect of CLAD phenotypes on survival after re-LTx for CLAD. Patients who underwent re-LTx for respiratory failure secondary to CLAD in four LTx centers between 2003 and 2013 were included in this retrospective analysis...
August 2015: American Journal of Transplantation
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