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chronic lung allograft dysfunction

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https://www.readbyqxmd.com/read/28691954/maintenance-belatacept-based-immunosuppression-in-lung-transplantation-recipients-who-failed-calcineurin-inhibitors
#1
Carlo J Iasella, Ryan J Winstead, Cody A Moore, Bruce A Johnson, Ayelet T Feinberg, Matthew R Morrell, J W Awori Hayanga, Elizabeth A Lendermon, Adriana Zeevi, John F McDyer, Christopher R Ensor
BACKGROUND: Traditional immunosuppressive regimens (ISR) used in lung transplantation rely on calcineurin inhibitors (CNI) that occasionally cause severe adverse reactions necessitating discontinuation. Belatacept is a novel costimulation antagonist approved for use in renal transplantation which lacks data in lung transplantation. This series aims to describe the response to belatacept ISR in 11 lung transplantation recipients after CNI failure. METHODS: Single center, retrospective medical record review of adult lung transplant recipients (LTR) before and after conversion to belatacept-based ISR...
July 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28686641/the-prognostic-importance-of-cxcr3-chemokine-during-organizing-pneumonia-on-the-risk-of-chronic-lung-allograft-dysfunction-after-lung-transplantation
#2
Michael Y Shino, S Samuel Weigt, Ning Li, Vyacheslav Palchevskiy, Ariss Derhovanessian, Rajan Saggar, David M Sayah, Richard H Huynh, Aric L Gregson, Michael C Fishbein, Abbas Ardehali, David J Ross, Joseph P Lynch, Robert M Elashoff, John A Belperio
RATIONALE: Since the pathogenesis of chronic lung allograft dysfunction (CLAD) remains poorly defined with no known effective therapies, the identification and study of key events which increase CLAD risk is a critical step towards improving outcomes. We hypothesized that bronchoalveolar lavage fluid (BALF) CXCR3 ligand concentrations would be augmented during organizing pneumonia (OP) and that episodes of OP with marked chemokine elevations would be associated with significantly higher CLAD risk...
2017: PloS One
https://www.readbyqxmd.com/read/28662986/therapy-options-for-chronic-lung-allograft-dysfunction-bronchiolitis-obliterans-syndrome-following-first-line-immunosuppressive-strategies-a-systematic-review
#3
Christian Benden, Maria Haughton, Saoirse Leonard, Lars C Huber
BACKGROUND: Long-term success of lung transplantation is limited by the development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common form. This systematic review sought to identify the current evidence base for CLAD-BOS therapies after initial immunosuppressive treatment strategies. METHODS: The MEDLINE, Embase, and Cochrane Library databases from inception to May 3, 2016, were searched using keywords relating to CLAD-BOS, study designs, and treatments of interest, including extracorporeal photopheresis (ECP), aerosolized cyclosporine, total lymphoid irradiation (TLI), alemtuzumab, and montelukast...
May 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28662022/impaired-esophageal-motility-and-clearance-post-lung-transplant-risk-for-chronic-allograft-failure
#4
Anupong Tangaroonsanti, Augustine S Lee, Michael D Crowell, Marcelo F Vela, Daryl R Jones, David Erasmus, Cesar Keller, Jorge Mallea, Francisco Alvarez, Cristina Almansa, Kenneth R DeVault, Lesley A Houghton
OBJECTIVES: Gastroesophageal reflux is common in patients post-lung transplantation (LTx) and thus considered a risk factor for aspiration and consequently allograft rejection and the development of chronic allograft failure. However, evidence supporting this remains unclear and often contradictory. Our aim was to examine the role played by esophageal motility on gastroesophageal reflux exposure, along with its clearance and that of boluses swallowed, and the relationship to development of obstructive chronic lung allograft dysfunction (o-CLAD)...
June 29, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28658530/the-role-of-biomechanical-anatomical-modeling-via-computed-tomography-for-identification-of-restrictive-allograft-syndrome
#5
Miho Horie, Tomohito Saito, Joanne Moseley, Luigia D'Errico, Pascal Salazar, Daisuke Nakajima, Kristy Brock, Kazuhiro Yasufuku, Matthew Binnie, Shaf Keshavjee, Narinder Paul
Chronic lung allograft dysfunction (CLAD) reduces long term graft survival. It is important to distinguish CLAD subtypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS) as RAS has a worse prognosis and accurate subtyping could facilitate targeted treatments. However, the current diagnosis of CLAD subtypes is based on pulmonary function test results that reflect global estimates of lung function; anatomical modeling based on computed tomography (CT) has the potential to provide detailed analysis of global and regional lung function...
June 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28653398/lung-transplant-recipients-on-long-term-extracorporeal-photopheresis
#6
Bruno Isenring, Cécile Robinson, Urs Buergi, Macé M Schuurmans, Malcolm Kohler, Lars C Huber, Christian Benden
Extracorporeal photophoresis (ECP) is an increasingly used therapy to address chronic lung allograft dysfunction (CLAD) following lung transplantation. In 2008, we reported the first single-center experience showing that ECP not only reduces lung function decline in patients with bronchiolitis obliterans syndrome (BOS) but results in stabilization of patients with recurrent acute cellular rejection (ACR). In the current study, the original cohort was followed up further 5 years. In addition, patients with CLAD were retrospectively classified according to recently published phenotypes...
June 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28651906/lung-clearance-index-is-sensitive-to-small-airway-disease-in-pediatric-lung-transplant-recipients
#7
Julia E Kao, Jacquelyn M Zirbes, Carol K Conrad, Carlos E Milla
BACKGROUND: The principal obstacle to long-term survival after lung transplant is chronic lung allograft dysfunction (CLAD), which primarily affects the small airways. After transplant, patients are monitored with spirometry, which is a generally insensitive detector of small airways obstruction. The lung clearance index (LCI) is a measure obtained during multiple breath washout (MBW) maneuvers. We hypothesized that among lung allograft recipients, LCI would detect small airways disease not detected with spirometry...
May 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28647206/ct-at-onset-of-chronic-lung-allograft-dysfunction-in-lung-transplant-patients-predicts-development-of-the-restrictive-phenotype-and-survival
#8
Sabine Dettmer, Hoen-Oh Shin, Jens Vogel-Claussen, Max Westphal, Axel Haverich, Gregor Warnecke, Tobias Welte, Frank Wacker, Jens Gottlieb, Hendrik Suhling
PURPOSE: To describe early signs for restrictive subtype of chronic lung allograft dysfunction (CLAD) after lung transplantation in computed tomography (CT) and to evaluate the predictive value for disease progression and survival. MATERIAL AND METHODS: 52 CT examinations in lung transplant patients at CLAD onset were scored for CT features referring to airways disease, parenchymal or pleural abnormality. Patients with and without later development of restrictive CLAD (TLC≤80%) were compared...
June 15, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28637080/the-prognostic-importance-of-bronchoalveolar-lavage-fluid-cxcl9-during-minimal-acute-rejection-on-the-risk-of-chronic-lung-allograft-dysfunction
#9
M Y Shino, S S Weigt, N Li, A Derhovanessian, D M Sayah, R Saggar, Richard H Huynh, A L Gregson, A Ardehali, D J Ross, J P Lynch, R M Elashoff, J A Belperio
The clinical significance and treatment strategies for minimal acute rejection (grade A1), the most common form of acute rejection (AR), remains controversial. In this retrospective single-center cohort study of 441 lung transplant recipients, we formally evaluate the association between minimal AR and chronic lung allograft dysfunction (CLAD) and test a novel hypothesis using BAL CXCL9 concentration during minimal AR as a biomarker of subsequent CLAD development. In univariable and multivariable models adjusted for all histopathologic injury patterns, minimal AR was not associated with CLAD development...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28620643/activin-biology-after-lung-transplantation
#10
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/28546378/pediatric-lung-transplantation
#11
Stuart C Sweet
Pediatric lung transplant is a viable option for treatment of end-stage lung disease in children, with > 100 pediatric lung transplants reported to the Registry of the International Society of Heart and Lung Transplantation each year. Long-term success is limited by availability of donor organs, debilitation as a result of chronic disease, impaired mucus clearance resulting from both surgical and pharmacologic interventions, increased risk for infection resulting from immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28545478/ltb4-and-montelukast-in-transplantation-related-bronchiolitis-obliterans-in-rats
#12
Zheng-Liang Tu, Zhen-Yu Zhou, Hai-Chao Xu, Jin-Lin Cao, Peng Ye, Lu-Ming Wang, Wang Lv, Jian Hu
BACKGROUND: Lung transplantation is the only effective treatment for end-stage lung diseases. Bronchiolitis obliterans, which is known as non-infectious chronic lung allograft dysfunction (CLAD) in the new classification, is the greatest threat to long-term survival after lung transplantation. This study investigated the role of leukotriene B4 (LTB4) and montelukast in transplantation-related bronchiolitis obliterans and discussed the pathophysiological significance of LTB4 in chronic rejection...
May 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28488260/cessation-of-extracorporeal-photopheresis-in-chronic-lung-allograft-dysfunction-effects-on-clinical-outcome-in-adults
#13
Cécile A Robinson, Lars Huber, Christian Murer, Macé Schuurmans, Malcolm Kohler, Günther Hofbauer, Christian Benden
BACKGROUND: Extracorporeal photopheresis (ECP) has been reported to be safe and the ultimate treatment option in lung transplant recipients with chronic lung allograft dysfunction (CLAD), the main overall cause of mortality in lung transplant recipients. However, ECP is not reimbursed in selected health jurisdictions, and reimbursement by health insurance providers is a major issue. In Switzerland, ECP is not recognised by the health authorities as a therapy option for CLAD; thus by the end of 2014, ECP had to be stopped in the majority of adult lung transplant recipients cared for at the University Hospital Zurich because of lack of continuous funding...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28470870/a-multicenter-study-on-long-term-outcomes-after-lung-transplantation-comparing-donation-after-circulatory-death-and-donation-after-brain-death
#14
V van Suylen, B Luijk, R A S Hoek, E A van de Graaf, E A Verschuuren, C Van De Wauwer, J A Bekkers, R C A Meijer, W van der Bij, M E Erasmus
The implementation of donation after circulatory death category 3 (DCD3) was one of the attempts to reduce the gap between supply and demand of donor lungs. In the Netherlands, the total number of potential lung donors was greatly increased by the availability of DCD3 lungs in addition to the initial standard usage of donation after brain death (DBD) lungs. From the three lung transplant centers in the Netherlands, 130 DCD3 recipients were one-to-one nearest neighbor propensity score matched with 130 DBD recipients...
May 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28469930/early-extracellular-matrix-changes-are-associated-with-later-development-of-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#15
Catharina Müller, Annika Andersson-Sjöland, Hans Henrik Schultz, Leif T Eriksson, Claus B Andersen, Martin Iversen, Gunilla Westergren-Thorsson
BACKGROUND: Chronic lung allograft dysfunction in the form of bronchiolitis obliterans syndrome (BOS) is the main cause of death beyond 1-year post-lung transplantation. The disease-initiating triggers as well as the molecular changes leading to fibrotic alterations in the transplanted lung are largely unknown. The aim of this study was to identify potential early changes in the extracellular matrix (ECM) in different compartments of the transplanted lung prior to the development of BOS...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28469087/models-of-lung-transplant-research-a-consensus-statement-from-the-national-heart-lung-and-blood-institute-workshop
#16
REVIEW
Vibha N Lama, John A Belperio, Jason D Christie, Souheil El-Chemaly, Michael C Fishbein, Andrew E Gelman, Wayne W Hancock, Shaf Keshavjee, Daniel Kreisel, Victor E Laubach, Mark R Looney, John F McDyer, Thalachallour Mohanakumar, Rebecca A Shilling, Angela Panoskaltsis-Mortari, David S Wilkes, Jerry P Eu, Mark R Nicolls
Lung transplantation, a cure for a number of end-stage lung diseases, continues to have the worst long-term outcomes when compared with other solid organ transplants. Preclinical modeling of the most common and serious lung transplantation complications are essential to better understand and mitigate the pathophysiological processes that lead to these complications. Various animal and in vitro models of lung transplant complications now exist and each of these models has unique strengths. However, significant issues, such as the required technical expertise as well as the robustness and clinical usefulness of these models, remain to be overcome or clarified...
May 4, 2017: JCI Insight
https://www.readbyqxmd.com/read/28457418/histopathological-findings-associated-with-gastroesophageal-reflux-disease-and-aspiration-after-lung-transplantation-initial-brazilian-single-center-experience
#17
R M Carraro, E C T Nascimento, S Szachnowicz, P C L B Camargo, S V Campos, J E Afonso, M N Samano, P M Pêgo-Fernandes, M Dolhnikoff, R H O B Teixeiraa, A N Costa
BACKGROUND: Gastro-esophageal reflux disease (GERD) and broncho-aspiration (BA) are known to increase the risk for chronic lung allograft dysfunction (CLAD). However, specific lung injury mechanisms are not clearly known. The objective of the study was to describe histopathological findings in surveillance lung transbronchial biopsies that can be correlated with episodes of BA in the lung allograft. METHODS: This retrospective analysis of surveillance transbronchial biopsies was performed in lung transplant recipients, with available data of broncho-alveolar fluid (cultures and cytology), lung function parameters, and esophageal functional tests...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28431983/comparison-of-extracorporeal-photopheresis-and-alemtuzumab-for-the-treatment-of-chronic-lung-allograft-dysfunction
#18
Anna Moniodis, Keri Townsend, Alexander Rabin, Obadah Aloum, Jessica Stempel, Patrick Burkett, Phillip Camp, Miguel Divo, Souheil El-Chemaly, Hari Mallidi, Ivan Rosas, Anne Fuhlbrigge, Sophia Koo, Hilary J Goldberg
BACKGROUND: Survival after lung transplantation is limited by chronic lung allograft dysfunction (CLAD). Immunomodulatory therapies such as extracorporeal photopheresis (ECP) and alemtuzumab (AL) have been described for refractory CLAD, but comparative outcomes are not well defined. METHODS: We retrospectively reviewed spirometric values and clinical outcomes after therapy with ECP, AL, or no treatment (NT) in patients with CLAD who underwent transplant between January 2005 and December 2014...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28415888/bioengineered-gold-nanoparticles-targeted-to-mesenchymal-cells-from-patients-with-bronchiolitis-obliterans-syndrome-does-not-rise-the-inflammatory-response-and-can-be-safely-inhaled-by-rodents
#19
Emanuela Cova, Simona Inghilleri, Laura Pandolfi, Monica Morosini, Sara Magni, Miriam Colombo, Davide Piloni, Chiara Finetti, Gabriele Ceccarelli, Laura Benedetti, Maria Gabriella Cusella, Manuela Agozzino, Fabio Corsi, Raffaele Allevi, Simona Mrakic-Sposta, Sarah Moretti, Simona De Gregori, Davide Prosperi, Federica Meloni
The use of gold nanoparticles (GNPs) as drug delivery system represents a promising issue for diseases without effective pharmacological treatment due to insufficient local drug accumulation and excessive systemic toxicity. Bronchiolitis obliterans syndrome (BOS) represents about 70% of cases of chronic lung allograft dysfunction, the main challenge to long-term lung transplantation. It is believed that due to repeated insults to epithelial bronchiolar cells local inflammatory response creates a milieu that favors epithelial-mesenchymal transition and activation of local mesenchymal cells (MCs) leading to airway fibro-obliteration...
April 27, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28404654/physiology-of-chronic-lung-allograft-dysfunction-back-to-the-future
#20
EDITORIAL
Allan R Glanville
No abstract text is available yet for this article.
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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