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chronic lung allograft dysfunction

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https://www.readbyqxmd.com/read/28488260/cessation-of-extracorporeal-photopheresis-in-chronic-lung-allograft-dysfunction-effects-on-clinical-outcome-in-adults
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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 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 favours epithelial mesenchymal transition and activation of local mesenchymal cells leading to airway fibro-obliteration...
April 18, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28404654/physiology-of-chronic-lung-allograft-dysfunction-back-to-the-future
#8
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
https://www.readbyqxmd.com/read/28404648/lung-volumes-predict-survival-in-patients-with-chronic-lung-allograft-dysfunction
#9
Nikolaus Kneidinger, Katrin Milger, Silke Janitza, Felix Ceelen, Gabriela Leuschner, Julien Dinkel, Melanie Königshoff, Thomas Weig, René Schramm, Hauke Winter, Jürgen Behr, Claus Neurohr
Identification of disease phenotypes might improve the understanding of patients with chronic lung allograft dysfunction (CLAD). The aim of the study was to assess the impact of pulmonary restriction and air trapping by lung volume measurements at the onset of CLAD.A total of 396 bilateral lung transplant recipients were analysed. At onset, CLAD was further categorised based on plethysmography. A restrictive CLAD (R-CLAD) was defined as a loss of total lung capacity from baseline. CLAD with air trapping (AT-CLAD) was defined as an increased ratio of residual volume to total lung capacity...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28389169/hard-to-swallow-dysmotility-reflux-and-chronic-lung-allograft-dysfunction-in-pediatric-lung-transplantation
#10
EDITORIAL
Joshua A Blatter
No abstract text is available yet for this article.
March 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28383790/post-transplant-lymphoproliferative-disease-in-lung-transplantation-a-nested-case-control-study
#11
Annelies Leyssens, Daan Dierickx, Eric K Verbeken, Thomas Tousseyn, Stijn E Verleden, Bart M Vanaudenaerde, Lieven J Dupont, Jonas Yserbyt, Geert M Verleden, Dirk E Van Raemdonck, Robin Vos
Post-transplant lymphoproliferative disorder (PTLD) may compromise long-term outcome of lung transplant (LTx) recipients. A case-control study was performed, comparing LTx recipients with PTLD (n=31) to matched recipients without PTLD (Controls, n=62). Risk factors for PTLD and post-transplant outcomes were assessed. PTLD prevalence was 3.9%, time to PTLD 323 (166-1132) days; and 54.8% had early-onset PTLD versus 45.2% late-onset PTLD. At LTx, more Epstein-Barr virus (EBV)-seronegative patients were present in PTLD (42%) compared to Controls (5%) (P<...
April 6, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28375571/hla-mismatching-favoring-host-versus-graft-nk-cell-activity-via-kir3dl1-is-associated-with-improved-outcomes-following-lung-transplantation
#12
J R Greenland, H Sun, D Calabrese, T Chong, J P Singer, J Kukreja, S R Hays, J A Golden, G H Caughey, J M Venstrom, R Rajalingam
Chronic lung allograft dysfunction (CLAD) is linked to rejection and limits survival following lung transplantation. HLA-Bw4 recipients of HLA-Bw6 grafts have enhanced host-versus-graft (HVG) natural killer (NK) cell activity mediated by killer cell immunoglobulin-like receptor (KIR)3DL1 ligand. Because NK cells may promote tolerance by depleting antigen-presenting cells, we hypothesized improved outcomes for HLA-Bw4 recipients of HLA-Bw6 grafts. We evaluated differences in acute cellular rejection and CLAD-free survival across 252 KIR3DL1+ recipients from University of California, San Francisco (UCSF)...
April 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28365177/high-dose-vitamin-d-after-lung-transplantation-a-randomized-trial
#13
Robin Vos, David Ruttens, Stijn E Verleden, Elly Vandermeulen, Hannelore Bellon, Anke Van Herck, Annelore Sacreas, Tobias Heigl, Veronique Schaevers, Dirk E Van Raemdonck, Eric K Verbeken, Arne P Neyrinck, Lieven J Dupont, Jonas Yserbyt, Bart M Vanaudenaerde, Geert M Verleden
BACKGROUND: Vitamin D may have innate immunomodulatory functions with potentially beneficial therapeutic effects in lung transplant recipients. METHODS: This was a single-center, double blind, randomized, placebo-controlled, prevention trial of once-monthly oral vitamin D (cholecalciferol; 100,000 IU, n = 44) vs placebo (n = 43) during 2 years in adult lung transplant recipients enrolled from October 2010 to August 2013. Primary outcome was prevalence of chronic lung allograft dysfunction (CLAD) 3 years after transplantation...
March 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28262440/telomere-length-in-patients-with-pulmonary-fibrosis-associated-with-chronic-lung-allograft-dysfunction-and-post-lung-transplantation-survival
#14
Chad A Newton, Julia Kozlitina, Jefferson R Lines, Vaidehi Kaza, Fernando Torres, Christine Kim Garcia
BACKGROUND: Prior studies have shown that patients with pulmonary fibrosis with mutations in the telomerase genes have a high rate of certain complications after lung transplantation. However, few studies have investigated clinical outcomes based on leukocyte telomere length. METHODS: We conducted an observational cohort study of all patients with pulmonary fibrosis who underwent lung transplantation at a single center between January 1, 2007, and December 31, 2014...
February 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28207638/association-of-local-intrapulmonary-production-of-antibodies-specific-to-donor-major-histocompatibility-complex-class-i-with-the-progression-of-chronic-rejection-of-lung-allografts
#15
Ei Miyamoto, Hideki Motoyama, Masaaki Sato, Akihiro Aoyama, Toshi Menju, Kei Shikuma, Terumasa Sowa, Akihiko Yoshizawa, Masao Saito, Akihiro Takahagi, Satona Tanaka, Mamoru Takahashi, Keiji Ohata, Takeshi Kondo, Kyoko Hijiya, Toyofumi F Chen-Yoshikawa, Hiroshi Date
BACKGROUND: Antibody-mediated rejection may lead to chronic lung allograft dysfunction, but antibody-mediated rejection may develop in the absence of detectable donor-specific antibody (DSA) in recipient serum. This study investigated whether humoral immune responses develop not only systemically but locally within rejected lung allografts, resulting in local production of DSA. METHODS: Lewis rats received orthotopic left lung transplantation from Lewis (syngeneic control) or Brown-Norway (major histocompatibility complex-mismatched allogeneic) donor rats...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28186707/mesenchymal-stromal-cell-therapy-for-chronic-lung-allograft-dysfunction-results-of-a-first-in-man-study
#16
Daniel C Chambers, Debra Enever, Sharon Lawrence, Marian J Sturm, Richard Herrmann, Stephanie Yerkovich, Michael Musk, Peter M A Hopkins
Chronic lung transplant rejection (termed chronic lung allograft dysfunction [CLAD]) is the main impediment to long-term survival after lung transplantation. Bone marrow-derived mesenchymal stromal cells (MSCs) represent an attractive cell therapy in inflammatory diseases, including organ rejection, given their relative immune privilege and immunosuppressive and tolerogenic properties. Preclinical studies in models of obliterative bronchiolitis and human trials in graft versus host disease and renal transplantation suggest potential efficacy in CLAD...
April 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28185711/impact-of-gastroesophageal-reflux-and-delayed-gastric-emptying-on-pediatric-lung-transplant-outcomes
#17
Fei Jamie Dy, Dawn Freiberger, Enju Liu, Debra Boyer, Gary Visner, Rachel Rosen
BACKGROUND: Gastroesophageal reflux disease is thought to predispose to adverse lung allograft outcomes. However, little is known about the burden of gastroesophageal reflux (GER) and gastroparesis in pediatric patients. In this study we describe the burden of reflux and gastroparesis in children undergoing lung transplant, and evaluates their impact on allograft survival and rejection incidence. METHODS: This study is a retrospective analysis of pediatric lung transplant recipients who had combined pH and multichannel intraluminal impedance testing (pH-MII) and gastric-emptying scans (GES)...
January 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28164137/immune-responses-to-tissue-restricted-nonmajor-histocompatibility-complex-antigens-in-allograft-rejection
#18
REVIEW
Ankit Bharat, T Mohanakumar
Chronic diseases that result in end-stage organ damage cause inflammation, which can reveal sequestered self-antigens (SAgs) in that organ and trigger autoimmunity. The thymus gland deletes self-reactive T-cells against ubiquitously expressed SAgs, while regulatory mechanisms in the periphery control immune responses to tissue-restricted SAgs. It is now established that T-cells reactive to SAgs present in certain organs (e.g., lungs, pancreas, and intestine) are incompletely eliminated, and the dysregulation of peripheral immuneregulation can generate immune responses to SAgs...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28138398/comparative-analysis-of-morphological-and-molecular-motifs-in-bronchiolitis-obliterans-and-alveolar-fibroelastosis-after-lung-and-stem-cell-transplantation
#19
Danny Jonigk, Berenice Rath, Paul Borchert, Peter Braubach, Lavinia Maegel, Nicole Izykowski, Gregor Warnecke, Wiebke Sommer, Hans Kreipe, Robert Blach, Adrian Anklamm, Axel Haverich, Matthias Eder, Michael Stadler, Tobias Welte, Jens Gottlieb, Mark Kuehnel, Florian Laenger
Chronic lung allograft dysfunction (CLAD) remains the major obstacle to long-term survival following lung transplantation (LuTx). Morphologically CLAD is defined by obliterative remodelling of the small airways (bronchiolitis obliterans, BO) as well as a more recently described collagenous obliteration of alveoli with elastosis summarised as alveolar fibroelastosis (AFE). Both patterns are not restricted to pulmonary allografts, but have also been reported following haematopoietic stem cell transplantation (HSCT) and radio chemotherapy (RC)...
January 2017: Journal of Pathology. Clinical Research
https://www.readbyqxmd.com/read/28120410/restrictive-allograft-syndrome-and-idiopathic-pleuroparenchymal-fibroelastosis-do-they-really-have-the-same-histology
#20
Maria A Montero, Tina Osadolor, Reena Khiroya, Maria Teresa Salcedo, Jan L Robertus, Alexandra Rice, Andrew G Nicholson, Antonio Roman, Victor Monforte
AIMS: Restrictive allograft syndrome (RAS) and idiopathic pleuroparenchymal fibroelastosis (IPPFE) are two different diseases reported to share the same histology. RAS relates to chronic allograft dysfunction in lung transplantation, with IPPFE being a rare condition in native lungs. Our aim is to compare their histologies alongside biopsies of usual interstitial pneumonia (UIP), to determine if there are differences that might help to elucidate the pathogenesis. METHODS AND RESULTS: We selected four postmortem allograft lungs from patients who developed a clear clinical RAS pattern, five biopsies diagnosed as IPPFE, five UIP biopsies and five sections of normal lung...
January 25, 2017: Histopathology
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