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chronic lung allograft dysfunction

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https://www.readbyqxmd.com/read/28904437/cryptococcal-infection-in-transplant-kidney-manifesting-as-chronic-allograft-dysfunction
#1
C Agrawal, V Sood, A Kumar, V Raghavan
Invasive fungal infections (IFIs) are a significant cause of morbidity in solid organ transplant (SOT) recipients. Common causes among them are Aspergillus, Candida, and Cryptococcus. Antifungal prophylaxis has led to decrease in overall incidence of IFI; however, there is very little decline in the incidence of Cryptococcal infections of SOT recipients because effective prophylaxis is not available against this infectious agent. Spectrum of manifestation of Cryptococcal infection varies in immunocompetent and immunocompromised host with subclinical and self-limiting with lungs being the primary site in immunocompetent and central nervous system as the most common site in an immunocompromised host...
September 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28845478/lung-ultrasound-a-novel-diagnostic-tool-to-phenotype-chronic-lung-allograft-dysfunction
#2
Jesper Rømhild Davidsen, Christian Borbjerg Laursen, Elisabeth Bendstrup, Hans Henrik Lawaetz Schultz
No abstract text is available yet for this article.
June 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28840631/domiciliary-non-invasive-ventilation-post-lung-transplantation
#3
Sakhee Kotecha, Catherine Buchan, Kerry Parker, Jo Toghill, Eldho Paul, Belinda Miller, Matthew Naughton, Gregory Snell, Eli Dabscheck
BACKGROUND AND OBJECTIVE: The benefits of domiciliary non-invasive ventilation (NIV) post lung transplantation (LTx) have not previously been described. This was a single-centre retrospective audit of patients requiring domiciliary NIV post-LTx. Our aim was to describe indications for NIV and outcomes in chronic lung allograft dysfunction (CLAD) and diaphragmatic palsy. METHODS: All patients requiring domiciliary NIV post-LTx between 2010 and June 2016 were assessed...
August 24, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28825953/chronic-airway-fibrosis-in-orthotopic-mouse-lung-transplantation-models-an-experimental-reappraisal
#4
Yoshito Yamada, Kevin Windirsch, Linus Dubs, David Kenkel, Jae-Hwi Jang, Ilhan Inci, Andreas Boss, Tereza Martinu, Bart Vanaudenaerde, Walter Weder, Wolfgang Jungraithmayr
BACKGROUND: Several mouse lung transplantation (Tx) models have been proposed for the study of chronic airway fibrosis (CAF), the most prevalent complication seen in human lung transplant recipients, termed chronic lung allograft dysfunction (CLAD). Alternatively, it has been called for to establish an experimental animal model for restrictive allograft syndrome (RAS), another phenotype of CLAD. However, these mouse transplant models exhibit significant heterogeneity in consistency and reproducibility...
August 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28798289/prolonged-administration-of-twice-daily-bolus-intravenous-tacrolimus-in-the-early-phase-after-lung-transplantation
#5
Yutaka Hirano, Seiichiro Sugimoto, Toshifumi Mano, Takeshi Kurosaki, Kentaroh Miyoshi, Shinji Otani, Masaomi Yamane, Motomu Kobayashi, Shinichiro Miyoshi, Takahiro Oto
BACKGROUND Although administration of tacrolimus, whether by the enteric, sublingual, or continuous intravenous routes, has some limitations, twice-daily bolus intravenous tacrolimus administration has been shown to be beneficial in optimizing efficacy and safety after lung transplantation. However, at present, the duration of bolus intravenous tacrolimus administration is limited, and the effects of prolonged bolus intravenous tacrolimus administration remain unknown. Our study was aimed at assessing the safety and efficacy of prolonged twice-daily bolus intravenous tacrolimus administration in the early phase after lung transplantation...
August 11, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28770204/development-of-a-multivariate-prediction-model-for-early-onset-bronchiolitis-obliterans-syndrome-and-restrictive-allograft-syndrome-in-lung-transplantation
#6
Angela Koutsokera, Pierre J Royer, Jean P Antonietti, Andreas Fritz, Christian Benden, John D Aubert, Adrien Tissot, Karine Botturi, Antoine Roux, Martine L Reynaud-Gaubert, Romain Kessler, Claire Dromer, Sacha Mussot, Hervé Mal, Jean-François Mornex, Romain Guillemain, Christiane Knoop, Marcel Dahan, Paola M Soccal, Johanna Claustre, Edouard Sage, Carine Gomez, Antoine Magnan, Christophe Pison, Laurent P Nicod
BACKGROUND: Chronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS), are major causes of mortality after lung transplantation (LT). RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described. METHODS: LT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28729000/airway-microbiota-signals-anabolic-and-catabolic-remodeling-in-the-transplanted-lung
#7
Stéphane Mouraux, Eric Bernasconi, Céline Pattaroni, Angela Koutsokera, John-David Aubert, Johanna Claustre, Christophe Pison, Pierre-Joseph Royer, Antoine Magnan, Romain Kessler, Christian Benden, Paola M Soccal, Benjamin J Marsland, Laurent P Nicod
BACKGROUND: Homeostatic turnover of the extracellular matrix conditions the structure and function of the healthy lung. In lung transplantation, long-term management remains limited by chronic lung allograft dysfunction, an umbrella term used for a heterogeneous entity ultimately associated with pathological airway and/or parenchyma remodeling. OBJECTIVE: This study assessed whether the local cross-talk between the pulmonary microbiota and host cells is a key determinant in the control of lower airway remodeling posttransplantation...
July 18, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28720212/changing-the-curve-in-chronic-lung-allograft-dysfunction-implications-of-chronic-lung-allograft-dysfunction-phenotypes-in-assessing-treatment-interventions
#8
EDITORIAL
Joshua J Mooney
No abstract text is available yet for this article.
May 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28720146/analysis-of-long-term-cd4-cd25highcd127-t-reg-cells-kinetics-in-peripheral-blood-of-lung-transplant-recipients
#9
Davide Piloni, Monica Morosini, Sara Magni, Alice Balderacchi, Luigia Scudeller, Emanuela Cova, Tiberio Oggionni, Giulia Stella, Carmine Tinelli, Filippo Antonacci, Andrea Maria D'Armini, Federica Meloni
BACKGROUND: The role of CD4(+)CD25(high)CD127(-) T-reg cells in solid-organ Transplant (Tx) acceptance has been extensively studied. In previous studies on kidney and liver recipients, peripheral T-reg cell counts were associated to graft survival, while in lung Tx, there is limited evidence for similar findings. This study aims to analyze long term peripheral kinetics of T-reg-cells in a cohort of lung recipients and tests its association to several clinical variables. METHODS: From jan 2009 to dec 2014, 137 lung Tx recipients were submitted to an immunological follow up (median: 105...
July 18, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28691954/maintenance-belatacept-based-immunosuppression-in-lung-transplantation-recipients-who-failed-calcineurin-inhibitors
#10
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
#11
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
#12
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...
September 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
#13
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
#14
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 (PFT) 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
#15
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
#16
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...
September 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
#17
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
#18
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
#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/28546378/pediatric-lung-transplantation
#20
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
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