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chronic lung allograft dysfunction

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https://www.readbyqxmd.com/read/29792746/high-resolution-ct-findings-of-obstructive-and-restrictive-phenotypes-of-chronic-lung-allograft-dysfunction-more-than-just-bronchiolitis-obliterans-syndrome
#1
Partha Hota, Chandra Dass, Maruti Kumaran, Scott Simpson
OBJECTIVE: The purpose of this article is to review the high-resolution CT characteristics of individual obstructive and restrictive chronic lung allograft dysfunction (CLAD) phenotypes to aid in making accurate diagnoses and guiding treatment. CONCLUSION: Long-term survival and function after lung transplant are considerably worse compared with after other organ transplants. CLAD is implicated as a major limiting factor for long-term graft viability. Historically thought to be a single entity, bronchiolitis obliterans syndrome, CLAD is actually a heterogeneous group of disorders with distinct subtypes...
May 24, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29781811/spleen-derived-classical-monocytes-mediate-lung-ischemia-reperfusion-injury-through-il-1%C3%AE
#2
Hsi-Min Hsiao, Ramiro Fernandez, Satona Tanaka, Wenjun Li, Jessica H Spahn, Stephen Chiu, Mahzad Akbarpour, Daniel Ruiz-Perez, Qiang Wu, Cem Turam, Davide Scozzi, Tsuyoshi Takahashi, Hannah P Luehmann, Varun Puri, G R Scott Budinger, Alexander S Krupnick, Alexander V Misharin, Kory J Lavine, Yongjian Liu, Andrew E Gelman, Ankit Bharat, Daniel Kreisel
Ischemia-reperfusion injury, a form of sterile inflammation, is the leading risk factor for both short-term mortality following pulmonary transplantation and chronic lung allograft dysfunction. While it is well recognized that neutrophils are critical mediators of acute lung injury, processes that guide their entry into pulmonary tissue are not well understood. Here, we found that CCR2+ classical monocytes are necessary and sufficient for mediating extravasation of neutrophils into pulmonary tissue during ischemia-reperfusion injury following hilar clamping or lung transplantation...
May 21, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29774598/evaluation-of-current-strategies-for-surveillance-and-management-of-donor-specific-antibodies-single-center-study
#3
Daniel Sullivan, Chul Ahn, Ang Gao, Chantale Lacelle, Fernando Torres, Srinivas Bollineni, Amit Banga, Jessica Mullins, Manish Mohanka, Steve Ring, Michael Wait, Matthias Peltz, Pavan Duddupudi, Dhiraj Surapaneni, Vaidehi Kaza
BACKGROUND: Although, presence of donor specific antibodies (DSA) is known to impact lung allograft, limited data exists regarding DSA management. METHODS: We did a retrospective study at our center evaluating DSA management in adult lung transplant recipients undergoing lung transplantation between January 1, 2010 and June 30, 2014. Study follow up was completed through October 2017. All recipients were stratified into two groups based on the presence or absence of DSA...
May 17, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29771243/breath-volatile-organic-compounds-of-lung-transplant-recipients-with-and-without-chronic-lung-allograft-dysfunction
#4
Lucas Küppers, Olaf Holz, Sven Schuchardt, Jens Gottlieb, Jan Fuge, Mark Greer, Jens Hohlfeld
Chronic lung allograft dysfunction (CLAD) with its clinical correlative of bronchiolitis obliterans syndrome (BOS) remains the major limiting factor for long-term graft survival. Currently there are no established methods for the early diagnosis or prediction of BOS. To assess the feasibility of breath collection as a non-invasive tool and the potential of breath volatile organic compounds (VOC) for the early detection of BOS, we compared the breath VOC composition between transplant patients without and different stages of BOS...
May 17, 2018: Journal of Breath Research
https://www.readbyqxmd.com/read/29754418/comprehensive-outcomes-after-lung-retransplantation-a-single-center-review
#5
Kieran Halloran, Meghan Aversa, Kathryn Tinckam, Tereza Martinu, Matthew Binnie, Cecilia Chaparro, Chung-Wai Chow, Tom Waddell, Karen McRae, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Marcelo Cypel, Shaf Keshavjee, Lianne G Singer
INTRODUCTION: Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. METHODS: We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n=38). We analyzed the post-operative course, graft function, renal function, microbiology, donor specific antibodies (DSA), quality of life and survival compared to a control cohort of primary transplant recipients matched for age and era...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29719115/preemptive-treatment-of-early-donor-specific-antibodies-with-iga-and-igm-enriched-intravenous-human-immunoglobulins-in-lung-transplantation
#6
Fabio Ius, Murielle Verboom, Wiebke Sommer, Reza Poyanmehr, Ann-Kathrin Knoefel, Jawad Salman, Christian Kuehn, Murat Avsar, Thierry Siemeni, Caroline Erdfelder, Michael Hallensleben, Dietmar Boethig, Nicolaus Schwerk, Carsten Mueller, Tobias Welte, Christine Falk, Axel Haverich, Igor Tudorache, Gregor Warnecke
This retrospective study presents our 4-year experience of preemptive treatment of early anti-HLA donor specific antibodies with IgA- and IgM-enriched immunoglobulins. We compared outcomes between patients with antibodies and treatment (case patients) and patients without antibodies (control patients). Records of patients transplanted at our institution between 03/2013 and 11/2017 were reviewed. The treatment protocol included one single 2g/kg immunoglobulin infusion followed by successive 0.5g/kg infusions for a maximum of 6 months, usually combined with a single dose of anti-CD20 antibody and, in case of clinical rejection or positive crossmatch, with plasmapheresis or immunoabsorption...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29713813/gastrointestinal-complications-after-lung-transplantation-in-japanese-patients
#7
Hidenao Kayawake, Toyofumi F Chen-Yoshikawa, Hideki Motoyama, Masatsugu Hamaji, Daisuke Nakajima, Akihiro Aoyama, Hiroshi Date
PURPOSE: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx. METHODS: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications...
April 30, 2018: Surgery Today
https://www.readbyqxmd.com/read/29676625/exposomics-based-analysis-of-environmental-factors-associated-with-forced-expiratory-volume-in-1-second-at-6-months-post-lung-transplantation
#8
Michelle L North, Musawir Ahmed, Sepehr Salehi, Kavindi Jayasinghe, Manisha Tilak, Joyce Wu, Cheol-Heon Jeong, Greg J Evans, Chung-Wai Chow
RATIONALE: Chronic lung allograft dysfunction is the biggest impediment to long-term survival after lung transplantation. Studies have shown an increased risk for chronic lung allograft dysfunction in patients exposed to traffic-related air pollution, using residential distance to roadways and outdoor pollution. OBJECTIVES: Personal monitoring and the indoor environment post-lung transplantation have not been investigated. The exposome is a novel conceptual framework that allows for concurrent examination of multiple intrinsic and extrinsic factors, including environmental exposures, as well as changes in exposures over time, to elucidate the complex environmental factors that affect health outcomes...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29628135/lung-transplantation-for-scleroderma-lung-disease-an-international-multicenter-observational-cohort-study
#9
Pauline Pradère, Igor Tudorache, Jesper Magnusson, Laurent Savale, Olivier Brugiere, Benoît Douvry, Martine Reynaud-Gaubert, Johanna Claustre, Aurélie Le Borgne, Are M Holm, Hans Henrik Schultz, Christiane Knoop, Laurent Godinas, Andrew J Fisher, Sandrine Hirschi, Jens Gottlieb, Jérôme Le Pavec
BACKGROUND: Due to its multisystemic nature, scleroderma is considered a relative contraindication to lung transplantation at many centers. However, recent studies suggest similar post-transplant outcomes in patients with scleroderma compared to those with other causes of interstitial lung disease (ILD). Furthermore, it remains unknown whether scleroderma-associated pulmonary arterial hypertension (PAH) influences post-transplant outcomes. Our objective in this study was to assess the indications, survival, and prognostic factors of lung or heart-lung transplantation for scleroderma lung disease...
March 15, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29620623/suicidal-hanging-donors-for-lung-transplantation-is-this-chapter-still-closed-midterm-experience-from-a-single-center-in-united-kingdom
#10
Olga Ananiadou, Bastian Schmack, Bartlomiej Zych, Anton Sabashnikov, Diana Garcia-Saez, Prashant Mohite, Alexander Weymann, Ashham Mansur, Mohamed Zeriouh, Nandor Marczin, Fabio De Robertis, Andre Rüdiger Simon, Aron-Frederik Popov
In the context of limited donor pool in cardiothoracic transplantation, utilization of organs from high risk donors, such as suicidal hanging donors, while ensuring safety, is under consideration. We sought to evaluate the outcomes of lung transplantations (LTx) that use organs from this group.Between January 2011 and December 2015, 265 LTx were performed at our center. Twenty-two recipients received lungs from donors after suicidal hanging (group 1). The remaining 243 transplantations were used as a control (group 2)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29607606/detection-of-chronic-lung-allograft-dysfunction-using-ventilation-weighted-fourier-decomposition-mri
#11
A Voskrebenzev, M Greer, M Gutberlet, C Schönfeld, J Renne, J Hinrichs, T Kaireit, T Welte, F Wacker, J Gottlieb, J Vogel-Claussen
Chronic lung allograft dysfunction (CLAD) remains the leading cause of morbidity and mortality after lung transplantation. Diagnosis requires spirometric change, that becomes increasingly difficult with advancing CLAD. Fourier decomposition MRI (FD-MRI) permits acquisition of ventilated-weighted images during free-breathing. This study evaluates FD-MRI in detecting CLAD in selected patients after bilateral lung transplantation (DLTx). DLTx recipients demonstrating CLAD at various stages participated. Radiologists remained blinded to clinical status until completion of image analysis...
April 1, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29603543/clinical-significance-of-post-prophylaxis-cytomegalovirus-infection-in-lung-transplant-recipients
#12
Nikta Jaamei, Angela Koutsokera, Jérôme Pasquier, Matteo Mombelli, Pascal Meylan, Manuel Pascual, John-David Aubert, Oriol Manuel
BACKGROUND: Cytomegalovirus (CMV) disease has been associated with the development of chronic lung allograft dysfunction (CLAD) after transplantation. However, the relevance of CMV replication occurring after the discontinuation of antiviral prophylaxis on the development of CLAD has not been fully established. METHODS: Patients who underwent lung transplantation during 2004-2014 were included. All patients received antiviral prophylaxis for 3-6 months, followed by monitoring of CMV replication during the first year post-transplantation (preemptive therapy)...
March 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29590671/primary-graft-dysfunction-pgd-following-lung-transplantation
#13
Rupal J Shah, Joshua M Diamond
Primary graft dysfunction (PGD) is a form of acute lung injury that results from ischemia reperfusion injury (IRI) and is the major cause of early posttransplant morbidity and mortality. Patients who survive PGD have decreased quality of life, an increased risk of chronic lung allograft dysfunction, specifically bronchiolitis obliterans syndrome, and a significantly increased risk of death. In 2017, the International Society for Heart and Lung Transplantation released updated consensus statements on the PGD definition, most up-to-date PGD risk factors, mechanisms of PGD development, and the state-of-the-art for PGD therapeutics...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29579772/community-acquired-respiratory-viruses
#14
Jens Gottlieb
The incidence of community-acquired respiratory viruses (CARVs) is ∼15 cases per 100 patient-years after lung transplantation (LTx). Paramyxoviruses account for almost 50% of the cases of CARV infection in LTx. Most patients will be symptomatic with a mean decline of 15 to 20% in forced expiratory volume in 1 second. The attributable death rate is low in recent years 15 to 25% CARV infected LTx patients will develop chronic lung allograft dysfunction within a year after CARV infection. This risk seems to be increased in comparison to the noninfected LTx recipient...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29579771/the-human-respiratory-microbiome-implications-and-impact
#15
Alicia B Mitchell, Allan R Glanville
Once considered a sterile site below the larynx, the tracheobronchial tree and parenchyma of the lungs are now known to harbor a rich diversity of microbial species including bacteria, viruses, fungi, and archaea. Many of these organisms, particularly the viruses which comprise the human respiratory virome, have not been identified, so their true role is unknown. It seems logical to conclude that a "healthy" respiratory microbiome exists which may be modified in disease states and perhaps by therapies such as antibiotics, antifungals, and antiviral treatments...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29579770/acute-cellular-rejection-is-it-still-relevant
#16
Angela Koutsokera, Liran Levy, Prodipto Pal, Ani Orchanian-Cheff, Tereza Martinu
Despite significant progress in the field of transplant immunology, acute cellular rejection (ACR) remains a very frequent complication after lung transplantation (LTx), with almost 30% of LTx recipients experiencing at least one episode of treated ACR during the first year of follow-up. Most episodes respond to the first-line immunosuppressive treatment and are rarely a direct cause of death. However, the association of ACR with later adverse outcomes, such as chronic lung allograft dysfunction, bronchial stricture, and infectious complications associated with the intensification of immunosuppression, negatively impacts long-term survival...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29579769/immunosuppression-have-we-learnt-anything
#17
Ramsey R Hachem
Outcomes after lung transplantation remain disappointing because there is a high incidence of chronic lung allograft dysfunction (CLAD), which typically follows a progressive clinical course and often results in allograft failure and death. Chronic rejection is considered the predominant cause of CLAD. Thus, optimal immunosuppression has been viewed as having the potential to prevent CLAD and improve survival after lung transplantation. Numerous clinical trials have been conducted investigating the efficacy and safety of various immunosuppressive agents...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29579768/chronic-lung-allograft-dysfunction-evolving-concepts-and-therapies
#18
Ariss DerHovanessian, W Dean Wallace, Joseph P Lynch, John A Belperio, S Sam Weigt
Lung transplantation has become an established therapeutic option for a variety of end-stage lung diseases. Technical advances in graft procurement, implantation, perioperative care, immunosuppression, and posttransplant medical management have led to significant improvements in 1-year survival, but outcomes after the first year have improved minimally over the last two decades. The main limitation to better long-term survival after lung transplantation is chronic lung allograft dysfunction (CLAD). CLAD also impairs quality of life and increases the costs of medical care...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29573785/upregulation-of-alveolar-neutrophil-enzymes-and-long-pentraxin-3-in-human-chronic-lung-allograft-dysfunction-subtypes
#19
Tomohito Saito, Mingyao Liu, Matthew Binnie, Tereza Martinu, Masaaki Sato, Shaf Keshavjee
No abstract text is available yet for this article.
February 23, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29559256/one-piece-at-a-time-making-sense-of-chronic-lung-allograft-dysfunction
#20
EDITORIAL
Victor van Berkel
No abstract text is available yet for this article.
June 2018: Journal of Thoracic and Cardiovascular Surgery
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