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"Lung transplantation"

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https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#1
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28734935/outcome-of-lung-transplantation-in-idiopathic-pulmonary-fibrosis-with-previous-anti-fibrotic-therapy
#2
Gabriela Leuschner, Florian Stocker, Tobias Veit, Nikolaus Kneidinger, Hauke Winter, René Schramm, Thomas Weig, Sandhya Matthes, Felix Ceelen, Paola Arnold, Dieter Munker, Friederike Klenner, Rudolf Hatz, Marion Frankenberger, Jürgen Behr, Claus Neurohr
BACKGROUND: Anti-fibrotic drugs may interfere with wound-healing after major surgery, theoretically preventing sufficient bronchial anastomosis formation after lung transplantation (LTx). The aim of this study was to assess the impact of previous treatment with pirfenidone and nintedanib on outcomes after LTx in patients with idiopathic pulmonary fibrosis (IPF). METHODS: All patients with IPF undergoing LTx at the University of Munich between January 2012 and November 2016 were retrospectively screened for previous use of anti-fibrotics...
July 5, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28734456/clamshell-closure-with-absorbable-sternal-pins-in-lung-transplant-recipients
#3
Anne Olland, Jérémie Reeb, Sophie Guinard, Joseph Seitlinger, Nicola Santelmo, Romain Kessler, Pierre-Emmanuel Falcoz, Gilbert Massard
Clamshell (bilateral anterolateral thoracotomy combined to transverse sternotomy) is an invasive surgical approach that is helpful in particular situations, especially bilateral lung transplantation. The closure technique remains challenging because clamshell incision can end with override, separation, or sternal pseudarthrosis complications. We describe the use of new absorbable sternal pins to stabilize the sternal closure and to help avoid additional sternal complications.
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28734446/successful-lung-transplantation-using-a-deceased-donor-mechanically-ventilated-for-ten-months
#4
Shin Tanaka, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Takahiro Oto
A successful outcome after lung transplant was achieved using lungs donated from a teenage boy who underwent prolonged mechanical ventilation. The donor experienced hypoxic brain damage and was declared brain dead 324 days after tracheal intubation. At the time of referral, the donor's lungs revealed diffuse radiologic infiltration and atelectasis but excellent function, with a PaO2/FiO2 ratio of 450. The lungs were transplanted to a 10-year-old girl with bronchiolitis obliterans. She developed grade 2 primary graft dysfunction, but recovered quickly...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28731908/prognostic-factors-in-lung-transplantation-after-hematopoietic-stem-cell-transplantation
#5
Toyofumi F Chen-Yoshikawa, Seiichiro Sugimoto, Takeshi Shiraishi, Masato Minami, Yasushi Matsuda, Masayuki Chida, Sumiko Maeda, Akihiro Aoyama, Yoshinori Okada, Meinoshin Okumura, Akinori Iwasaki, Shinichiro Miyoshi, Takahiro Oto, Hiroshi Date
BACKGROUND: Lung transplantation is the final life-saving option for patients with pulmonary complications after hematopoietic stem cell transplantation (HSCT). Patients undergoing HSCT for hematologic diseases are thought to be high-risk candidates for lung transplantation; therefore, few lung transplants are performed for these patients, and few studies have been reported. This study aimed to describe the characteristics and outcomes of lung transplantation in patients with pulmonary complications after HSCT...
July 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28730633/pd-1-expression-on-cd8-t-cells-regulates-their-differentiation-within-lung-allografts-and-is-critical-for-tolerance-induction
#6
T Takahashi, H M Hsiao, S Tanaka, W Li, R Higashikubo, D Scozzi, A Bharat, J H Ritter, A S Krupnick, A E Gelman, D Kreisel
Immunological requirements for rejection and tolerance induction differ between various organs. While memory CD8(+) T cells are considered a barrier to immunosuppression-mediated acceptance of most tissues and organs, tolerance induction after lung transplantation is critically dependent on central memory CD8(+) T lymphocytes. Here we demonstrate that costimulation blockade-mediated tolerance after lung transplantation is dependent on PD-1 expression on CD8(+) T cells. In the absence of PD-1 expression, CD8(+) T cells form prolonged interactions with graft-infiltrating CD11c(+) cells, their differentiation is skewed towards an effector memory phenotype and grafts are rejected acutely...
July 20, 2017: American Journal of Transplantation
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 (CLAD), an umbrella term used for a heterogeneous entity ultimately associated with pathological airway and/or parenchyma remodeling. OBJECTIVE: To assess whether the local cross-talk between the pulmonary microbiota and host cells is a key determinant in the control of lower airway remodeling post-transplantation...
July 17, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28721353/hepatitis-e-virus-associated-meningoencephalitis-in-a-lung-transplant-recipient-diagnosed-by-clinical-metagenomic-sequencing
#8
Jamie A Murkey, Kara W Chew, Margrit Carlson, Chelsea L Shannon, Deepika Sirohi, Hannah A Sample, Michael R Wilson, Paul Vespa, Romney M Humphries, Steve Miller, Jeffrey D Klausner, Charles Y Chiu
Hepatitis E virus (HEV) infection uncommonly causes chronic hepatitis and neurologic disease. We describe a case of genotype 3a HEV meningoencephalitis diagnosed by metagenomic next-generation sequencing, illustrating the power of an unbiased molecular approach to microbial testing and the first reported case of HEV infection presumably acquired through lung transplantation.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28721035/intracellular-interactions-of-umeclidinium-and-vilanterol-in-human-airway-smooth-muscle
#9
Nooreen Shaikh, Malcolm Johnson, David A Hall, Kian Fan Chung, John H Riley, Sally Worsley, Pankaj K Bhavsar
BACKGROUND: Intracellular mechanisms of action of umeclidinium (UMEC), a long-acting muscarinic receptor antagonist, and vilanterol (VI), a long-acting β2-adrenoceptor (β2R) agonist, were investigated in target cells: human airway smooth-muscle cells (ASMCs). MATERIALS AND METHODS: ASMCs from tracheas of healthy lung-transplant donors were treated with VI, UMEC, UMEC and VI combined, or control compounds (salmeterol, propranolol, ICI 118.551, or methacholine [MCh])...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28720146/analysis-of-long-term-cd4-cd25highcd127-t-reg-cells-kinetics-in-peripheral-blood-of-lung-transplant-recipients
#10
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/28719755/clinical-risk-factors-and-prognostic-model-for-primary-graft-dysfunction-after-lung-transplantation-in-patients-with-pulmonary-hypertension
#11
Mary K Porteous, James C Lee, David J Lederer, Scott M Palmer, Edward Cantu, Rupal J Shah, Scarlett L Bellamy, Vibha N Lama, Sangeeta M Bhorade, Maria M Crespo, John F McDyer, Keith M Wille, A Russell Localio, Jonathan B Orens, Pali D Shah, Ann B Weinacker, Selim Arcasoy, David S Wilkes, Lorraine B Ware, Jason D Christie, Steven M Kawut, Joshua M Diamond
RATIONALE: Pulmonary hypertension from pulmonary arterial hypertension or parenchymal lung disease is associated with an increased risk of primary graft dysfunction after lung transplantation. OBJECTIVE: We evaluated the clinical determinants of severe primary graft dysfunction in pulmonary hypertension and developed and validated a prognostic model. METHODS: We conducted a retrospective cohort study of patients in the multi-center Lung Transplant Outcomes Group with pulmonary hypertension at transplant listing...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28719441/fourteen-day-in-vivo-testing-of-a-compliant-thoracic-artificial-lung
#12
David J Skoog, Joshua R Pohlmann, David S Demos, Christopher N Scipione, Amit Iyengar, Rebecca E Schewe, Ahmed B Suhaib, Kelly L Koch, Keith E Cook
The compliant thoracic artificial lung (cTAL) has been studied in acute in vivo and in vitro experiments. The cTAL's long-term function and potential use as a bridge to lung transplantation are assessed presently. The cTAL without anticoagulant coatings was attached to sheep (n = 5) via the pulmonary artery and left atrium for 14 days. Systemic heparin anticoagulation was used. Compliant thoracic artificial lung resistance, cTAL gas exchange, hematologic parameters, and organ function were recorded. Two sheep were euthanized for nondevice-related issues...
July 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28719135/multiple-breath-washout-in-paediatric-patients-after-lung-transplantation
#13
Sylvia Nyilas, Julia Carlens, Timothy Price, Florian Singer, Carsten Müller, Gesine Hansen, Gregor Warnecke, Philipp Latzin, Nicolaus Schwerk
Forced expiratory volume in 1 second (FEV1 ) from spirometry, is the most commonly used parameter to detect early allograft dysfunction after lung transplantation (LTx). There are concerns regarding its sensitivity. Nitrogen-multiple breath washout (N2 -MBW) is sensitive at detecting early global (lung clearance index; LCI), and acinar (Sacin ) airway inhomogeneity. We investigated whether N2 -MBW indices indicate small airways pathology after LTx in children with stable spirometry. Thirty-seven children without BOS on median 1...
July 18, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28718917/proliferation-of-elastic-fibers-in-idiopathic-pulmonary-fibrosis-a-whole-slide-image-analysis-and-comparison-with-pleuroparenchymal-fibroelastosis
#14
Yoshiaki Kinoshita, Kentaro Watanabe, Hiroshi Ishii, Hisako Kushima, Masaki Fujita, Kazuki Nabeshima
BACKGROUND: We occasionally encounter patients with idiopathic pulmonary fibrosis (IPF) who have similar imaging patterns to pleuroparenchymal fibroelastosis (PPFE) in the upper lung fields but are not diagnosed as PPFE clinically. The clinicopathological features and intrapulmonary distribution of elastic fibers and collagen fibers in these patients have not been fully elucidated. METHODS: We retrospectively reviewed the medical records of patients with a clinical diagnosis of IPF and selected the consecutive patients who received autopsy or pneumonectomy for lung transplantation...
July 18, 2017: Histopathology
https://www.readbyqxmd.com/read/28716440/removal-notice-to-617-candida-colonization-is-associated-with-improved-survival-after-lung-transplant-j-heart-lung-transplant-36-2017-s238
#15
J S Green, R Brown, T Umeda, K Rudser, S Elde, J M Roberts, M I Hertz, G Loor, J H Young, R Tomic
No abstract text is available yet for this article.
August 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28712677/extracorporeal-membrane-oxygenation-following-lung-transplantation-indications-and-survival
#16
Michael S Mulvihill, Babatunde A Yerokun, Robert Patrick Davis, David N Ranney, Mani A Daneshmand, Matthew G Hartwig
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is employed to rescue patients with early graft dysfunction after lung transplantation (LTx). Rates of post-LTx ECMO and subsequent outcomes have been limited to single-center reports. METHODS: UNOS registry was queried for LTx recipients from March 2015 to March 2016; 2,001 recipients were identified and stratified by need for post-LTx ECMO. Logistic regression was used to determine variables associated with post-LTx ECMO...
July 1, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28712587/clinical-implications-of-donor-age-a-single-institution-analysis-spanning-3%C3%A2-decades
#17
Christopher T Holley, Rosemary F Kelly, Sara J Shumway, Roland Z Brown, Marshall I Hertz, Kyle D Rudser, Coco W Quinlan, Irena Cich, Gabriel Loor
BACKGROUND: We sought to clarify the effect of donor age as a continuous variable on morbidity and mortality in a single-institution experience. METHODS: From 1986 to 2016, 882 adult lung transplants were performed, including 396 in the lung allocation score era. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the association of donor age with overall survival and bronchiolitis obliterans syndrome (BOS) score ≥1-free survival. Logistic regression was used to evaluate the association with primary graft dysfunction grade 3...
June 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711221/the-evolution-of-lung-transplantation-for-cystic-fibrosis-a-2017-update
#18
REVIEW
Gregory Snell, Anna Reed, Marc Stern, Denis Hadjiliadis
Lung transplantation (LTx) is an established therapy for patients with end-stage cystic fibrosis (CF). Indeed, CF is the commonest indication for those aged<50years of age needing LTx. CF LTx is associated with a 45% 10year survival - according to the world's largest registry. It is important all otherwise suitable CF patients with severe lung disease have a timely referral for discussion and consideration of the possibility of LTx. LTx discussions must carefully consider colonisation or infection with Burkholderia cenocepacia, Mycobacterium abscessus and Scediosporium - as good LTx outcomes cannot be guaranteed...
July 12, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28710580/assessment-of-acute-kidney-injury-with-t1-mapping-mri-following-solid-organ-transplantation
#19
Matti Peperhove, Van Dai Vo Chieu, Mi-Sun Jang, Marcel Gutberlet, Dagmar Hartung, Susanne Tewes, Gregor Warnecke, Christiane Fegbeutel, Axel Haverich, Wilfried Gwinner, Frank Lehner, Jan Hinrich Bräsen, Hermann Haller, Frank Wacker, Faikah Gueler, Katja Hueper
OBJECTIVES: To evaluate T1 mapping as a non-invasive, functional MRI biomarker in patients shortly after solid organ transplantation to detect acute postsurgical kidney damage and to correlate T1 times with renal function. METHODS: 101 patients within 2 weeks after solid organ transplantation (49 kidney transplantation, 52 lung transplantation) and 14 healthy volunteers were examined by MRI between July 2012 and April 2015 using the modified Look-Locker inversion recovery (MOLLI) sequence...
July 14, 2017: European Radiology
https://www.readbyqxmd.com/read/28708843/prevalence-of-respiratory-viruses-among-adults-by-season-age-respiratory-tract-region-and-type-of-medical-unit-in-paris-france-from-2011-to-2016
#20
Benoit Visseaux, Charles Burdet, Guillaume Voiriot, François-Xavier Lescure, Taous Chougar, Olivier Brugière, Bruno Crestani, Enrique Casalino, Charlotte Charpentier, Diane Descamps, Jean-François Timsit, Yazdan Yazdanpanah, Nadhira Houhou-Fidouh
BACKGROUND: Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. METHODS: All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units)...
2017: PloS One
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