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https://www.readbyqxmd.com/read/28936437/ex-vivo-lung-perfusion-review-of-a-revolutionary-technology
#1
REVIEW
George Makdisi, Tony Makdisi, Tambi Jarmi, Christiano C Caldeira
Donor lung shortage has been the main reason to the increasing number of patients waiting for lung transplant. Ex vivo lung perfusion (EVLP) is widely expanding technology to assess and prepare the lungs who are considered marginal for transplantation. the outcomes are encouraging and comparable to the lungs transplanted according to the standard criteria. in this article, we will discuss the history of development, the techniques and protocols of ex vivo, and the logics and rationales for ex vivo use.
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28932586/single-lung-retrieval-from-a-donor-supported-by-a-left-ventricular-assist-device
#2
Keitaro Matsumoto, Naoya Yamasaki, Tomoshi Tsuchiya, Takuro Miyazaki, Ryotaro Kamohara, Go Hatachi, Kazuyoshi Tanigawa, Kiyoyuki Eishi, Takeshi Nagayasu
The number of patients who need cardiac support with a left ventricular assist device (LVAD) has increased over the last decade. However, the number of reports of organ retrieval from donors with an LVAD is still small. Successful lung retrieval for single lung transplantation was performed from a donor on LVAD support. This required special care not to injure the heart, great vessels, and the device, particularly the outflow conduit, because of significant conglutination around the device. A right single lung transplantation was performed successfully, with no postoperative complications...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932576/outcomes-after-lung-transplantation
#3
REVIEW
Gabriel Thabut, Herve Mal
With more than 50,000 procedures having been performed worldwide, lung transplantation (LT) has become the standard of care for patients with end-stage chronic respiratory failure. LT leads to dramatic improvements in both pulmonary function and health related quality of life. Survival after LTs has steadily improved, but still lags far behind that observed after other solid organ transplantations, as evidenced by a median survival rate that currently stands at 5.8 years. Because of these disappointing results, the ability of LT to expand survival has been questioned...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932575/pediatric-lung-transplantation
#4
REVIEW
Christian Benden
Pediatric lung transplantation has been undertaken since the 1980s, and it is today considered an accepted therapy option in carefully selected children with end-stage pulmonary diseases, providing carefully selected children a net survival benefit and improved health-related quality of life. Nowadays, >100 pediatric lung transplants are done worldwide every year. Here, specific pediatric aspects of lung transplantation are reviewed such as the surgical challenge, effects of immunosuppression on the developing pediatric immune system, and typical infections of childhood, as it is vital to comprehend that children undergoing lung transplants present a real challenge as children are not 'just small adults'...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932574/lung-allocation
#5
REVIEW
Jens Gottlieb
Shortage of donor lungs in most western countries and broadening of indications for lung transplantation (LTx) has led increased waiting list mortality in the past. Usually donor lungs and recipients are matched by size as measured by total lung capacity and blood type in first order. In some countries regional allocation comes first, in other countries a national wait list exists and some nations are organized in supranational allocation systems. Organ distribution should respect the ethical principles of equity, justice, beneficence and utility...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932573/donors-after-cardiocirculatory-death-and-lung-transplantation
#6
REVIEW
Ilhan Inci
The number of patients actively awaiting lung transplantation (LTx) is more than the number of suitable donor lungs. The percentage of lung retrieval rate is lower when compared to other solid organs. The use of lungs from donation after cardiocirculatory death (DCD) donors is one of the options to avoid organ shortage in LTx. After extensive experimental research, clinical application of DCD donation is becoming wider. The results from most of the centers show at least equal survival rate compared to donors from brain death...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932572/chronic-lung-allograft-dysfunction-phenotypes-and-treatment
#7
REVIEW
Stijn E Verleden, Robin Vos, Bart M Vanaudenaerde, Geert M Verleden
Chronic lung allograft dysfunction (CLAD) remains a major hurdle limiting long-term survival post lung transplantation. Given the clinical heterogeneity of CLAD, recently two phenotypes of CLAD have been defined [bronchiolitis obliterans syndrome (BOS) vs. restrictive allograft syndrome (RAS) or restrictive CLAD (rCLAD)]. BOS is characterized by an obstructive pulmonary function, air trapping on CT and obliterative bronchiolitis (OB) on histopathology, while RAS/rCLAD patients show a restrictive pulmonary function, persistent pleuro-parenchymal infiltrates on CT and pleuroparenchymal fibro-elastosis on biopsies...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932558/results-of-quantitative-chest-ct-in-chronic-pulmonary-graft-vs-host-disease-cgvhd-3-years-after-allogeneic-stem-cell-transplantation
#8
Christopher Kloth, Wolfgang M Thaiss, Jürgen Hetzel, Georg Bier, Stefan Wirths, Konstantin Nikolaou, Marius Horger
BACKGROUND: To quantify lung parenchymal changes in symptomatic patients with chronic pulmonary graft-versus-host disease 3 years after allogeneic stem cell transplantation (allo-SCT) by means of CT-densitometry (CTD) and to compare results with those of established pulmonary function tests (PFT). METHODS: The study group consisted of 26 patients with pulmonary cGvHD (19 males, 7 females; mean age, 49.29±15.89; range, 19-72 years). The diagnosis was based on clinical symptoms, PFT and chest-CT findings...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932229/association-between-a-single-donor-tarc-ccl17-promotor-polymorphism-and-obstructive-chronic-lung-allograft-dysfunction-after-lung-transplantation
#9
Kevin Budding, Jessica van Setten, Eduard A van de Graaf, Oliver A van Rossum, Tineke Kardol-Hoefnagel, Erik-Jan D Oudijk, C Erik Hack, Henderikus G Otten
Lung transplantation (LTx) outcome is hampered by development of chronic rejection, often manifested as the bronchiolitis obliterans syndrome (BOS). Low serum levels of thymus and activation-regulated chemokine (TARC/CCL17), a chemoattractant, measured during the first month post-LTx are predictive for BOS development. Since TARC/CCL17 promotor polymorphisms correlate with serum TARC/CCL17 levels, we investigated seven single-nucleotide polymorphisms (SNPs) within this region and their potential association with LTx outcome...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28929280/ecology-of-scedosporium-species-present-knowledge-and-future-research
#10
A Rougeron, S Giraud, A Alastruey-Izquierdo, J Cano-Lira, J Rainer, A Mouhajir, S Le Gal, G Nevez, W Meyer, J P Bouchara
The genus Scedosporium, which comprises at least five clinically relevant species, i.e. Scedosporium apiospermum, Scedosporium boydii, Scedosporium aurantiacum, Scedosporium dehoogii and Scedosporium minutisporum, ranks the second among the filamentous fungi colonizing the airways of patients with cystic fibrosis (CF). This colonization of the airways is thought to contribute to the inflammatory reaction leading to a progressive deterioration of the lung function. Additionally, these colonizing fungi may lead to severe disseminated infections in case of lung transplantation...
September 19, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28926522/bos-is-associated-with-increased-cytotoxic-proinflammatory-cd8-t-nkt-like-and-nk-cells-in-the-small-airways
#11
Greg Hodge, Sandra Hodge, Aeneas Yeo, Phan Nguyen, Emily Hopkins, Chien-Li Holmes-Liew, Paul N Reynolds, Mark Holmes
BACKGROUND: Immunosuppression therapy after lung transplantation fails to prevent bronchiolitis obliterans syndrome (BOS) in many patients, primarily a disease of the small airways. We have reported that BOS is associated with a lack of suppression of cytotoxic mediators, and proinflammatory cytokines, in peripheral blood T, NKT-like (particularly CD8+) and NK cells. We also showed a loss of glucocorticoid receptor (GCR) in proinflammatory lymphocytes after transplant. It is unknown whether these proinflammatory lymphocytes target the small and/or large airways in BOS...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28926489/high-levels-of-morbidity-and-mortality-among-pediatric-hematopoietic-cell-transplant-recipients-with-severe-sepsis-insights-from-the-sepsis-prevalence-outcomes-and-therapies-international-point-prevalence-study
#12
Robert B Lindell, Shira J Gertz, Courtney M Rowan, Jennifer McArthur, Florian Beske, Adrian Plunkett, Scott L Weiss, Neal J Thomas, Vinay M Nadkarni, Julie C Fitzgerald
OBJECTIVES: Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant. DESIGN: Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant...
September 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28925583/decreasing-incidence-of-cancer-after-liver-transplantation-a-nordic-population-based-study-over-three-decades
#13
A Nordin, F Åberg, E Pukkala, C R Pedersen, H H Storm, A Rasmussen, W Bennet, M Olausson, H Wilczek, B-G Ericzon, S Tretli, P-D Line, T H Karlsen, K M Boberg, H Isoniemi
Cancer remains one of the most serious long-term complications after liver transplantation (LT). Data for all adult LT patients between 1982 and 2013 was extracted from the Nordic Liver Transplant Registry. Through linkage with respective national cancer-registry data, we calculated standardized incidence ratios (SIRs) based on country, sex, calendar time, and age-specific incidence rates. Altogether 461 cancers were observed in 424 individuals out the 4246 LT patients during a mean 6.6-year follow-up. The overall SIR was 2...
September 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28925582/the-dangers-of-oversimplification-quality-metrics-and-lung-transplantation
#14
EDITORIAL
Victor van Berkel
While many aspects of medical care are learning how to cope with the sudden proliferation of publicly reported quality metrics[1], the transplant community has been interpreting this type of data for over thirty years. Under the National Organ Transplantation Act of 1984, transplant centers are required to report their candidate and recipient information to the Organ Procurement and Transplantation Network (OPTN), and that data is then analyzed by the Scientific Registry of Transplant Recipients (SRTR), with outcomes reported on a twice yearly basis on a public website (www...
September 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28925053/extracorporeal-membrane-oxygenation-can-save-lives-in-children-with-heart-or-lung-failure-after-liver-transplantation
#15
Sandrine Jean, Christophe Chardot, Mehdi Oualha, Carmen Capito, Olivier Bustarret, Philippe Pouard, Sylvain Renolleau, Florence Lacaille, Laurent Dupic
The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported...
September 2017: Artificial Organs
https://www.readbyqxmd.com/read/28924464/the-relationship-between-mortality-of-lung-transplant-recipients-and-serum-cyclosporine-levels-joint-modeling-of-time-to-event-data-and-longitudinal-data
#16
F S Hosseini-Baharanchi, E Hajizadeh, A R Baghestani, K Najafzadeh
BACKGROUND: Lung transplantation (LTx) is a well-accepted treatment that can prolong survival of patients with advanced lung disease. OBJECTIVE: To evaluate the association between serum cyclosporine level (SCL) pattern and mortality of LTx recipients. METHODS: This retrospective cohort study included 1019 observations on 38 patients who underwent LTx in Masih Daneshvari Hospital from 2000 to 2013. The analysis applied a joint model with shared random effects...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28923643/feasibility-of-lung-transplantation-from-donation-after-circulatory-death-donors-following-portable-ex%C3%A2-vivo-lung-perfusion-a-pilot-study
#17
J G Y Luc, K Jackson, J G Weinkauf, D H Freed, J Nagendran
BACKGROUND: Donation after circulatory death (DCD) has the potential to significantly alleviate the shortage of transplantable lungs. We report our initial experience with the use of portable ex vivo lung perfusion (EVLP) with the Organ Care System Lung device for evaluation of DCD lungs. METHODS: We performed a retrospective review of the DCD lung transplantation (LTx) experience at a single institution through the use of a prospective database. RESULTS: From 2011 to 2015, 208 LTx were performed at the University of Alberta, of which 11 were DCD LTx with 7 (64%) that underwent portable EVLP...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922286/nocardia-infections-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#18
Julien Coussement, David Lebeaux, Claire Rouzaud, Olivier Lortholary
PURPOSE OF REVIEW: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. RECENT FINDINGS: Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus...
September 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28918471/extracorporeal-membrane-oxygenation-versus-cardiopulmonary-bypass-during-lung-transplantation-a-meta-analysis
#19
Dimitrios E Magouliotis, Vasiliki S Tasiopoulou, Alexis A Svokos, Konstantina A Svokos, Dimitris Zacharoulis
BACKGROUND: We reviewed the available literature on patients undergoing lung transplantation supported by cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO). METHODS: A systematic literature search was performed in three databases, in accordance with the PRISMA guidelines. Meta-analyses were used to compare the outcomes of ECMO and CPB procedures. RESULTS: Seven observational studies met the inclusion criteria incorporating 785 patients...
September 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28917997/lung-transplantation-for-scleroderma-strength-in-numbers
#20
EDITORIAL
Allan C Gelber
No abstract text is available yet for this article.
September 13, 2017: Joint, Bone, Spine: Revue du Rhumatisme
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