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https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#1
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28652431/cortisol-levels-and-gastrointestinal-disorders-after-stressful-surgery-in-rabbits
#2
Seok Jin Jang, Seong Soo Kang, Soo Jin Son, Jae Yeon Lee, Gonhyung Kim, Seok Hwa Choi
Rabbits are widely used in biomedical studies because they are docile and manageable. However, they are prone to gastrointestinal disorders due to their vulnerability to stress. Eighteen adult rabbits were used for allogenic tracheal surgery. The tracheas for allograft, 20-mm length, were transplanted into 20-mm tracheal defects. Immediately after surgery, most rabbits suffered from poor appetite. Food and water intake gradually recovered within 7 days after surgery, but six rabbits had severe anorexia from day 7 post-surgery...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28619045/human-adipose-derived-mesenchymal-stem-cells-alleviate-obliterative-bronchiolitis-in-a-murine-model-via-ido
#3
Guoping Zheng, Guanguan Qiu, Menghua Ge, Jianping He, Lanfang Huang, Ping Chen, Wei Wang, Qi Xu, Yaoqin Hu, Qiang Shu, Jianguo Xu
BACKGROUND: Long-term survival of lung transplantation is hindered by the development of obliterative bronchiolitis (OB). Adipose-derived stem cells (ASCs) were documented to have more potent immunosuppressive ability than mesenchymal stem cells (MSCs) from bone marrow and placenta. The goal of our study is to evaluate the effect of repeated administration of ASCs on OB and the involvement of indoleamine 2,3-dioxygenase (IDO) mediating the protective effect of ASCs in a heterotopic tracheal transplantation (HTT) model...
June 15, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28570606/effects-of-two-different-decellularization-routes-on-the-mechanical-properties-of-decellularized-lungs
#4
Jessica Julioti Urbano, Renata Kelly da Palma, Flávia Mafra de Lima, Paula Fratini, Leticia Lopes Guimaraes, Juan J Uriarte, Letícia Heineck Alvarenga, Maria Angelica Miglino, Rodolfo de Paula Vieira, Renato Araujo Prates, Daniel Navajas, Ramon Farrè, Luis Vicente Franco Oliveira
Considering the limited number of available lung donors, lung bioengineering using whole lung scaffolds has been proposed as an alternative approach to obtain lungs suitable for transplantation. However, some decellularization protocols can cause alterations on the structure, composition, or mechanical properties of the lung extracellular matrix. Therefore, the aim of this study was to compare the acellular lung mechanical properties when using two different routes through the trachea and pulmonary artery for the decellularization process...
2017: PloS One
https://www.readbyqxmd.com/read/28545478/ltb4-and-montelukast-in-transplantation-related-bronchiolitis-obliterans-in-rats
#5
Zheng-Liang Tu, Zhen-Yu Zhou, Hai-Chao Xu, Jin-Lin Cao, Peng Ye, Lu-Ming Wang, Wang Lv, Jian Hu
BACKGROUND: Lung transplantation is the only effective treatment for end-stage lung diseases. Bronchiolitis obliterans, which is known as non-infectious chronic lung allograft dysfunction (CLAD) in the new classification, is the greatest threat to long-term survival after lung transplantation. This study investigated the role of leukotriene B4 (LTB4) and montelukast in transplantation-related bronchiolitis obliterans and discussed the pathophysiological significance of LTB4 in chronic rejection...
May 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28544662/tracheal-replacement-therapy-with-a-stem-cell-seeded-graft-lessons-from-compassionate-use-application-of-a-gmp-compliant-tissue-engineered-medicine
#6
Martin J Elliott, Colin R Butler, Aikaterini Varanou-Jenkins, Leanne Partington, Carla Carvalho, Edward Samuel, Claire Crowley, Peggy Lange, Nicholas J Hamilton, Robert E Hynds, Tahera Ansari, Paul Sibbons, Anja Fierens, Claire McLaren, Derek Roebuck, Colin Wallis, Nagarajan Muthialu, Richard Hewitt, David Crabbe, Sam M Janes, Paolo De Coppi, Mark W Lowdell, Martin A Birchall
Tracheal replacement for the treatment of end-stage airway disease remains an elusive goal. The use of tissue-engineered tracheae in compassionate use cases suggests that such an approach is a viable option. Here, a stem cell-seeded, decellularized tissue-engineered tracheal graft was used on a compassionate basis for a girl with critical tracheal stenosis after conventional reconstructive techniques failed. The graft represents the first cell-seeded tracheal graft manufactured to full good manufacturing practice (GMP) standards...
June 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28528427/repeated-systemic-administration-of-adipose-tissue-derived-mesenchymal-stem-cells-prevents-tracheal-obliteration-in-a-murine-model-of-bronchiolitis-obliterans
#7
William Lorenzi, Fabiany Da Costa Gonçalves, Natália Schneider, Éverton Franco Silva, Fernanda Visioli, Ana Helena Paz, Mauricio Guidi Saueressig
OBJECTIVE: To investigate the effect of adipose tissue-derived mesenchymal stem cell (ASC) administered either systemically or locally in a murine model of bronchiolitis obliterans. RESULTS: When compared to controls, systemic treatment with 10(6) ASCs on D0 and a second dose on D7 significantly prevented tracheal obliteration 28 days after heterotopic tracheal transplantation (median of 94 vs. 16%; P < 0.01). A single dose tended towards less stenosis than controls, but did not reach statistical significance (28 vs...
May 20, 2017: Biotechnology Letters
https://www.readbyqxmd.com/read/28508001/closing-a-tracheal-defect-with-an-omental-pedicled-gastric-flap-a-technical-note
#8
Holger Rupprecht, Marius Ghidau, Katharina Gaab
Due to an adenocarcinoma of the right upper lobe with infiltration of the main bronchus a 49-years-old female patient underwent an upper bilobectomy with sleeve resection. After two completed chemotherapy bouts and signs of sepsis another thoracotomy was inevitable.  As a complicating factor a supracarinal, necrotic and perforating lesion of the trachea appeared. The defect can be initially repaired with a suture and covered with azygos vein material. However surgical revision showed an enlargement of the tracheal necrosis...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28480504/the-feasibility-of-gamma-radiation-sterilization-for-decellularized-tracheal-grafts
#9
Christopher M Johnson, DeHuang Guo, Stephanie Ryals, Gregory N Postma, Paul M Weinberger
OBJECTIVES/HYPOTHESIS: The most promising stem cell-derived tracheal transplantation approach is dependent upon the use of decellularized tracheal grafts. It has been assumed that a sterilization step, such as gamma radiation, would damage the delicate extracellular matrix of the graft, thus rendering it less viable for cellular repopulation, although this has not been thoroughly investigated. STUDY DESIGN: Laboratory-based comparative analysis. METHODS: Fifteen murine tracheas of strain C57/B-6 mice were obtained...
May 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28472471/successful-immunosuppressant-free-heterotopic-transplantation-of-tracheal-allografts-in-the-pig
#10
Julien De Wolf, Mathias Brieu, Christophe Zawadzki, Alexandre Ung, Eric Kipnis, Ramadan Jashari, Thomas Hubert, Pierre Fayoux, Christophe Mariette, Marie-Christine Copin, Alain Wurtz
OBJECTIVES: It has been demonstrated that both heterotopic and orthotopic transplants of epithelium-denuded cryopreserved tracheal allografts are feasible in immunosuppressant-free rabbits. Validation of these results in large animals is required before considering clinical applications. We evaluated the viability, immune tolerance and strain properties of such tracheal allografts heterotopically transplanted in a pig model. METHODS: Ten tracheal segments, 5 short (5 rings) and 5 long (10 rings), were obtained from male Landrace pigs...
May 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28447930/a-novel-and-simple-method-for-tracheal-intubation-in-a-swine-model-preparing-for-the-era-of-xenotransplantation
#11
Hyub Huh, Hyong Hwan Lim, Ji Yeong Kim, Hye Won Shin, Hae Ja Lim, Suk Min Yoon, Seung Zhoo Yoon, Hye Won Lee
OBJECTIVES: Organ transplant in humans is an established therapy for a variety of end-stage organ diseases. However, due to organ shortages and lack of donors, the need for xenotransplant has gradually increased. Xenotransplantation has great potential to solve many of the problems facing organ transplantation. Pigs are being developed as xenogeneic organ donors for use in humans. In this study, we propose a novel and simple method for tracheal intubation in a swine model using neuromuscular blocking agents and laryngeal mask airway...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28427861/divergent-function-of-programmed-death-ligand-1-in-donor-tissue-versus-recipient-immune-system-in-a-murine-model-of-bronchiolitis-obliterans
#12
Katharina Schütte-Nütgen, Olaf Boenisch, Hakima Harrach, Alicia Casey, Indira Guleria, Nader Najafian, Mohamed H Sayegh, Craig J Gerard, Meera Subramaniam
Costimulatory molecules, such as the programmed death ligand (PD-L1), might exert differential effects on T-cell function, depending on the clinical setting and/or immunological environment. Given the impact of T cells on bronchiolitis obliterans (BO) in lung transplantation, we used an established tracheal transplant model inducing BO-like lesions to investigate the impact of PD-L1 on alloimmune responses and histopathological outcome in BO. In contrast to other transplant models in which PD-L1 generally shows protective functions, we demonstrated that PD-L1 has divergent effects depending on its location in donor versus recipient tissue...
June 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28424763/airway-problems-in-neonates-a-review-of-the-current-investigation-and-management-strategies
#13
REVIEW
Quen Mok
Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal "communication" in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28359676/transplantation-of-the-decellularized-tracheal-allograft-in-animal-model-rabbit
#14
Reza Ershadi, Mohamadbagher Rahim, Siavash Jahany, Siamak Rakei
BACKGROUND: It has been difficult to perform tracheal allotransplantation without immunosuppression. To determine whether decellularized trachea can be used in tracheal replacement, we evaluated the viability of decellularized tracheal allografts in a rabbit model of immunosuppressant-free transplantation. METHOD: Half allograft (Group 1, n = 7) was harvested from adult New Zealand white rabbits, subjected to a detergent-enzymatic method (containing sodium deoxycholate/DNase lavations) of decellularization for as many cycles as needed, and the other half was stored in phosphate-buffered saline at 4°C as a control (Group 2, n = 7)...
March 27, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28260471/culture-positive-pulmonary-aspergillosis-infection-clinical-and-laboratory-features-of-solid-organ-transplant-recipients
#15
Balam Er Dedekarginoglu, Serife Savas Bozbas, Gaye Ulubay, Fusun Oner Eyuboglu, Mehmet Haberal
OBJECTIVES: Aspergillosis is a common fungal infection among solid-organ transplant recipients. Even after awareness of this infection occurs, there are still gaps in nonculture diagnostic tests, which can delay treatment initiation. Here, we aimed to define the common traits of pulmonary aspergillosis infection among solid-organ transplant recipients, thus shedding light on prevention and early diagnosis. MATERIALS AND METHODS: We conducted a database search of patients at Baskent University who had a positive aspergillosis culture between January 2010 and March 2016...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28251796/cytotoxicity-of-natural-killer-cells-activated-through-nkg2d-contributes-to-the-development-of-bronchiolitis-obliterans-in-a-murine-heterotopic-tracheal-transplant-model
#16
T Kawakami, K Ito, Y Matsuda, M Noda, A Sakurada, Y Hoshikawa, Y Okada, K Ogasawara
Bronchiolitis obliterans after lung transplantation is a major cause of postoperative mortality in which T cell-mediated immunity is known to play an important role. However, the exact contribution of natural killer (NK) cells, which have functions similar to CD8(+) T cells, has not been defined. Here, we assessed the role of NK cells in murine bronchiolitis obliterans through heterotopic tracheal transplantations and found a greater percentage of NK cells in allografts than in isografts. Depletion of NK cells using an anti-NK1...
March 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28228614/current-solutions-for-long-segment-tracheal-reconstruction
#17
Ahmed A Abouarab, Hany H Elsayed, Hussein Elkhayat, Ahmed Mostafa, David C Cleveland, Ahmed El Nori
This article is a continuation of previous reviews about the appropriate method for long-segment tracheal reconstruction. We attempted to cover the most recent, successful and promising results of the different solutions for reconstruction that are rather innovative and suitable for imminent clinical application. Latest efforts to minimize the limitations associated with each method have been covered as well. In summary, autologous and allogenic tissue reconstruction of the trachea have been successful methods for reconstruction experimentally and clinically...
April 20, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28122791/repair-of-challenging-non-malignant-tracheo-or-broncho-oesophageal-fistulas-by-extrathoracic-muscle-flaps
#18
Petra Rosskopfova, Jean Yannis Perentes, Markus Schäfer, Thorsten Krueger, Alban Lovis, Gian Dorta, Moira Baeriswyl, Hans-Beat Ris, Michel Gonzalez
OBJECTIVES: Evaluation of complex, acquired, non-malignant tracheo/broncho-oesophageal fistulas (TEF) repaired by extrathoracic pedicled muscle flaps that were, in addition to their interposition between the airways and the gastro-intestinal tract, patched into gastro-intestinal or airway defects if primary closure seemed risky. METHODS: A single institution experience of patients treated between 2003 and 2015. Twenty-two patients required TEF repair following oesophageal surgery (18), Boerhaave syndrome (1), chemotherapy for mediastinal lymphoma (1), carinal resection and irradiation (1) and laryngectomy (1); 64% of them underwent prior radio- or chemotherapy and 50% prior airway or oesophageal stenting...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28119095/unilateral-vocal-fold-adductor-paralysis-after-tracheal-intubation
#19
Takao Goto, Takaharu Nito, Rumi Ueha, Akihito Yamauchi, Taku Sato, Tatsuya Yamasoba
Vocal fold immobility is a relatively rare complication that can occur after tracheal intubation. Differential diagnoses include a rare clinical entity called unilateral vocal fold adductor paralysis in which only branches entering the thyroarytenoid and lateral cricoarytenoid muscles of the recurrent laryngeal nerve become paralyzed. Computed tomography and laryngeal electromyography are required to distinguish this condition from others such as cricoarytenoid dislocation/subluxation. Here, we describe two patients who developed vocal fold adductor paralysis after intubation...
January 21, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28109571/in%C3%A2-vivo-tissue-engineering-of-human%C3%A2-airways
#20
Emmanuel Martinod, Joseph Paquet, Hervé Dutau, Dana M Radu, Morad Bensidhoum, Sébastien Abad, Yurdagül Uzunhan, Eric Vicaut, Hervé Petite
BACKGROUND: Airway transplantation remains a major challenge in thoracic surgery. Based on our previous laboratory work, we developed the techniques required to bioengineer a tracheal substitute in vivo using cryopreserved aortic allografts as biological matrices (Replacement of the Airways and/or the Pulmonary Vessels Using a Cryopreserved Arterial Allograft [TRACHEOBRONCART] Study, NCT01331863). We present here 2 patients who had a definitive tracheostomy for complex laryngotracheal stenoses refractory to conventional therapy...
January 18, 2017: Annals of Thoracic Surgery
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