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https://www.readbyqxmd.com/read/27932148/low-dose-spinal-block-with-continuous-epidural-infusion-for-renal-transplantation-in-a-patient-with-alport-syndrome-a-case-report
#1
F Gobbi, G Sales, P Bretto, P P Donadio, L Brazzi
OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931586/observational-study-of-methotrexate-in-the-treatment-of-bronchiolitis-obliterans-syndrome
#2
S Sithamparanathan, L Thirugnanasothy, K E Morley, A J Fisher, J L Lordan, G Meachery, G Parry, P A Corris
BACKGROUND: Methotrexate (MTX) is potential change in immunosuppression after lung transplantation that may help to slow down the decline in lung function in bronchiolitis obliterans syndrome (BOS). METHODS: We sought to analyze the safety and efficacy of MTX in patients with BOS, by retrospective case review. RESULTS: Thirty lung allograft patients were treated with MTX for BOS after one bilateral lower lobe, nine single, 16 bilateral, and four heart-lung transplants...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#3
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916031/-experience-of-the-selection-and-maintainence-for-donor-lung-62-cases-attached
#4
G L Peng, X Xu, D X Huang, B Wei, D Xiao, W Wang, Y D Wang, J X He
Objective: To summarize the experience of selection and maintainence for the lungs from donation. Methods: From January 2015 to June 2016, 62 cases had been evaluated by Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University. All the clinic data had been collected to evaluate the donor lungs, including the basic information, physical examination, results of radiology and laboratory, the bronchoscope, etc. All the satisfactory donors had been harvested and transplanted to the receipient and then follow up...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27890037/grouped-cases-of-pulmonary-pneumocystosis-after-solid-organ-transplantation-advantages-of-coordination-by-an-infectious-diseases-unit-for-overall-management-and-epidemiological-monitoring
#5
Claire Wintenberger, Daniele Maubon, Elena Charpentier, John Rendu, Patricia Pavese, Caroline Augier, Paolo Malvezzi, Boubou Camara, Marie-Reine Mallaret, Laurence Bouillet, Olivier Epaulard
OBJECTIVE To determine the origin of grouped cases of Pneumocystis pneumonia in solid-organ transplant recipients at our institution. DESIGN A case series with clinical examinations, genotyping, and an epidemiological survey. SETTING A university hospital in France. PATIENTS We report 12 solid-organ transplant recipients with successive cases of Pneumocystis pneumonia that occurred over 3 years; 10 of these cases occurred in a single year. METHODS We used molecular typing of P. jirovecii strains by multilocus sequence typing and clinical epidemiological survey to determine potential dates and places of transmission...
November 28, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27873446/the-first-two-years-of-activity-of-a-specialized-organ-procurement-centre-report-of-an-innovative-approach-to-improve-organ-donation
#6
Pierre Marsolais, Philippe Durand, Emmanuel Charbonney, Karim Serri, Anne-Marie Lagacé, Francis Bernard, Martin Albert
The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized Organ Procurement Centre (OPC) with dedicated intensive care unit beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians and multidisciplinary staff. All organ donors within a designated geographic area were transferred and managed within the OPC...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27872804/pulmonary-hypertension-secondary-to-pulmonary-veno-occlusive-disease-complicated-by-right-heart-failure-hypotension-and-acute-kidney-injury
#7
Nima Golzy, Stuti Fernandes, Justin Sharim, Rikin Tank, Henry D Tazelaar, Howard E Epstein, Victor Tapson, Antoine Hage
Pulmonary veno-occlusive disease (PVOD) is rare condition which can lead to severe pulmonary hypertension, right ventricular dysfunction, and cardiopulmonary failure. The diagnosis of PVOD can be challenging due to its nonspecific symptoms and its similarity to idiopathic pulmonary arterial hypertension and interstitial lung disease in terms of diagnostic findings. This case describes a 57 year old female patient who presented with a 5-month history of progressive dyspnea on exertion and nonproductive cough...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27866929/long-term-outcomes-of-pulmonary-arterial-hypertension-under-specific-drug-therapy-in-eisenmenger-syndrome
#8
Sébastien Hascoët, Alban-Elouen Baruteau, Marc Humbert, Gérald Simonneau, Xavier Jais, Jérôme Petit, Daniela Laux, Olivier Sitbon, Virginie Lambert, André Capderou
BACKGROUND: The long-term effectiveness of pulmonary arterial hypertension-specific drug therapy (PAH-SDT) in Eisenmenger syndrome is controversial. We investigated short-term and long-term hemodynamic changes under PAH-SDT and their associations with outcomes in a bicentric cohort. METHODS: Over 20 years, we included 69 patients with congenital heart disease, an indexed pulmonary vascular resistance (PVRi) >8 WU·m(2), and 292 standardized catheterizations at baseline and after PAH-SDT initiation or intensification...
October 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27866861/outcomes-after-transplantation-of-lungs-preserved-for-more-than-12-h-a-retrospective-study
#9
Jonathan C Yeung, Thorsten Krueger, Kazuhiro Yasufuku, Marc de Perrot, Andrew F Pierre, Thomas K Waddell, Lianne G Singer, Shaf Keshavjee, Marcelo Cypel
BACKGROUND: Ex-vivo lung perfusion (EVLP) can be used to extend overall lung preservation time by splitting one long cold ischaemic time into two shorter ones and interposing an additional EVLP time. We assessed the outcomes after clinical transplantation of lungs with more than 12 h of preservation time. METHODS: For this retrospective study, we searched the Toronto Lung Transplant Program database for patients who had received at least one lung transplant between Jan 1, 2006, and April 30, 2015, at a single hospital in Toronto, Canada...
November 17, 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27866319/successful-posaconazole-therapy-of-disseminated-alternariosis-due-to-alternaria-infectoria-in-a-heart-transplant-recipient
#10
Pavlina Lyskova, Milos Kubanek, Vit Hubka, Eva Sticova, Ludek Voska, Dana Kautznerova, Miroslav Kolarik, Petr Hamal, Martina Vasakova
We report a case of phaeohyphomycosis caused by Alternaria infectoria in a 61-year-old heart transplant recipient with multiple skin lesions and pulmonary infiltrates. The infection spread via the haematogenous route from the primary cutaneous lesions into the lungs. The diagnosis was based on the histopathological examination, direct microscopy, skin lesion cultures and detection of Alternaria DNA in the bronchoalveolar lavage fluid using molecular methods. The treatment consisted of a combination of surgical excision and systemic antifungal therapy...
November 19, 2016: Mycopathologia
https://www.readbyqxmd.com/read/27861431/pediatric-artificial-lung-a-low-resistance-pumpless-artificial-lung-alleviates-an-acute-lamb-model-of-increased-right-ventricle-afterload
#11
Fares Alghanem, Benjamin S Bryner, Emilia M Jahangir, Uditha P Fernando, John M Trahanas, Hayley R Hoffman, Robert H Bartlett, Alvaro Rojas-Peña, Ronald B Hirschl
Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload.Five juvenile lambs (20-30 Kg) underwent PAL implantation in a pulmonary artery to left atrium configuration...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27861290/pathophysiological-trends-during-withdrawal-of-life-support-implications-for-organ-donation-after-circulatory-death
#12
Arjun Iyer, Hong Chee Chew, Ling Gao, Jeanette Villanueva, Mark Hicks, Aoife Doyle, Gayathri Kumarasinghe, Andrew Jabbour, Paul Cassius Jansz, Michael P Feneley, Richard P Harvey, Robert M Graham, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Donation after circulatory death (DCD) provides an alternative pathway to deceased organ transplantation. Although clinical DCD lung, liver, and kidney transplantation are well established, transplantation of hearts retrieved from DCD donors has reached clinical translation only recently. Progress has been limited by concern regarding the viability of DCD hearts. The aim of this study was to document the pathophysiological changes that occur in the heart and circulation during withdrawal of life (WLS) support...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27826340/role-of-soluble-st2-as-a-marker-for-rejection-after-heart-transplant
#13
Ga Yeon Lee, Jin-Oh Choi, Eun-Seon Ju, Yoo-Jung Lee, Eun-Seok Jeon
BACKGROUND AND OBJECTIVES: Endomyocardial biopsy is obligatory during the first year after heart transplant (HTx) for the surveillance of acute rejection. Previous attempts using cardiac biomarkers for the detection of rejection failed to show enough evidence to substitute endomyocardial biopsy. Therefore, this study sought the possibility of using soluble ST2 (sST2), a novel cardiovascular marker, as a surrogate marker for acute allograft rejection after HTx. SUBJECTS AND METHODS: A total of 494 blood samples acquired at the time of endomyocardial biopsy were analyzed in 67 HTx cases from September 2006 to August 2014...
November 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27821818/de-novo-malignancy-in-organ-transplant-recipients-in-taiwan-a-nationwide-cohort-population-study
#14
Hsin-I Tsai, Chao-Wei Lee, Chang-Fu Kuo, Lai-Chu See, Fu-Chao Liu, Meng-Jiun Chiou, Huang-Ping Yu
Organ transplant recipients appear to have a higher risk of de novo malignancy. The aim of the study was designed to estimate cancer risk in heart, lung, kidney and liver transplant recipients. The cohort study used the Taiwan National Health Insurance Research Database (1996-2011) and followed the outcomes of organ recipients until 2012. De novo cancer and mortality rates after organ transplantation were evaluated using standardized incidence ratios, excess absolute risks of cancer, and standardized mortality ratios in recipients were compared with those in the general population...
November 4, 2016: Oncotarget
https://www.readbyqxmd.com/read/27819763/diagnosis-of-acute-cellular-rejection-and-antibody-mediated-rejection-on-lung-transplant-biopsies-a-perspective-from-members-of-the-pulmonary-pathology-society
#15
Anja C Roden, Dara L Aisner, Timothy C Allen, Marie Christine Aubry, Roberto J Barrios, Mary B Beasley, Philip T Cagle, Vera L Capelozzi, Sanja Dacic, Yimin Ge, Lida P Hariri, Sylvie Lantuejoul, Ross A Miller, Mari Mino-Kenudson, Andre L Moreira, Kirtee Raparia, Natasha Rekhtman, Lynette Sholl, Maxwell L Smith, Ming S Tsao, Marina Vivero, Yasushi Yatabe, Eunhee S Yi
CONTEXT: - The diagnosis and grading of acute cellular and antibody-mediated rejection (AMR) in lung allograft biopsies is important because rejection can lead to acute graft dysfunction and/or failure and may contribute to chronic graft failure. While acute cellular rejection is well defined histologically, no reproducible specific features of AMR are currently identified. Therefore, a combination of clinical features, serology, histopathology, and immunologic findings is suggested for the diagnosis of AMR...
November 7, 2016: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/27810156/pulmonary-arterial-capacitance-index-is-a-strong-predictor-for-adverse-outcome-in-children-with-idiopathic-and-heritable-pulmonary-arterial-hypertension
#16
Shinichi Takatsuki, Tomotaka Nakayama, Satoshi Ikehara, Hiroyuki Matsuura, David Dunbar Ivy, Tsutomu Saji
OBJECTIVES: To evaluate the clinical utility of pulmonary artery capacitance index (PACi) in the assessment of disease severity and prognostic value in children with idiopathic and heritable pulmonary arterial hypertension (PAH). STUDY DESIGN: PACi is defined as the ratio of stroke volume index over pulmonary pulse pressure. A retrospective study was performed to compare PACi, brain natriuretic peptide (BNP), 6-minute walk distance, New York Heart association (NYHA) functional class, and adverse outcomes (hospitalization due to heart failure, lung transplantation, and cardiac mortality) in 72 Japanese children (10 ± 3...
October 31, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27805513/microbiologic-monitoring-of-kidney-transplant-recipients-before-transplant
#17
Nelya Bissenova, Aigerim Yergaliyeva
OBJECTIVES: Drug immunosuppression, traditionally used to minimize autoimmune developments after liver, kidney, heart, and lung transplant, and which requires high doses of corticosteroids, creates favorable conditions for the development of various infectious processes and the existence of pathogens, which can be activated after transplant. This study aimed to investigate the bacterial pathogens in patients before living-donor kidney transplant. MATERIALS AND METHODS: We prospectively investigated 117 clinical samples of 33 patients who were seen during 2015 at the National Scientific Research Center (Astana, Kazakhstan) before living-donor kidney transplant...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27801552/th17-responses-to-col-v-k%C3%AE-1-tubulin-and-vimentin-are-present-early-in-human-development-and-persist-lifelong
#18
Jeremy A Sullivan, Ewa Jankowska-Gan, Subramanya Hegde, Matthew A Pestrak, Vrushali V Agashe, Arick C Park, Matthew E Brown, John F Kernien, David S Wilkes, Dixon B Kaufman, Daniel S Greenspan, William J Burlingham
Th17-dependent autoimmune responses can develop after heart or lung transplantation, and are associated with fibro-obliterative forms of chronic rejection. However, the specific self-antigens involved are typically different from those associated with autoimmune disease. To investigate the basis of these responses, we questioned whether removal of Tregs or blockade of function reveals a similar auto-antigen bias. We found that Th17 cells specific for collagen type V (Col V), kα-1-tubulin, and vimentin were present in healthy, adult PBMC, cord blood, and fetal thymus...
November 1, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27801422/-clinical-guidelines-for-the-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-part-2
#19
I E Chazova, T V Martynyuk
The paper gives current approaches to treating chronic thromboembolic pulmonary hypertension (CTEPH) from the document «Federal Guidelines for the Diagnosis and Treatment of CTEPH» approved at the Third Russian Congress on Pulmonary Hypertension on December 11, 2015. The guidelines had been elaborated to optimize the treatment of patients with CTEPH on the basis of an analysis of the data of the present-day registries and multicenter randomized clinical trials, national and international guidelines and consensus documents, and documents published in recent years...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27791997/stem-cells-and-vascular-regenerative-medicine
#20
J-F Stoltz, D Bensoussan, N De Isla, L Zhang, Z Han, J Magdalou, C Huselstein, J S Ye, N Li, V Decot, L Reppel
Most human tissues do not regenerate spontaneously, which is why "cell therapy" are promising alternative treatments. The Principe is simple: patients' or donors' cells are collected and introduced into the injured tissues or organs directly or in a porous 3D material, with or without modification of their properties. This concept of regenerative medicine is an emerging field which can be defined as "the way to improve health and quality of life by restoring, maintaining, or enhancing tissue and organ functions"...
October 27, 2016: Clinical Hemorheology and Microcirculation
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