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https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#1
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28329162/the-value-of-fluorine-18-deoxyglucose-positron-emission-tomography-scans-in-patients-with-ventricular-assist-device-specific-infections%C3%A2
#2
Alexander M Bernhardt, Mustafa A Pamirsad, Chantal Brand, Daniel Reichart, Milena Tienken, Markus J Barten, Andreas Schaefer, Hanno Grahn, Meike Rybczynski, Tobias Deuse, Hermann Reichenspurner, Florian M Wagner
BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 ( 18 F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18 F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis. METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28323904/pyrrolidine-dithiocarbamate-administered-during-ex-vivo-lung-perfusion-promotes-rehabilitation-of-injured-donor-rat-lungs-obtained-after-prolonged-warm-ischemia
#3
Cyril Francioli, Xingyu Wang, Roumen Parapanov, Etienne Abdelnour, Jérôme Lugrin, Fabrizio Gronchi, Jean Perentes, Philippe Eckert, Hans-Beat Ris, Lise Piquilloud, Thorsten Krueger, Lucas Liaudet
Damaged lung grafts obtained after circulatory death (DCD lungs) and warm ischemia may be at high risk of reperfusion injury after transplantation. Such lungs could be pharmacologically reconditioned using ex-vivo lung perfusion (EVLP). Since acute inflammation related to the activation of nuclear factor kappaB (NF-κB) is instrumental in lung reperfusion injury, we hypothesized that DCD lungs might be treated during EVLP by pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-κB. Rat lungs exposed to 1h warm ischemia and 2 h cold ischemia were subjected to EVLP during 4h, in absence (CTRL group, N = 6) or in presence of PDTC (2...
2017: PloS One
https://www.readbyqxmd.com/read/28320631/outcomes-of-adolescent-recipients-after-lung-transplantation-an-analysis-of-the-international-society-for-heart-and-lung-transplantation-registry
#4
Miranda A Paraskeva, Leah B Edwards, Bronwyn Levvey, Josef Stehlik, Samuel Goldfarb, Roger D Yusen, Glen P Westall, Greg I Snell
BACKGROUND: Recipient adolescent age for non-lung solid-organ transplantation is associated with higher rates of rejection, graft loss and mortality. Although there have been no studies specifically examining adolescent outcomes after lung transplantation (LTx), limited data from the International Society of Heart and Lung Transplantation (ISHLT) Registry suggest that a similar association may exist. Recently, adolescence has been defined as 10 to 24 years of age, taking into account the biologic and sociologic transitions that occur during this age interval...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28314071/epidemiology-risk-factors-and-outcome-of-clostridium-difficile-infection-in-heart-and-heart-lung-transplant-recipients
#5
Jackrapong Bruminhent, Kelly A Cawcutt, Charat Thongprayoon, Tanya M Petterson, Walter K Kremers, Raymund R Razonable
BACKGROUND: Clostridium difficile is a major cause of diarrhea in thoracic organ transplant recipients. We investigated the epidemiology, risk factors and outcome of Clostridium difficile infection (CDI) in heart and heart-lung transplant (HT) recipients. METHODS: This is a retrospective study from 2004-2013. CDI was defined by diarrhea and a positive toxigenic Clostridium difficile in stool measured by toxin enzyme immunoassay (2004-2006) or polymerase chain reaction (2007-2013)...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28302503/the-giessen-pulmonary-hypertension-registry-survival-in-pulmonary-hypertension-subgroups
#6
Henning Gall, Janine F Felix, Franziska K Schneck, Katrin Milger, Natascha Sommer, Robert Voswinckel, Oscar H Franco, Albert Hofman, Ralph T Schermuly, Norbert Weissmann, Friedrich Grimminger, Werner Seeger, Hossein A Ghofrani
BACKGROUND: Pulmonary hypertension (PH) is a severe, progressive disease. Although 5 PH subgroups are recognized, reports on survival have focused mainly on pulmonary arterial hypertension (PAH). METHODS: Long-term transplant-free survival and its determinants were investigated in patients with PH (diagnosed by right heart catheterization) within a prospective registry at a single referral center in Giessen, Germany. RESULTS: In total, 2,067 patients were enrolled (PAH, 685 patients [33...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28302502/clinical-relevance-of-the-international-society-for-heart-and-lung-transplantation-consensus-classification-of-primary-graft-dysfunction-after-heart-transplantation-epidemiology-risk-factors-and-outcomes
#7
Mario Sabatino, Giuseppe Vitale, Valentina Manfredini, Marco Masetti, Laura Borgese, Giuseppe Maria Raffa, Antonio Loforte, Sofia Martin Suarez, Calogero Falletta, Giuseppe Marinelli, Francesco Clemenza, Francesco Grigioni, Luciano Potena
BACKGROUND: Primary graft dysfunction (P-GD) is the leading cause of early mortality after heart transplantation (HT). In this 2-center study we analyze outcomes and risk factors of P-GD according to the recent consensus conference classification endorsed by International Society for Heart and Lung Transplantation. METHODS: We included all adult HTs performed between 1999 and 2013. P-GD was graded as mild, moderate, and severe, according to International Society for Heart and Lung Transplantation recommendations, and analyzed separately from secondary GD...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28298957/the-intersection-of-pulmonary-hypertension-and-solid-organ-transplantation
#8
Adaani E Frost
Pulmonary hypertension (PH) is a complication and marker of disease severity in many parenchymal lung diseases. It also is a frequent complication of portal hypertension and negatively impacts survival with liver transplant. Pulmonary hypertension is frequently diagnosed in patients with end-stage renal disease who are undergoing dialysis, and it has recently been demonstrated to adversely affect posttransplant outcome in this patient population even though the mechanism of PH is substantially different from that associated with liver disease...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28294481/mycoplasma-hominis-periaortic-abscess-following-heart-lung-transplantation
#9
Hideharu Hagiya, Hisao Yoshida, Norihisa Yamamoto, Keigo Kimura, Akiko Ueda, Isao Nishi, Yukihiro Akeda, Kazunori Tomono
We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation, to our knowledge. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail...
March 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28287948/spectrum-of-ct-findings-in-thoracic-extranodal-non-hodgkin-lymphoma
#10
Mathew P Bligh, Joy N Borgaonkar, Steven C Burrell, David A MacDonald, Daria Manos
Non-Hodgkin lymphoma (NHL) frequently manifests in extranodal structures in the chest, often in the form of secondary involvement but occasionally as primary disease. Because staging and treatment are affected by the presence of extranodal disease at imaging, radiologists' interpretation and management of suspicious findings are critical to patient care. Unfortunately, owing to considerable imaging overlap with other diseases, primary extranodal lymphoma is difficult to diagnose with imaging alone. Radiologists should have a heightened degree of suspicion in patients at risk (including patients with immune compromise, autoimmune diseases, or a history of stem cell or solid organ transplant) or with particular imaging appearances (including the vertebral wraparound sign, nonresolving consolidation, an infiltrative soft-tissue mass, and lesions demonstrating vascular encasement without invasion)...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28286566/gastrointestinal-manifestations-of-mitochondrial-disorders-a-systematic-review
#11
REVIEW
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28286190/outcome-of-adults-with-eisenmenger-syndrome-treated-with-drugs-specific-to-pulmonary-arterial-hypertension-a-french-multicentre-study
#12
Sebastien Hascoet, Emmanuelle Fournier, Xavier Jaïs, Lauriane Le Gloan, Claire Dauphin, Ali Houeijeh, Francois Godart, Xavier Iriart, Adelaïde Richard, Jelena Radojevic, Pascal Amedro, Gilles Bosser, Nathalie Souletie, Yvette Bernard, Pamela Moceri, Hélène Bouvaist, Pierre Mauran, Elise Barre, Adeline Basquin, Clement Karsenty, Damien Bonnet, Laurence Iserin, Olivier Sitbon, Jérôme Petit, Elie Fadel, Marc Humbert, Magalie Ladouceur
BACKGROUND: The relationship between pulmonary arterial hypertension-specific drug therapy (PAH-SDT) and mortality in Eisenmenger syndrome (ES) is controversial. AIMS: To investigate outcomes in patients with ES, and their relationship with PAH-SDT. METHODS: Retrospective, observational, nationwide, multicentre cohort study. RESULTS: We included 340 patients with ES: genetic syndrome (n=119; 35.3%); pretricuspid defect (n=75; 22...
March 9, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28275174/physiological-and-clinical-relevance-of-exercise-ventilatory-efficiency-in-copd
#13
REVIEW
J Alberto Neder, Danilo C Berton, Flavio F Arbex, Maria Clara Alencar, Alcides Rocha, Priscila A Sperandio, Paolo Palange, Denis E O'Donnell
Exercise ventilation (V'E) relative to carbon dioxide output (V'CO2 ) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease (COPD). High V'E-V'CO2 (poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s (FEV1). Establishing an association between high V'E-V'CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28267897/outcomes-of-pediatric-kidney-transplantation-in-recipients-of-a-previous-non-renal-solid-organ-transplant
#14
Gilad Hamdani, Bin Zhang, Chunyan Liu, Jens Goebel, Yue Zhang, Edward Nehus
Children who receive a non-renal solid organ transplant may develop secondary renal failure requiring kidney transplantation. We investigated outcomes of 165 pediatric kidney transplant recipients who previously received a heart, lung, or liver transplant using data from 1988-2012 reported to the United Network for Organ Sharing. Patient and allograft survival were compared with 330 matched primary kidney transplant (PKT) recipients. Kidney transplantation after solid organ transplant (KASOT) recipients experienced similar allograft survival: 5 and 10-year graft survival was 78% and 60% in KASOT recipients, compared to 80% and 61% in PKT recipients (p=0...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28266825/cardiovascular-disease-update-pulmonary-hypertension
#15
Johnathan D McDivitt, Craig Barstow
Pulmonary hypertension (PH) is a spectrum disorder with multiple causes of the elevation of pressure in the lungs. It often is difficult to diagnose because it mimics many commonly reported symptoms (eg, dyspnea, exercise intolerance, chest pain). Diagnosis is made via right heart catheterization; however, transthoracic echocardiography may show evidence of elevated pulmonary pressure as the first clue to the diagnosis. Diagnostic tests to consider include a liver panel, complete blood count, and thyroid function test; electrocardiogram; chest x-ray; pulmonary function testing; and possibly lung imaging via computed tomography scan or ventilation-perfusion scan...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28259595/donor-recipient-size-matching-and-mortality-in-heart-transplantation-influence-of-body-mass-index-and-gender
#16
Henrik Bergenfeldt, Josef Stehlik, Peter Höglund, Bodil Andersson, Johan Nilsson
BACKGROUND: The International Society for Heart and Lung Transplantation (ISHLT) guidelines advise against inappropriate weight match (IWM) for heart transplant, defined as donor weight <70% of recipient's weight. Few studies have explored in detail this size-matching recommendation, especially with regard to body mass index (BMI) and gender matching. We aimed to determine whether any difference could be observed between size-matching in obese and non-obese recipients with regard to mortality after cardiac transplantation...
February 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28258242/successful-cardiac-transplantation-outcomes-in-patients-with-adult-congenital-heart-disease
#17
Jonathan N Menachem, Jessica R Golbus, Maria Molina, Jeremy A Mazurek, Nicole Hornsby, Pavan Atluri, Stephanie Fuller, Edo Y Birati, Yuli Y Kim, Lee R Goldberg, Joyce W Wald
OBJECTIVES: The purpose of our study is (1) to characterise patients with congenital heart disease undergoing heart transplantation by adult cardiac surgeons in a large academic medical centre and (2) to describe successful outcomes associated with our multidisciplinary approach to the evaluation and treatment of adults with congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT). BACKGROUND: Heart failure is the leading cause of death in patients with ACHD leading to increasing referrals for OHT...
March 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28255902/imaging-spectrum-of-central-nervous-system-complications-of-hematopoietic-stem-cell-and-solid-organ-transplantation
#18
REVIEW
Andrés Server, Nuria Bargalló, Yngvar Fløisand, Jon Sponheim, Francesc Graus, John K Hald
Neurologic complications are common after hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) and affect 30-60% of transplant recipients. The aim of this article is to provide a practical imaging approach based on the timeline and etiology of CNS abnormalities, and neurologic complications related to transplantation of specific organs. The lesions will be classified based upon the interval from HSCT procedure: pre-engraftment period <30 days, early post-engraftment period 30-100 days, late post-engraftment period >100 days, and the interval from SOT procedure: postoperative phase 1-4 weeks, early posttransplant syndromes 1-6 months, late posttransplant syndromes >6 months...
March 2, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28250859/-18-f-fdg-pet-ct-for-the-diagnosis-of-malignant-and-infectious-complications-after-solid-organ-transplantation
#19
Nastassja Muller, Romain Kessler, Sophie Caillard, Eric Epailly, Fabrice Hubelé, Céline Heimburger, Izzie-Jacques Namer, Raoul Herbrecht, Cyrille Blondet, Alessio Imperiale
PURPOSE: Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of (18)F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. METHODS: Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis...
March 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28237697/heart-transplantation-in-adults-with-congenital-heart-disease
#20
REVIEW
Lucile Houyel, Ngoc-Tram To-Dumortier, Yannick Lepers, Jérôme Petit, Régine Roussin, Mohamed Ly, Emmanuel Lebret, Elie Fadel, Jürgen Hörer, Sébastien Hascoët
With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients...
February 22, 2017: Archives of Cardiovascular Diseases
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