Because chronic lung allograft dysfunction (CLAD) develops predominantly on one side after bilateral living-donor lobar lung transplantation (LDLLT), lung perfusion scintigraphy (Q-scinti) was expected to show a perfusion shift to the contralateral unaffected lung with the development of CLAD. Our study examined the potential usefulness of Q-scinti in the diagnosis of CLAD after bilateral LDLLT. We conducted a single-center retrospective cohort study of 58 recipients of bilateral LDLLT. The unilateral shift values on Q-scinti were calculated and compared between the CLAD group (N=27) and the non-CLAD group (N=31) from 5 years before to 5 years after the diagnosis of CLAD. The unilateral shift values in Q-scinti were significantly higher in the CLAD group than in the non-CLAD group from 5 years before the diagnosis of CLAD to 5 years after the diagnosis ( ...

TY - JOUR. T1 - Stage I adenocarcinoma presenting in the pneumonectomy specimen at the time of single lung transplantation. AU - Svendsen, Charles A.. AU - Bengtson, Ross B.. AU - Park, Soon J.. AU - Shumway, Sara J.. PY - 1998/10/27. Y1 - 1998/10/27. N2 - Two patients at our institution underwent single lung transplantation. The procedure and the patients postoperative course were uncomplicated in each case. Pathological examination of each pneumonectomy specimen revealed a well-differentiated adenocarcinoma; both were less than 1 cm in size. The remainder of each lung showed no evidence of adenocarcinoma and all lymph nodes were negative. Work-ups for an occult malignancy before and after surgery were negative. This is believed to be the first report of a single lung transplant in a patient with a primary adenocarcinoma of the lung. The implications and management of these patients are discussed.. AB - Two patients at our institution underwent single lung transplantation. The procedure and ...

TY - JOUR. T1 - Surgical issues in lung transplantation. T2 - Options, donor selection, graft preservation, and airway healing. AU - Daly, Richard C.. AU - Mcgregor, Christopher G.A.. N1 - Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 1997. Y1 - 1997. N2 - To present an overview of the surgical issues in lung transplantation, including the historical context and the rationale for choosing a particular procedure for a specific patient, we reviewed and summarized the current medical literature and our personal experience. Several surgical options are available, including single lung transplantation; double lung transplantation; heart-lung transplantation; bilateral, sequential single lung transplantation; and (recently) single lobe transplantation. Although single lung transplantation is preferred for maximal use of the available organs, bilateral lung transplantation is necessary for septic lung diseases and may be appropriate for pulmonary hypertension and bullous ...

TY - JOUR. T1 - Living-donor lobar lung transplantation for bronchiolitis obliterans after Stevens-Johnson syndrome. AU - Date, Hiroshi. AU - Sano, Yoshifumi. AU - Aoe, Motoi. AU - Goto, Keiji. AU - Tedoriya, Takeo. AU - Sano, Shunji. AU - Andou, Akio. AU - Shimizu, Nobuyoshi. PY - 2002/1/1. Y1 - 2002/1/1. UR - http://www.scopus.com/inward/record.url?scp=0036164451&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0036164451&partnerID=8YFLogxK. U2 - 10.1067/mtc.2002.119331. DO - 10.1067/mtc.2002.119331. M3 - Article. C2 - 11828317. AN - SCOPUS:0036164451. VL - 123. SP - 389. EP - 391. JO - Journal of Thoracic and Cardiovascular Surgery. JF - Journal of Thoracic and Cardiovascular Surgery. SN - 0022-5223. IS - 2. ER - ...

This case series describes 7 patients with severe chronic graft-versus-host disease (cGvHD) associated with bronchiolitis obliterans (BO) after allogeneic hematopoietic stem cell transplantation (HCT) who underwent lung transplantation. About 20% of patients with severe cGVHD develop BO, which portends a poor prognosis. Lung transplantation may be performed for severe refractory BO. In this group, 6 patients underwent bilateral lung transplantation and 1 underwent single lung transplantation. Explanted lung pathology confirmed BO in all patients. The median survival after lung transplantation in this group was 24 months. The authors conclude that lung transplantation is a possible therapeutic option for certain patients with severe therapy-refractory BO.. ...

TY - JOUR. T1 - Improved results of lung transplantation for patients with cystic fibrosis. AU - Egan, Thomas M.. AU - Detterbeck, Frank C.. AU - Mill, Michael R.. AU - Paradowski, Linda J.. AU - Lackner, Rudy P.. AU - Ogden, W. David. AU - Yankaskas, James R.. AU - Westerman, Jan H.. AU - Thompson, Jeanette T.. AU - Weiner, Meredith A.. AU - Cairns, Ellen L.. AU - Wilcox, Benson R.. PY - 1995/2. Y1 - 1995/2. N2 - Patients with cystic fibrosis pose particular challenges for lung transplantation surgeons. Earlier reports from North America centers suggested that patients with cystic fibrosis were greater risk for heart-lung or isolated lung transplantation than other patients with end-stage pulmonary disease. During a 3 1/2 year period, 44 patients with end-stage lung disease resulting from cystic fibrosis underwent double lung transplantation at this institution. During the same interval, 18 patients with cystic fibrosis, died while waiting for a double lung transplantation. The ages of the ...

TY - JOUR. T1 - Effects of inhaled nitric oxide following lung transplantation. AU - Yerebakan, Can. AU - Ugurlucan, Murat. AU - Bayraktar, Selcan. AU - Bethea, Brian T.. AU - Conte, John V.. PY - 2009/5/1. Y1 - 2009/5/1. N2 - Background: Lung transplantation offers an established therapeutic option for end-stage lung disease. It is associated with several complications, and early allograft failure is one of the most devastating among all. Different studies are focused on an attempt to minimize these complications, especially transplant failure. We aimed to evaluate the effects of inhaled nitric oxide (iNO) treatment in patients receiving lung transplantation. Methods: Nine patients (six female, three male; mean age 42.9 ± 15.8) requiring lung transplantation for end-stage pulmonary disease - chronic obstructive pulmonary disease (three patients), cystic fibrosis (three patients), scleroderma and systemic sclerosis (two patients), Eisenmengers syndrome (one patient), and treated with iNO were ...

Airway complications following lung transplantation remain a significant cause of morbidity and mortality. The management of bronchial complications in Bronchus Intermedius (BI) is challenging due to the location of right upper bronchus. The aim of this study was to analyze the results of BI Montgomery T-tube stent in a consecutive patients with lung transplantations. Between January 2007 and December 2010, 132 lung transplantations were performed at Foch Hospital, Suresnes, France. All the patients who had BI Montgomery T-tube after lung transplantation were included in this retrospective study. The demographic and interventional data and also complications were recorded. Out of 132 lung transplant recipients, 12 patients (9 male and 3 female) were entered into this study. The indications for lung transplantation were: cystic fibrosis 8 (67%), emphysema 3 (25%), and idiopathic pulmonary fibrosis 1 (8%). Most of the patients (83%) had bilateral lung transplantation. The mean interval between lung

Experience with cyclosporine in living-donor lobar lung transplantation.: Living-donor lobar lung transplantation is an alternative to conventional cadaveric lu

TY - JOUR. T1 - An observational study of Donor Ex Vivo Lung Perfusion in UK lung transplantation: DEVELOP-UK. AU - Fisher, Andrew. AU - Andreasson, Anders. AU - Chrysos, Alexandros. AU - Lally, Joanne. AU - Mamasoula, Chrysovalanto. AU - Exley, Catherine. AU - Wilkinson, Jennifer. AU - Qian, Jessica. AU - Watson, Gillian. AU - Lewington, Oli. AU - Chadwick, Thomas. AU - McColl, Elaine. AU - Pearce, Mark. AU - Mann, Kay. AU - McMeekin, Nicola. AU - Vale, Luke. AU - Tsui, Steven. AU - Yonan, Nizar. AU - Simon, Andre. AU - Marczin, Nandor. AU - Mascaro, Jorge. AU - Dark, John. PY - 2016/11/1. Y1 - 2016/11/1. N2 - Background - Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. Objective - The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in ...

article{25205500-431b-46ab-9210-2bfbb4cda0fd, abstract = {,p,AIMS: The aims of this study were two-fold: to develop the concept analysis by Allvin et al. from lung recipients perspective of their post-transplant recovery process and to identify the recovery trajectories including critical junctions in the post-transplant recovery process after lung transplantation.,/p,,p,BACKGROUND: Lung transplantation is an established treatment for patients with end-stage lung disease. The recovery process after lung transplantation is very demanding. Today, patients are expected to play an active role in their own recovery but require ongoing support during the process.,/p,,p,DESIGN: A deductive, retrospective interview study using directed content analysis and Allvins recovery concept analysis.,/p,,p,METHOD: Fifteen adult lung transplant recipients who were due their 12-month follow-up were consecutively included and interviewed during 2015. Patients who were medically unstable or had difficulties ...

Background Many benefits and adverse effects of positioning are related to changes in ventilation and perfusion. A number of unique factors related to the allograft make the effects of positioning difficult to determine in single-lung transplant recipients.. • Objectives To determine the effect of 3 body positions (supine, lateral with allograft lung down, and lateral with native lung down) on oxygenation and blood flow in single-lung transplant recipients in the 24 hours immediately after surgery.. • Methods A quasi-experimental repeated-measures design with stratified assignment to 1 of 3 different sequencing patterns for turning group was used to study 15 transplant recipients, 9 with emphysema and 6 with fibrosis. Oxygenation, ventilation, and blood flow measures (heart rate, blood pressure) were assessed after each turn. The effect of ischemic reperfusion injury was also explored.. • Results The oxygenation, ventilation, and blood flow variables did not differ significantly across ...

Inhaled nitric oxide during anesthesia for bilateral single lung transplantation. Case report - Minerva Anestesiologica 1998 June;64(6):297-301 - Minerva Medica - Journals

TY - JOUR. T1 - Removal and repositioning of permanent expandable wire stents in bronchial airway stenosis after lung transplantation. AU - Sonett, J. R.. AU - Conte, John. AU - Orens, J.. AU - Krasna, M.. PY - 1998/4/29. Y1 - 1998/4/29. N2 - Significant airway stenosis occurs in 7% to 14% of lung transplant recipients. The use of permanent, nonadjustable, wire mesh stents can be of concern in the transplant recipient with nonmalignant stricture. We report the replacement and repositioning of an expandable wire mesh stent in a double lung transplantation with distal bronchial stenosis.. AB - Significant airway stenosis occurs in 7% to 14% of lung transplant recipients. The use of permanent, nonadjustable, wire mesh stents can be of concern in the transplant recipient with nonmalignant stricture. We report the replacement and repositioning of an expandable wire mesh stent in a double lung transplantation with distal bronchial stenosis.. UR - ...

Background: Lung transplantation is an important option to treat patients with advanced cystic fibrosis (CF) lung disease. The outcomes of a large UK cohort of CF lung transplantation recipients is reported.. Methods: Retrospective review of case notes and transplantation databases.. Results: 176 patients with CF underwent lung transplantation at our centre. The majority (168) had bilateral sequential lung transplantation. Median age at transplantation was 26 years. Diabetes was common pretransplantation (40%). Polymicrobial infection was common in individual recipients. A diverse range of pathogens were encountered, including the Burkholderia cepacia complex (BCC). The bronchial anastomotic complication rate was 2%. Pulmonary function (forced expiratory volume in 1 s % predicted) improved from a pretransplantation median of 0.8 l (21% predicted) to 2.95 l (78% predicted) at 1 year following transplantation. We noted an acute rejection rate of 41% within the first month. Our survival values were ...

TY - JOUR. T1 - Nitrite reduces acute lung injury and improves survival in a rat lung transplantation model. AU - Sugimoto, R.. AU - Okamoto, T.. AU - Nakao, A.. AU - Zhan, J.. AU - Wang, Y.. AU - Kohmoto, J.. AU - Tokita, D.. AU - Farver, C. F.. AU - Tarpey, M. M.. AU - Billiar, T. R.. AU - Gladwin, M. T.. AU - McCurry, K. R.. N1 - Copyright: Copyright 2013 Elsevier B.V., All rights reserved.. PY - 2012/11. Y1 - 2012/11. N2 - Ischemia/reperfusion injury (IRI) is the most common cause of early mortality following lung transplantation (LTx). We hypothesized that nitrite, an endogenous source of nitric oxide (NO), may protect lung grafts from IRI. Rat lung grafts were stored in preservation solution at 4°C for 6 hours. Both grafts and recipients were treated with nitrite. Nitrite treatment was associated with significantly higher levels of tissue oxygenation, lower levels of cytokines and neutrophil/macrophage infiltration, lower myeloperoxidase activity, reduced oxidative injury and increased ...

Once a patient has been selected as a possible organ recipient, the process of waiting for a donor organ match begins. The donor organ must meet specific requirements for tissue match in order to reduce the chance of organ rejection. It is estimated that it takes an average of one to two years to receive a suitable donor lung, and the wait is made less predictable by the necessity for tissue match. Patients on a recipient list must be available and ready to come to the hospital immediately when a donor match is found, since the life of the lungs outside the body is brief. Single lung transplantation is performed via a standard thoracotomy (incision in the chest wall) with the patient under general anesthesia. Cardiopulmonary bypass (diversion of blood flow from the heart) is not always necessary for a single lung transplant. If bypass is necessary, it involves re-routing of the blood through tubes to a heart-lung bypass machine. Double lung transplantation involves implanting the lungs as two ...

Lung Transplantation may be suitable for those patients, physically eligible to undergo a major transplant operation.. In IPF patients, lung transplantation reduces the risk of death by 75% as compared with patients who remain on the waiting list.. Since the introduction of the lung allocation score (LAS), which prioritizes transplant candidates based on survival for lung transplantation in the USA.. Symptomatic patients with IPF younger than 65 years of age and with a body mass index (BMI) ≤ 26kg/m² should be referred for lung transplantation, but there are no clear data to guide the precise timing for LT.. Bilateral lung transplantation is superior to single lung transplantation in patients with IPF ...

Lung transplantation has become a therapeutic option for a number of end-stage pulmonary disorders. Lung transplant recipients experience more complications due to acute and chronic allograft rejection as compared to recipients of other solid organs. We postulated that the generation of TNF-alpha plays a significant role in the pathogenesis of acute lung allograft rejection. To test our hypothesis, we used a RT1-incompatible rat lung allograft model and demonstrated the time course, cellular source(s), and major compartment(s) of TNF production during the course of lung allograft rejection. This model allowed for immunogenetic standardization and reproducibility of lung allograft rejection across disparate major histocompatibility barriers. TNF production was characterized at the whole animal, organ, cellular, and molecular levels, and was found to be compartmentalized and expressed in a bimodal fashion from the lung allograft during lung allograft reimplantation and maximal rejection. Lung ...

Norihisa Shigemura, MD, PhD, has been appointed Surgical Director of Lung Failure, and Surgical Director of Lung Transplantation at Temple University Hospital (TUH), and Associate Professor of Surgery at the Lewis Katz School of Medicine at Temple University (LKSOM).. Dr. Shigemura earned his medical degree from Osaka University School of Medicine in Osaka, Japan. He completed a general surgery residency at Ohtemae General Hospital in Osaka, Japan, as well as cardiovascular surgery and thoracic surgery residencies at Osaka Prefectural Hospital in Osaka, Japan. In addition, Dr. Shigemura completed cardiothoracic surgery fellowships in Osaka, Japan; Hong Kong, China; and at University of Pittsburgh Medical Center (UMPC) in Pittsburgh, PA.. Dr. Shigemuras clinical and research interests include advanced lung failure/ end-stage lung disease; lung transplantation; minimally invasive thoracic surgery; extracorporeal circulatory support; artificial lungs; lung repair/regeneration; and organ ...

TY - JOUR. T1 - Effect of calcitriol on bone loss after cardiac or lung transplantation. AU - Sambrook, Philip. AU - Henderson, N. Kathy. AU - Keogh, Anne. AU - MacDonald, Peter. AU - Glanville, Allan. AU - Spratt, Phillip. AU - Bergin, Peter. AU - Ebeling, Peter. AU - Eisman, John. PY - 2000/1/1. Y1 - 2000/1/1. N2 - Rapid bone loss after cardiac and lung transplantation results in an increased risk of osteoporotic fracture. This study examined the efficacy of treatment with calcitriol (1,25-dihydroxyvitamin D3) in preventing bone loss in patients undergoing cardiac or lung transplantation. In this 2-year double-blind, stratified study, 65 patients undergoing cardiac or single lung transplantation were randomly allocated to receive either placebo or calcitriol (0.5-0.75 μg/day), the latter for either 12 months or 24 months. All patients received 600 mg calcium/day. Bone mineral density (BMD) was measured every 6 months for 2 years by dual-energy X-ray absorptiometry. There was no significant ...

Purpose: Primary graft dysfunction (PGD) is a form of acute lung injury driven by ischemia-reperfusion mediated damage. An increase in plasma complement proteins - specifically C4a and C5a - is associated with PGD, and an increase in C3a and C5a levels is associated with mortality, independent of PGD. However, serum levels appear to be high at baseline post-lung transplantation (LTx); and hence, make it harder to distinguish patients at risk. Given that PGD manifests as an acute lung injury, we hypothesized that local complement activation would help identify those who go on to develop PGD post-LTx.. *Methods: Bronchoalveolar lavage (BAL) specimens were obtained from recipients at 2 and 24h post-LTx. PGD was scored based on the consensus definition at 24, 48 and 72h post-LTx by an investigator blinded to the results. Complement activation proteins were measured using ELISA. Specifically, levels of C4d, indicating classical/lectin pathway activation and soluble C5b-9 (sC5b-9), a marker of ...

Michael W. Sims, Michael F. Beers, Vivek N. Ahya, Steven M. Kawut, Karen D. Sims, David J. Lederer, Scott M. Palmer, Keith Wille, Vibha N. Lama, Pali D. Shah, Jonathan B. Orens, Sangeeta Bhorade, Maria Crespo, Ann Weinacker, Ejigayehu Demissie, Scarlett Bellamy, Jason D. Christie, Lorraine B. Ware ...

Home , International guidelines for the selection of lung transplant candidates: 2006 update--a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung ...

TY - JOUR. T1 - cAMP-mediated vascular protection in an orthotopic rat lung transplant model. T2 - Insights into the mechanism of action of prostaglandin E1 to improve lung preservation. AU - Naka, Yoshifumi. AU - Roy, Dilip K.. AU - Liao, Hui. AU - Chowdhury, Nepal C.. AU - Michler, Robert E.. AU - Oz, Mehmet C.. AU - Pinsky, David J.. PY - 1996/1/1. Y1 - 1996/1/1. N2 - Prostaglandin E1 (PGE1) is often added to the donor pulmonary flush solution to enhance clinical lung preservation for transplantation. Although PGE1 is thought to act as a pulmonary vasodilator during the harvest period, the precise mechanism(s) of action whereby PGE1 enhances lung preservation is unknown. Because cAMP levels decline in endothelial and vascular smooth muscle cells exposed to hypoxia, we hypothesized that a PGE1-mediated increase in cAMP levels within the preserved lungs might improve pulmonary vascular homeostasis following lung transplantation. Rat lungs demonstrated a time-dependent decline in cAMP levels ...

THURSDAY, June 11, 2020 (HealthDay News) -- A young COVID-19 survivor received a double-lung transplant to save her life in whats believed to be the first such surgery in the United States, Northwestern Medicine doctors report.. Following her infection, the Hispanic woman in her 20s suffered irreversible lung damage and had to be put on a life-support machine that does the work of the heart and lungs.. A lung transplant was her only chance for survival, said Dr. Ankit Bharat, surgical director of Northwestern Medicines lung transplant program.. We are one of the first health systems to successfully perform a lung transplant on a patient recovering from COVID-19. We want other transplant centers to know that while the transplant procedure in these patients is quite technically challenging, it can be done safely, and it offers the terminally ill COVID-19 patient another option for survival, Bharat said in a Northwestern news release.. Before the patient could be put on the transplant ...

TY - JOUR. T1 - Lung transplantation. T2 - Chronic allograft dysfunction and establishing immune tolerance. AU - Gracon, Adam S.A.. AU - Wilkes, David S.. PY - 2014/8. Y1 - 2014/8. N2 - Despite significant medical advances since the advent of lung transplantation, improvements in long-term survival have been largely unrealized. Chronic lung allograft dysfunction, in particular obliterative bronchiolitis, is the primary limiting factor. The predominant etiology of obliterative bronchiolitis involves the recipients innate and adaptive immune response to the transplanted allograft. Current therapeutic strategies have failed to provide a definitive treatment paradigm to improve long-term outcomes. Inducing immune tolerance is an emerging therapeutic strategy that abrogates allograft rejection, avoids immunosuppression, and improves long-term graft function. The aim of this review is to discuss the key immunologic components of obliterative bronchiolitis, describe the state of establishing immune ...

Background Right-heart-catheterization and transthoracic echocardiography are routine tests to measure pulmonary artery systolic pressure among lung transplantation candidates. Echocardiography may be as accurate as right-heart-catheterization, without the inherent risks of an invasive test. Methods We examined the correlation between pulmonary pressures estimated by echocardiography versus right-heart-catheterization among lung transplantation candidates and their correlation to measurements during lung transplantation. Our cohort included all lung transplantation candidates during 1997 through 2004 who initially underwent pulmonary pressure evaluation by right-heart-catheterization and echocardiography, as well as measurements during lung transplantation. Results Of the 106 candidates, evaluation by transthoracic echocardiography was possible in 79 (74.5%). Median pulmonary systolic pressures by right-heart-catheterization was 44.0 [33.2-50.0] mm Hg and by echocardiography 40.0 [32.5-51.5] mm ...

Obliterative bronchiolitis is the key impediment to the long-term survival of lung transplant recipients and the lack of a robust...

Figure S1: Low donor lung SP-A mRNA-level associates with decreased survival. The graph shows the survival curves for recipients of double lung transplant excluding patient with ILD. This ad hoc analysis was to address the possible selection bias that is shown in Table S1 with greater percentage of ILD and single lung transplant in the study cohort. Lung transplant patients that received lung allografts with low levels of SP-A mRNA expression prior to implantation had significantly reduced survival. The number of patients in each group is indicated in brackets. The x-axis represents the cumulative survival. Circles indicate the censored patients within the analysis. ...

CD8+ T-cell maturation following lung transplantation: the differential impact of CMV and acute rejection.: Studies on persistent viral infections demonstrate t

Targeting viral proteins early during infection may limit exacerbation of human cytomegalovirus infection. The viral chemokine-receptor homologue US28 interferes with leukocyte trafficking and, possibly, viral replication. Because US28 molecules are abundant on the surface of infected cells, this homologue is a potential target for antiviral therapy. To assess the relationship between US28 and disease activity, we measured, by quantitative reverse-transcription polymerase chain reaction, the levels of US28 and immediate-early (IE) 1 gene transcripts in the blood of lung-transplant recipients. We found that, during primary and secondary infection, the IE1 and US28 genes have early transcription kinetics and are expressed at similar levels. This may render US28 an attractive target for antiviral therapy ...

Researchers have shown for the first time that lung transplant patients in Europe who live on or near busy roads with high levels of air pollution are more likely to die or to experience chronic organ rejection, than those living in less polluted areas.. Dr David Ruttens, from the University of Leuven (Belgium) told the European Respiratory Societys International Congress today (29 September, 2015) that the risk of dying increased by 10% for patients living in an area where air pollution was above World Health Organization (WHO) recommended maximum levels, compared with patients living in areas with lower levels of pollution. However, this increased risk was not seen in lung transplant patients who were taking a class of antibiotics called macrolides, which include azithromycin and clarithromycin.. WHO estimates that 3.7 million people worldwide die prematurely every year as a result of exposure to small particulate matter measuring between 2.5-10 micrometers in diameter (known as PM10). Ten ...

TY - JOUR. T1 - Tuberculosis in lung transplant recipients. AU - Bravo, Carlos. AU - Roldán, Juan. AU - Roman, Antonio. AU - DeGrada, Javier. AU - Majo, Joaquim. AU - Guerra, Javier. AU - Monforte, Víctor. AU - Vidal, Rafael. AU - Morell, Ferran. PY - 2005/1/15. Y1 - 2005/1/15. N2 - Background. Post-lung transplant infection is one of the leading causes of morbidity and mortality. The cause and incidence are similar in many series; however, infections such as Mycobacterium tuberculosis are influenced by the epidemiologic situation. The authors present a prospective and observational study to define the incidence, clinical presentation, and course of tuberculosis in a cohort of lung transplant patients at a single center in Spain. Methods. Between 1990 and 2002, cutaneous delayed-type hypersensitivity testing and pathologic and microbiologic study of explanted lungs were conducted in 187 lung transplant patients. Serial bronchoscopies with transbronchial biopsy and bronchioalveolar lavage were ...

Chronic rejection significantly limits long-term success of solid organ transplantation. De novo donor-specific antibodies (DSAs) to mismatched donor human leukocyte antigen after human lung transplantation predispose lung grafts to chronic rejection. We sought to delineate mediators and mechanisms of DSA pathogenesis and to define early inflammatory events that trigger chronic rejection in lung transplant recipients and obliterative airway disease, a correlate of human chronic rejection, in mouse. Induction of transcription factor zinc finger and BTB domain containing protein 7a (Zbtb7a) was an early response critical in the DSA-induced chronic rejection. A cohort of human lung transplant recipients who developed DSA and chronic rejection demonstrated greater Zbtb7a expression long before clinical diagnosis of chronic rejection compared to nonrejecting lung transplant recipients with stable pulmonary function. Expression of DSA-induced Zbtb7a was restricted to alveolar macrophages (AMs), and ...

Blatter JA, Noyes B, Sweet SC. Pediatric lung transplantation. In: Wilmott RW, Deterding R, Li A, et al. eds. Kendigs Disorders of the Respiratory Tract in Children. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 67.. Brown LM, Puri V, Patterson GA. Lung transplantation. In: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston and Spencer Surgery of the Chest. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 14.. Chandrashekaran S, Emtiazjoo A, Salgado JC. Intensive care unit management of lung transplant patients. In: Vincent J-L, Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Textbook of Critical Care. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 158.. Kliegman RM, Stanton BF, St. Geme JW, Schor NF. Pediatric heart and heart-lung transplantation. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 443.. Kotloff RM, Keshavjee S. Lung transplantation. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadels ...

BackgroundGastroesophageal reflux disease (GERD) is common in patients with end-stage lung disease (ESLD). GERD may cause obliterative bronchiolitis after lung

Pulmonary rehabilitation (PR) is a cornerstone of treatment following lung transplantation (LTx). The aim of this study was to observe the influence of a prolonged postsurgical clinical course on success of a 3-week inpatient PR. LTx recipients were divided according to their clinical course defined …

TY - JOUR. T1 - The Registry of the International Society for Heart and Lung Transplantation. T2 - Twenty-seventh official adult lung and heart-lung transplant report2010. AU - Christie, Jason D.. AU - Edwards, Leah B.. AU - Kucheryavaya, Anna Y.. AU - Aurora, Paul. AU - Dobbels, Fabienne. AU - Kirk, Richard. AU - Rahmel, Axel O.. AU - Stehlik, Josef. AU - Hertz, Marshall I.. PY - 2010/10. Y1 - 2010/10. UR - http://www.scopus.com/inward/record.url?scp=77957229065&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=77957229065&partnerID=8YFLogxK. U2 - 10.1016/j.healun.2010.08.004. DO - 10.1016/j.healun.2010.08.004. M3 - Article. C2 - 20870165. AN - SCOPUS:77957229065. VL - 29. SP - 1104. EP - 1118. JO - Journal of Heart and Lung Transplantation. JF - Journal of Heart and Lung Transplantation. SN - 1053-2498. IS - 10. ER - ...

TY - JOUR. T1 - The registry of the international society for heart and lung transplantation. T2 - Twenty-eighth adult lung and heart-lung transplant report-2011. AU - Christie, Jason D.. AU - Edwards, Leah B.. AU - Kucheryavaya, Anna Y.. AU - Benden, Christian. AU - Dobbels, Fabienne. AU - Kirk, Richard. AU - Rahmel, Axel O.. AU - Stehlik, Josef. AU - Hertz, Marshall I.. PY - 2011/10/1. Y1 - 2011/10/1. UR - http://www.scopus.com/inward/record.url?scp=80053316665&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=80053316665&partnerID=8YFLogxK. U2 - 10.1016/j.healun.2011.08.004. DO - 10.1016/j.healun.2011.08.004. M3 - Article. C2 - 21962018. AN - SCOPUS:80053316665. VL - 30. SP - 1104. EP - 1122. JO - Journal of Heart and Lung Transplantation. JF - Journal of Heart and Lung Transplantation. SN - 1053-2498. IS - 10. ER - ...

Living-donor lobar lung transplantation (LDLLT) was developed to deal with the severe shortage of brain dead door for patients who would not survive the long waiting period. In standard LDLLT, right and left lower lobes removed from two healthy donors are implanted into a recipient after right and left pneumonectomies using cardiopulmonary bypass (CPB). The number of LDLLT has decreased in the USA due to the recent change in allocation system for cadaveric donor lungs. For the past several years, most of the reports on LDLLT have been from Japan, where the average waiting time for a cadaveric lung is exceeding 800 days. LDLLT has been performed both for adult and pediatric patients suffering from various end-stage lung diseases including restrictive, obstructive, vascular and infectious lung diseases. Since only two lobes are implanted, size matching is a very important issue. Functional size matching by measuring donor pulmonary function and anatomical size matching by three-dimensional ...

The lung allocation score (LAS) is a numerical value used by the United Network for Organ Sharing (UNOS) to assign relative priority for distributing donated lungs for transplantation within the United States. The lung allocation score takes into account various measures of a patients health in order to direct donated organs towards the patients who would best benefit from a lung transplant. The LAS system replaces the older method within the United States of allocating donated lungs strictly on a first-come, first-served basis, according to blood type compatibility and distance from the donor hospital. The older method is still used for patients under the age of 12. The LAS system is still being evaluated and revised.[1] The reason for this continuing analysis is the need to balance on one hand the desire to help those patients in direct need, versus the statistical likelihood of the patient to survive the procedure, as well as the post-operative risks of infection and transplant rejection.[2] ...

End-stage lung disease (ESLD) is a frequent cause of death. What are the differences in the supports needed by caregivers of individuals with ESLD at end of life versus other life-limiting diagnoses? The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey. In 2002, 2003 and 2005-2007, respondents were asked a range of questions about end-of-life care; there were approximately 3000 survey participants annually (participation rate 77.9%). Responses were standardised for the whole population. The families and friends who cared for someone with ESLD were the focus of this analysis. In addition to describing caring, respondents reported additional support that would have been helpful. Of 1504 deaths reported, 145 (9.6%) were due to ESLD. The ESLD cohort were older than those with other expected causes of death (| 65 years of age; 92.6% versus 70.6%; p | 0.0001) and were less likely to access specialised palliative care services (38.4% versus 61.9%; p | 0.0001). For

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BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second ...

Lung transplant survival is usually limited by obliterative bronchiolitis (OB), but the mechanisms of OB development are unknown. CD4, T-cells, lung transplantation, Th17 cells, STAT3, T-cells Introduction Lung transplantation is usually a useful therapeutic option for patients with end-stage lung diseases. The major obstacle limiting lung transplant survival and function is usually chronic lung allograft dysfunction (CLAD), Cichoric Acid IC50 with one of the major manifestations being obliterative bronchiolitis (OB) with fibrous obliteration of the airways (1). Progressive air passage injury mediated by ongoing alloimmune and nonalloimmune responses to the lung allograft is usually thought to be the precursor of subsequent graft CALML3 fibrosis (2). OB/BOS remains one of the major limitations to long term success of lung transplant with approximately 50% of lung transplant recipients affected by 5 years (3). Recently, IL-17 and T helper 17 (Th17) cells have been linked to OB/BOS development ...

Survival after lung transplantation (LTx) is often limited by bronchiolitis obliterans syndrome (BOS). Survey of 278 recipients who underwent LTx. The endpoint used was BOS (BOS grade ≥ 2), death or Re-lung transplantation (Re-LTx) assessed by competing risk regression analyses. The incidence of BOS grade ≥ 2 among double LTx (DLTx) recipients was 16 ± 3% at 5 years, 30 ± 4% at 10 years, and 37 ± 5% at 20 years, compared to single LTx (SLTx) recipients whose corresponding incidence of BOS grade ≥ 2 was 11 ± 3%, 20 ± 4%, and 24 ± 5% at 5, 10, and 20 years, respectively (p | 0. 05). The incidence of BOS grade ≥ 2 by major indications ranked in descending order: other, PF, CF, COPD, PH and AAT1 (p | 0. 05). The mortality rate by major indication ranked in descending order: COPD, PH, AAT1, PF, Other and CF (p | 0. 05). No differences were seen in the incidence of BOS grade ≥ 2 regarding type of transplant, however, DLTx recipients showed a better chance of survival despite developing BOS

Bronchiolitis obliterans syndrome (BOS) is a form of chronic lung allograft dysfunction that affects a majority of lung transplant recipients and is the primary factor limiting long-term transplant survival. It is characterized by progressive airflow obstruction resulting in acute rejection of the graft, followed by infections, or other coexistent condition.. It is an uncommon respiratory disease characterized by fixed airway obstruction, where the bronchioles in the lung become narrowed or blocked by fibrous tissue. The disease is disabling and can be potentially severe. It may be caused occupationally by accidental, acute, high concentration exposure to industrial gases, such as nitrogen dioxide etc.. Bronchiolitis obliterans can also be associated with rheumatoid arthritis and graft-versus-host disease following a lung or hematopoietic cell transplantation. Exposure to certain food flavoring agents, notably the buttery food flavoring agent diacetyl, with the development of bronchiolitis ...

TY - JOUR. T1 - Clinical risk factors for primary graft dysfunction after lung transplantation. AU - Diamond, Joshua M.. AU - Lee, James C.. AU - Kawut, Steven M.. AU - Shah, Rupal J.. AU - Localio, A. Russell. AU - Bellamy, Scarlett L.. AU - Lederer, David J.. AU - Cantu, Edward. AU - Kohl, Benjamin A.. AU - Lama, Vibha N.. AU - Bhorade, Sangeeta M.. AU - Crespo, Maria. AU - Demissie, Ejigayehu. AU - Sonett, Joshua. AU - Wille, Keith. AU - Orens, Jonathan. AU - Shah, Ashish S.. AU - Weinacker, Ann. AU - Arcasoy, Selim. AU - Shah, Pali D.. AU - Wilkes, David S.. AU - Ware, Lorraine B.. AU - Palmer, Scott M.. AU - Christie, Jason D.. PY - 2013/3/1. Y1 - 2013/3/1. N2 - Rationale: Primary graft dysfunction (PGD) is the main cause of early morbidity and mortality after lung transplantation. Previous studies have yielded conflicting results for PGD risk factors. Objectives: We sought to identify donor, recipient, and perioperative risk factors for PGD. Methods: Weperformeda 10-center prospective ...

In 2002 the International Society for Heart and Lung Transplantation (ISHLT) modified the 1993 criteria for the bronchiolitis obliterans syndrome (BOS, obliterative bronchiolitis).

TY - JOUR. T1 - Endovascular management of pseudoaneurysm formation in the ascending aorta following lung transplantation. AU - Joyce, David L.. AU - Singh, Steve K.. AU - Mallidi, Hari R.. AU - Dake, Michael D.. PY - 2012. Y1 - 2012. N2 - Purpose: To demonstrate the role of endovascular approaches to the ascending aorta in the post-transplant context. Case Reports: Three patients (2 women and 1 man aged 52, 68, and 43 years, respectively) developed pseudoaneurysm of the ascending aorta following thoracic organ transplantation. Due to the prohibitive risk of open surgery in each case, an endovascular repair of the ascending aorta was performed, with implantation of 1 to 3 stent-grafts to span the lesions. Follow-up imaging demonstrated complete exclusion of the pseudoaneurysms, with excellent outcomes at 4 months, 6 months, and 3 years. Conclusion: Stent-grafting of the ascending aorta represents a viable approach to pseudoaneurysm in the post-transplant setting.. AB - Purpose: To demonstrate ...

TY - JOUR. T1 - Post-operative Infections in Cystic Fibrosis and Non-Cystic Fibrosis Patients After Lung Transplantation. AU - Bonvillain, Ryan W.. AU - Valentine, Vincent G.. AU - Lombard, Gisele. AU - LaPlace, Stephanie. AU - Dhillon, Gundeep. AU - Wang, Guoshun. PY - 2007/9. Y1 - 2007/9. N2 - Background: Cystic fibrosis (CF) lung disease is the major cause of mortality in CF patients. Lung transplantation remains a valid therapeutic option. It is unknown whether CF patients receiving healthy lungs have an equal susceptibility to infections when compared with non-CF lung transplant patients. Herein we present the largest analyses to date of the post-operative infection profiles of 60 CF and 60 non-CF lung transplant patients. Methods: Bilateral allogeneic lung transplantations and post-transplant management were performed according to standard clinical procedures. Post-operative infections were diagnosed by conventional methods based on clinical symptoms and laboratory cultures. Results: Sixty ...

TY - JOUR. T1 - Genetic regulation of rejection and survival following human lung transplantation by the innate immune receptor CD14. AU - Palmer, S. M.. AU - Klimecki, W.. AU - Yu, L.. AU - Reinsmoen, N. L.. AU - Snyder, L. D.. AU - Ganous, T. M.. AU - Burch, L.. AU - Schwartz, D. A.. PY - 2007/3. Y1 - 2007/3. N2 - We have developed the hypothesis that genetic polymorphisms which alter the expression or function of innate immune receptors contribute to the marked interindividual differences in the onset and severity of lung transplant rejection. In this analysis, we considered the effects of a common promotor polymorphism of the lipopolysaccharide receptor CD14 associated with increased transcriptional activity upon the development of posttransplant rejection and graft survival. Genotyping was performed in 226 lung transplant recipients well characterized with regards to clinical outcomes. An earlier onset of acute rejection, bronchiolitis obliterans syndrome (BOS) and worse posttransplant ...

TY - JOUR. T1 - Reconstruction of pulmonary artery with donor aorta and autopericardium in lung transplantation. AU - Noda, Masafumi. AU - Okada, Yoshinori. AU - Saiki, Yoshikatsu. AU - Sado, Tetsu. AU - Hoshikawa, Yasushi. AU - Endo, Chiaki. AU - Sakurada, Akira. AU - Maeda, Sumiko. AU - Oishi, Hisashi. AU - Kondo, Takashi. PY - 2013/7/1. Y1 - 2013/7/1. N2 - A 44-year-old man with Eisenmengers syndrome due to ventricular septal defect (VSD) was listed for lung transplantation. The patients condition was complicated by a giant pulmonary artery (PA) aneurysm. Concurrent VSD closure and total reconstruction of the recipient PA with the donor aorta were planned. When the patient underwent bilateral lung transplantation, the aortic graft obtained turned out to be too short to complete the reconstruction. A PA graft made of the recipients pericardium was successfully interposed between the donors PA and the donors aortic graft.. AB - A 44-year-old man with Eisenmengers syndrome due to ...

TY - JOUR. T1 - A panel of lung injury biomarkers enhances the definition of primary graft dysfunction (PGD) after lung transplantation. AU - Shah, Rupal J.. AU - Bellamy, Scarlett L.. AU - Localio, A. Russell. AU - Wickersham, Nancy. AU - Diamond, Joshua M.. AU - Weinacker, Ann. AU - Lama, Vibha N.. AU - Bhorade, Sangeeta. AU - Belperio, John A.. AU - Crespo, Maria. AU - Demissie, Ejigayehu. AU - Kawut, Steven M.. AU - Wille, Keith M.. AU - Lederer, David J.. AU - Lee, James C.. AU - Palmer, Scott M.. AU - Orens, Jonathan. AU - Reynolds, John. AU - Shah, Ashish. AU - Wilkes, David S.. AU - Ware, Lorraine B.. AU - Christie, Jason D.. PY - 2012/9. Y1 - 2012/9. N2 - Background: We aimed to identify combinations of biomarkers to enhance the definition of primary graft dysfunction (PGD) for translational research. Methods: Biomarkers reflecting lung epithelial injury (soluble receptor for advance glycation end products [sRAGE] and surfactant protein-D [SP-D]), coagulation cascade (plasminogen ...

TY - JOUR. T1 - Does reperfusion injury still cause significant mortality after lung transplantation?. AU - Ailawadi, Gorav. AU - Lau, Christine L.. AU - Smith, Philip W.. AU - Swenson, Brian R.. AU - Hennessy, Sara A.. AU - Kuhn, Courtney J.. AU - Fedoruk, Lynn M.. AU - Kozower, Benjamin D.. AU - Kron, Irving L.. AU - Jones, David R.. N1 - Funding Information: Supported in part through National Institutes of Health Cardiovascular Surgery Research Training grant T32 HL007849 (to PWS). Copyright: Copyright 2009 Elsevier B.V., All rights reserved.. PY - 2009/3. Y1 - 2009/3. N2 - Objectives: Severe reperfusion injury after lung transplantation has mortality rates approaching 40%. The purpose of this investigation was to identify whether our improved 1-year survival after lung transplantation is related to a change in reperfusion injury. Methods: We reported in March 2000 that early institution of extracorporeal membrane oxygenation can improve lung transplantation survival. The records of ...

Implementation of an evidence-based guideline for managing respiratory and hemodynamic status is feasible and safe and was associated with reduction in severity of primary graft dysfunction. Further studies are required to determine whether such a guideline would lead to a consistent reduction in severity of primary graft dysfunction at other institutions. Creation of a protocol for postoperative care provides a template for further studies of novel therapies or management strategies for primary graft dysfunction ...

The St Vincents Hospital transplant program is one of the largest and longest running programs in Australia with survival rates which exceed that of the international figures. The first heart transplant in Australia was performed by Dr Harry Windsor at St Vincents Hospital in 1968. However, it was not until 1984 that the National Heart Transplant Program was commenced by Dr Victor Chang and the second heart transplant was carried out eventually leading to the first heart-lung transplant in 1986. It was only natural that the heart transplantation program would soon be followed by the development of a lung transplantation program. This milestone was reached in 1990 when the first single lung transplant in Australia was performed at St Vincents Hospital and the program has since expanded to include bilateral lung transplantation. The transplant unit also runs a mechanical heart device program which can offer patients waiting for a donor to become available an improved quality of life and ...

TY - JOUR. T1 - Registry of the International Society for Heart and Lung Transplantation. T2 - Eleventh Official Pediatric Heart Transplantation Report-2008. AU - Kirk, Richard. AU - Edwards, Leah B.. AU - Aurora, Paul. AU - Taylor, David O.. AU - Christie, Jason. AU - Dobbels, Fabienne. AU - Kucheryavaya, Anna Y.. AU - Rahmel, Axel O.. AU - Hertz, Marshall I.. PY - 2008/9/1. Y1 - 2008/9/1. UR - http://www.scopus.com/inward/record.url?scp=50249105267&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=50249105267&partnerID=8YFLogxK. U2 - 10.1016/j.healun.2008.06.016. DO - 10.1016/j.healun.2008.06.016. M3 - Article. C2 - 18765188. AN - SCOPUS:50249105267. VL - 27. SP - 970. EP - 977. JO - Journal of Heart and Lung Transplantation. JF - Journal of Heart and Lung Transplantation. SN - 1053-2498. IS - 9. ER - ...

Traffic-related air pollution, as estimated by the proximity of the home to a major road, is a major risk factor for BOS and mortality after lung transplantation. The risk was present in either a dichotomous or a continuous analysis, and was not affected by adjustments for relevant covariables. Indicators of pulmonary (BAL neutrophils, IL-6) and systemic (plasma CRP) inflammation, which are probably involved in the onset of BOS, were also associated with proximity to traffic.. The strengths of our study include the relatively large lung transplant population from a single centre and the statistically robust associations. The statistical significance of our observations follows in part from the high incidence of BOS and mortality. The robustness of the associations is apparent from the fact that inclusion of relevant potential confounders, ranging from SES, transplantation-related characteristics to active smoking, tended to increase the risk estimates.18. Many other authors have estimated ...

臺大位居世界頂尖大學之列，為永久珍藏及向國際展現本校豐碩的研究成果及學術能量，圖書館整合機構典藏（NTUR）與學術庫（AH）不同功能平台，成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。. To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of NTU Repository with Academic Hub to form NTU Scholars.. ...

Paraquat is a water soluble quaternary ammonium derivative, poorly absorbed by the oral route (5-10%) and unbound to plasma proteins. Peak plasma concentrations are reached within 1-4 hours and decrease rapidly thereafter as the compound is taken up by the tissues and cleared by the kidney.2 In our case paraquat was undetectable in plasma obtained four days after the start of gastrointestinal symptoms whereas high levels were found on lung and muscle samples taken as late as nine weeks after herbicide ingestion. Indeed, paraquat is actively concentrated in alveolar pneumocytes and skeletal muscles. The acute pulmonary lesions have been attributed to the formation of oxygen derived free radicals and lipid peroxidation products whereas activation of resident macrophages are implicated in lung fibrosis.3 All pharmacological treatments including free radical scavengers, iron chelators, cochicine or corticoids are of unproven value, but encouraging results have recently been reported with a ...

TY - JOUR. T1 - Pirfenidone alleviates lung ischemia-reperfusion injury in a rat model. AU - Saito, Masao. AU - Chen-Yoshikawa, Toyofumi F.. AU - Suetsugu, Kimitaka. AU - Okabe, Ryo. AU - Takahagi, Akihiro. AU - Masuda, Satohiro. AU - Date, Hiroshi. PY - 2019/7. Y1 - 2019/7. N2 - Objective: Lung ischemia-reperfusion injury is among the complications seen after lung transplantation, resulting in morbidity and mortality. Pirfenidone, an antifibrotic agent for the treatment of idiopathic pulmonary fibrosis, is reported to have cytoprotective properties in various disease models. The purpose of this study was to investigate the effect of pirfenidone on lung ischemia-reperfusion injury. Methods: Male Lewis rats (260-290 g) were divided into 3 groups: sham group (n = 5), warm ischemia (WI) group (n = 10), and WI plus pirfenidone (WI+PFD) group (n = 10). The sham group underwent 210 minutes of perfusion without ischemia. The WI and WI+PFD groups underwent 90 minutes of warm ischemia and 120 minutes of ...

Now in its 18th year of continuous publication, The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential clinical information about the rapidly evolving field of intrathoracic transplantation, support, and replacement. Peer-reviewed articles cover topics that include: assist devices and artificial hearts; diagnosis and treatment of complications; immunosuppressive therapies; new techniques in noninvasive diagnosis of rejection; outcome analyses; preoperative and postoperative evaluation; socioeconomic and ethical aspects of transplantation.. The journals scope also addresses all aspects of advanced diseases of native thoracic organs, and includes articles with new insights into the immunology, pathogenesis, diagnosis, and management of heart failure and advanced lung disease. In addition, the journal has expanded its coverage in the rapidly maturing field of nontransplantation cardiac ...

Respiratory viral infections can cause severe pneumonia in lung transplant recipients as well are associated with acute rejection and long-term morbidity with bronchiolitis obliterans syndrome. There are no specific antiviral options for the majority of respiratory viruses. DAS181 is a novel sialidase fusion protein and is administered by inhalation. The authors describe the use of this new antiviral in a lung transplant patient with parainfluenza virus infection requiring ICU admission. The authors obtained this drug under an emergency investigational new drug application. The case report describes clinical and virologic improvement with use of this medication, which was also well-tolerated. Newer therapies for respiratory virus infections are a welcome addition especially for transplant patients where disease is severe and options are limited.. ...

TY - JOUR. T1 - Cell-Free Hemoglobin-mediated Increases in Vascular Permeability. A Novel Mechanism of Primary Graft Dysfunction and a New Therapeutic Target. AU - Shaver, Ciara M.. AU - Wickersham, Nancy. AU - McNeil, J. Brennan. AU - Nagata, Hiromasa. AU - Sills, Gillian. AU - Kuck, Jamie L.. AU - Janz, David R.. AU - Bastarache, Julie A.. AU - Ware, Lorraine B.. PY - 2017/9/1. Y1 - 2017/9/1. N2 - RATIONALE: Cell-free hemoglobin (CFH) is a potent oxidant associated with poor clinical outcomes in a variety of clinical settings. Recent studies suggest that acetaminophen (APAP), a specific hemoprotein reductant, can abrogate CFH-mediated oxidative injury and organ dysfunction. Preoperative plasma CFH levels are independently associated with primary graft dysfunction (PGD) after lung transplant ( 1 ).OBJECTIVES: Our objectives were to determine whether CFH would increase lung vascular permeability in the isolated perfused human lung and whether APAP would limit these effects.METHODS: Human lungs ...

The development of bronchiolitis obliterans in the allograft lung does not necessarily mean that it is due to immunologic activity. Numerous causes of small airway scarring have been recognized in lung transplant and non-transplant patients. Particularly relevant to the lung allograft recipient is the role of infection. Numerous infectious agents (to which the immunocompromised lung recipient is exposed) have been documented to cause bronchiolitis obliterans. These include many bacterial infections, viral infections, and some atypical organisms, including mycoplasma and chlamydia. In our practice, if we note histologic OB after a non-rejection related inflammatory process, we are certain to note this etiology in our pathology reports so that patients are not treated as for rejection induced OB. Second the development of acute harvest (ischemic) injury to the lung parenchyma has been associated with airway and interstitial scarring. This is particularly relevant in individuals who experience ...

During the last 20 years, there has been a shift away from combined heart-lung transplantation (HLT) in favor of bilateral lung transplantation. This paradigm shift allowed for the donor heart to be t

TY - JOUR. T1 - Long-term lung preservation with the PAF antagonist BN 52021. AU - Conte, John. AU - Katz, Nevin M.. AU - Wallace, Robert B.. AU - Foegh, Marie L.. PY - 1991/1/1. Y1 - 1991/1/1. N2 - Platelet activating factor (PAF, l-alkyl-2(R)-acetyl- glycero-3-phosphorylcholine) is a phospholipid that is released by a variety of cells. The similarity between the pathophysiological effects of PAF and posttrans-plant pulmonary dysfunction led to an evaluation of a PAF antagonist as an adjunct to lung preservation. The ginkgolide B, BN 52021, was selected as the PAF antagonist to be studied because of the large data base available on this compound. BN 52021 was given to the donor and recipient (10 mg/kg i.v.) prior to harvest and transplantation and was included in 1 L of preservation solution (10 mg/kg) used for flushing the pulmonary artery and for storage. Left single-lung transplantation was performed following a 22-hr preservation period at 10°C. Arterial oxygen tension (pO2), pulmonary ...

Chronic allograft dysfunction in form of bronchiolitis obliterans is the most important hurdle to improved longterm survival after clinical lung transplantation to date. Recently, it was observed that the progression of bronchiolitis obliterans in lung transplant recipients might be inhibited by macrolide antibiotics. The authors therefore tested whether macrolide therapy can attenuate fibrous obliteration of airways in an animal model of bronchiolitis obliterans. Rats with heterotopic tracheal allografts were treated intraperitoneally with clarithromycin and compared to untreated transplanted animals with respect to allograft histology and expression of selected cytokines. At day 21 after transplantation, the tracheal allografts of treated animals were free of fibrous material or partially occluded dependent of clarithromycin dosage. Untreated animals had completely obliterated allografts. In treated animals, tumor necrosis factor alpha (TNF-alpha) was down-regulated early (5 days) and late (21 ...

Birch, Jodie, Sunny, Syba, Hester, Katy, Parry, Gareth, Gould, F. Kate, Dark, John, Clark, Stephen, Meachery, Gerard, Lordan, James, Fisher, Andrew, Corris, Paul and De Soyza, Anthony (2018) Outcomes of lung transplantation in adults with bronchiectasis. BMC Pulmonary Medicine, 18. ISSN 1471-2466 Sithamparanathan, Sasiharan, Thirugnanasothy, Logan, Clark, Stephen, Dark, John, Fisher, Andrew, Gould, Kate, Hasan, Asif, Lordan, James, Meachery, Gerard, Parry, Gareth and Corris, Paul (2016) Observational study of lung transplant recipients surviving 20 years. Respiratory Medicine, 117. pp. 103-108. ISSN 0954-6111 Ong, Lay Ping, Thompson, Emily, Sachdeva, Ashwin, Ramesh, B. C., Muse, Hazel, Wallace, Kirstie, Parry, Gareth and Clark, Stephen (2016) Allogeneic blood transfusion in bilateral lung transplantation: impact on early function and mortality. European Journal of Cardio-Thoracic Surgery, 49 (2). pp. 668-674. ISSN 1010-7940 Ong, Lay Ping, Sachdeva, Ashwin, Ramesh, Bandigowdanapalya Channaiah, ...

Pulmonary hypertension is one of the indications for lung transplantation. Recent advances on medical management of the disease have dramatically decreased the number of patients who required lung transplantation. In reported series, single or double lung transplantation have been successfully undertaken by many transplant centers. In patients, whose cardiac functions are irreversibly damaged heart-lung transplantation remains as an only option for long term survival. Transplantation should only be considered in those patients who are having optimal medical support and relatively good condition for a major operation.

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2017 The Authors. Background: Extended criteria donor lungs deemed unsuitable for immediate transplantation can be reconditioned using ex vivo lung perfusion (EVLP). Objective identification of which donor lungs can be successfully reconditioned and will function well post-operatively has not been established. This study assessed the predictive value of markers of inflammation and tissue injury in donor lungs undergoing EVLP as part of the DEVELOP-UK study. Methods: Longitudinal samples of perfusate, bronchoalveolar lavage, and tissue from 42 human donor lungs undergoing clinical EVLP assessments were analyzed for markers of inflammation and tissue injury. Levels were compared according to EVLP success and post-transplant outcomes. Neutrophil adhesion to human pulmonary microvascular endothelial cells (HPMECs) conditioned with perfusates from EVLP assessments was investigated on a microfluidic platform. Results: The most effective markers to differentiate between in-hospital survival and ...

Acute lung injury within 72 hours of lung transplantation, termed Primary Graft Dysfunction (PGD), is a major cause of early post-transplant morbidity and morta...

TY - JOUR. T1 - Increased levels of circulating nitrates and impaired endothelium- mediated vasodilation suggest multiple roles of nitric oxide during acute rejection of pulmonary allografts. AU - Wiklund, L.. AU - Lewis, D. H.. AU - Sjoquist, P. O.. AU - Nilsson, F.. AU - Tazelaar, H.. AU - Miller, V. M.. AU - McGregor, C. G.A.. PY - 1997/7/22. Y1 - 1997/7/22. N2 - Experiments were designed to determine whether changes in pulmonary artery function could be reduced by treatment with a lipid peroxidation inhibitor (H 290/51) during acute rejection of pulmonary allografts. Single lung transplantation was performed in three groups of dogs: group 1 was maintained on immunosuppression for 8 days after operation (immunosuppressed, n = 5); in group 2, immunosuppression was discontinued on postoperative day 5, so that rejection occurred on postoperative day 8 (rejecting, n = 6); in group 3, immunosuppression was discontinued after 5 days, and the lipid peroxidation inhibitor H 290/51 (25 mg/kg) was ...

Importance: Bronchiolitis obliterans syndrome has been associated with increased morbidity and mortality after allogeneic hematopoietic stem cell transplant (HSCT). Previous studies have suggested that azithromycin may reduce the incidence of post-lung transplant bronchiolitis obliterans syndrome. Objective: To evaluate if the early administration of azithromycin can improve airflow decline-free survival after allogeneic HSCT. Design, Setting, and Participants: The ALLOZITHRO parallel-group trial conducted in 19 French academic transplant centers and involving participants who were at least 16 years old, had undergone allogeneic HSCT for a hematological malignancy, and had available pretransplant pulmonary function test results. Enrollment was from February 2014 to August 2015 with follow-up through April 26, 2017. Interventions: Patients were randomly assigned to receive 3 times a week either 250 mg of azithromycin (n = 243) or placebo (n = 237) for 2 years, starting at the time of the ...

Despite his underlying lung condition, Anthony was able to move around and exercise with little or no supplemental oxygen before getting infected with COVID-19. After COVID-19, it was a different ballgame, he said. He required higher and higher levels of oxygen but it became clear that he couldnt survive on a ventilator. He was placed on a transplant wait list, and, to buy time, his care team put him on ECMO (extracorporeal membrane oxygenation), which works like the heart and lungs to remove carbon dioxide and return oxygen-filled blood back to the tissues. Then, on Feb. 6, Anthony became the first COVID-related lung transplantation patient at UMMC.. COVID-19 was also a different ballgame for the UMMC lung transplant team, which routinely performs 25-30 lung transplants each year. Unique to COVID-19 is the rapid ebb and flow of symptoms. Within a matter of months, the two men were sick with COVID-19, then seemingly recovered from their initial infection only to get sick again, the second ...

2016 Elsevier Inc. Background Primary graft dysfunction (PGD) is a frequent complication after cardiac transplantation and remains one of the leading causes of mortality in these patients. The objective of this case-control study is to identify donor and surgical procedures factors associated with PGD, and further guide possible strategies to prevent PGD. Methods Retrospective analysis of the medical records of patients who underwent cardiac transplantation at Memorial Hermann Hospital at Texas Medical Center between October 2012 and February 2015. Results The study population included 99 patients, of which 18 developed PGD. Univariate analysis of donor characteristics revealed opioid use (P =.049) and death owing to anoxia (P =.021) were associated with PGD. The recipient/donor blood type match AB/A was significantly associated with PGD (P =.031). Time from brain death to aortic cross clamp (TBDACC) of ≥3 and ≥5 days were also found to be associated with PGD (P =.0011 and.0003, ...

The survival associated with double lung transplantation (LTx) is 7.1 years, however, closer inspection of recipient pre-LTx disease demonstrates that survival amongst COPD patients (related to cigarette smoke [CS] exposure) is amongst the worst at 5.5 years, as compared to 8.9 years in cystic fibrosis patients. A number of risk factors are thought to lead to this observed inferior outcome, chief amongst these, are pre-LTx diagnosis, recipient and donor age, and donor CS history. Indeed, CS exposure in either the recipients or donors has been linked with increased rates of severe primary graft dysfunction, acute rejection (AR), and ultimately earlier graft failure. The goal of these proposed studies is to demonstrate evidence that CS exposure, either donor or recipient, alters the local lung-specific immune environment in such a way as to predispose to exacerbated ischemia-reperfusion injury (IRI), with a resultant worsening of AR. We first examined the role of CS exposure on the lung ...

Global Markets Directs, Lung Transplant Rejection - Pipeline Review, H1 2020, provides an overview of the Lung Transplant Rejection pipeline

By Megan Rauscher. NEW YORK (Reuters Health) - Lung transplantation in children with cystic fibrosis (CF) is not likely to prolong life and may do more harm than good, according to a look back at essentially the entire U.S. pediatric experience with lung transplantation for cystic fibrosis for the period 1992 through 2002.. According to a report in November 22 issue of The New England Journal of Medicine, a total of 248 of the 514 children with cystic fibrosis who were on the waiting list during the 10-year-period underwent lung transplantation.. Children undergoing lung transplant did much worse than expected, Dr. Theodore G. Liou of the University of Utah, Salt Lake City, told Reuters Health.. We fully expected, at the start of the study, that we would find a group that did well and others that did not do so well. Unfortunately, we found that the group that most likely did well with transplant was very small, while the group that most likely did poorly (worse than if not transplanted) was ...

Citing reports, the drug device platform of Breath Therapeutics involves a liposomal cyclosporine A for the delivery of inhaled drug with PARI Pharmas eFlow nebulizer technology. L-CsA-i, the lead product candidate, has initiated two global phase 3 clinical trials to treat Bronchiolitis obliterans syndrome (BOS), the post-lung transplantation which is respiratory orphan disease that can be fatal and has no approved therapies.. Breath Therapeutics Board Member and Sofinnova Partners Managing Partner, Graziano Seghezzi, said that Breath Therapeutics is a cutting-edge platform with smart entrepreneurs developing products to treat devastating diseases that have no effective treatment, standing as perfect symbol for the companys investment strategy.. The company had clear vision for transatlantic operation that has strong bases in the U.S. and Europe in order to maximize any commercial opportunity. The company believes it has achieved the said vision and has gathered an excellent management team ...

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