Air pollution, traffic linked to deaths, organ rejection in lung transplant patients
For the first time, research shows 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.
Recurrent granulation tissue or anastomotic stenosis cause major morbidity for patients undergoing lung transplantation. Common therapeutic options include bronchoscopic interventions (BI) like surgical debridement, cryotherapy, LASER coagulation, balloon bronchoplasty and stent placement. Small institutional experiences have suggested efficacy of endobronchial brachytherapy (EBB) for recurrent post-transplant bronchial stenosis (PTBS) which has an anti-inflammatory effect similar to it's use for keloids or heterotopic ossification.
Publication date: 2018 Source:Respiratory Medicine Case Reports, Volume 25 Author(s): Pradnya D. Patil, Samir Sultan, M. Frances Hahn, Sreeja Biswas Roy, Mitchell D. Ross, Hesham Abdelrazek, Ross M. Bremner, Nitika Thawani, Rajat Walia, Tanmay S. Panchabhai Patients under consideration for lung transplantation as treatment for end-stage lung diseases such as idiopathic pulmonary fibrosis (IPF) often have risk factors such as a history of smoking or concomitant emphysema, both of which can predispose the patient to lung cancer. In fact, IPF itself increases the risk of lung cancer development by 6.8% to 20%. Solid organ ma...
We report a case 57-year-old male patient with double lung transplant secondary to idiopathic pulmonary fibrosis presented with shortness of breath after vertebroplasty. CTA chest showed thin dense opacities within the bilateral pulmonary arteries consistent with pulmonary cement embolism. The patient was treated with therapeutic enoxaparin and remained stable at one year follow up.
We describe a patient with acute exacerbation of idiopathic pulmonary fibrosis supported by ECMO for 403 days while waiting for a LTx. In this case, we kept the patient awake, and he was communicating frequently with his family. We changed the membrane oxygenator 23 times and the cannula 10 times without complication. However, we terminated the treatment on day 403 of ECMO because there was no access site for cannula insertion due to blockage by a venous thrombotic occlusion, making it impossible to continue this bridge to lung transplantation. It has become possible to maintain patients on ECMO for extended periods of tim...
Conclusions ECMO as BTT has led to encouraging perioperative outcomes and early survival. Careful patient selection and early use of ECMO seems to allow for preservation of vitality while these critically ill candidates await donor organs, which may improve outcomes.
Conclusions Preoperative functional independence and maintenance of employment are associated with superior long-term outcomes in lung recipients. The results highlight potential benefits of pretransplant functional rehabilitation for patients on the waiting list for lungs.
Invasive aspergillosis (IA) is a frequent complication in lung transplant recipients (LTRs). Clinical risk factors for IA have not been fully characterized, especially in the era of extensive antifungal prophylaxis.
We examined safety and long-term outcomes of intravenous treprostinil administered via the implantable LENUS Pro ® pump in patients with severe pulmonary hypertension (PH).
The Fried frailty phenotype is associated with morbidity and mortality in lung transplant (LTx) candidates, but its clinical application and association with post-transplant outcomes are not well defined. We aimed to assess two alternate frailty indices in LTx candidates and evaluate associations of frailty with early post-transplant outcomes and one-year mortality.
Interstitial lung diseases (ILDs) are a heterogeneous entity of diffuse parenchymal lung diseases characterised by damage of the parenchyma as a result of varying patterns of inflammation and fibrosis . Idiopathic pulmonary fibrosis (IPF) is a specific subgroup of ILDs and has a devastating prognosis  with a median survival time of 2–3 years [2–4]. Pirfenidone (Esbriet) and nintedanib (Ofev) were approved for IPF treatment, showing a stabilisation of the disease [5, 6], and are the treatments recommended by international guidelines . Nintedanib was shown to increase the risk of bleeding events in ...