Normothermic Ex Vivo Lung Perfusion in Clinical Lung Transplantation

Abstract Normothermic ex vivo lung perfusion is a novel strategy of donor lung preservation that preserves the metabolic activity of the organ. There are therefore opportunities for further lung evaluation and therapeutic intervention during the ex vivo stage. We review our clinical experience with this technique and offer perspectives for future development.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Heart Transplantation (HT) from donation after circulatory death (DCD) is a promising alternative to expand the heart donor pool. Cold storage can be used in a strategy to successfully retrieve and transplant DCD hearts after reconditioning using normothermic regional perfusion for distant procurement. Herein, we present the first report of a pediatric DCD heart reconditioned with normothermic regional perfusion, preserved using only cold storage while being transported to a neighboring center, and then successfully transplanted after nearly 2 hours of cold static storage.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Innovation Source Type: research
The field of heart transplantation continues to evolve, with major changes in allocation systems, and increasing use of extended-criteria donor hearts, including hearts from donation after circulatory death (DCD) donors, hearts supported with ex-vivo perfusion, and hearts from hepatitis C viremic donors. Use of such non-traditional donor hearts has made transplantation available to a larger number of recipients, but the demand continues to outpace the supply. Given this persistent donor heart shortage, much attention has been given to the topic of donor-recipient size matching.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
CONCLUSION: Plasma levels of ceftolozane are stable in the extracorporeal membrane oxygenation circuit, suggesting that adjustment of standard doses of ceftolozane in patients with extracorporeal membrane oxygenation support may not be needed. PMID: 31387460 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Publication date: Available online 1 August 2019Source: The Lancet Respiratory MedicineAuthor(s): Gabriel Loor, Gregor Warnecke, Mauricio A Villavicencio, Michael A Smith, Jasleen Kukreja, Abbas Ardehali, Matthew Hartwig, Mani A Daneshmand, Marshall I Hertz, Stephen Huddleston, Axel Haverich, Joren C Madsen, Dirk Van RaemdonckSummaryBackgroundDonor lung use for transplantation is the lowest among solid organ tranplants because of several complex and multifactorial reasons; one area that could have a substantial role is the limited capabilities of cold ischaemic storage. The aim of the EXPAND trial was to evaluate the effic...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Abstract BACKGROUND: Thrombocytopenia is a common disorder after heart or lung transplantation. Platelet transfusion is often required to maintain haemostasis but represents a specific cause of morbidity and mortality in this setting including alloimmunisation and graft rejection. STUDY DESIGN AND METHODS: As part of a health-care quality improvement project, in a single-centre before-after pilot study, the relevance of a platelet transfusion saving strategy based on romiplostim administration after transplantation was assessed in patients with platelet count
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Authors: Faverio P, De Giacomi F, Bonaiti G, Stainer A, Sardella L, Pellegrino G, Sferrazza Papa GF, Bini F, Bodini BD, Carone M, Annoni S, Messinesi G, Pesci A Abstract Interstitial lung diseases (ILDs) may be complicated by chronic respiratory failure (CRF), especially in the advanced stages. Aim of this narrative review is to evaluate the current evidence in management of CRF in ILDs. Many physiological mechanisms underlie CRF in ILDs, including lung restriction, ventilation/perfusion mismatch, impaired diffusion capacity and pulmonary vascular damage. Intermittent exertional hypoxemia is often the initial sign ...
Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
The application of mesenchymal stromal cell (MSC)-based therapy during ex vivo lung perfusion (EVLP) could repair injured donor lungs prior to transplantation. The aim of this study was to determine the efficacy of MSC therapy performed during EVLP on ischemia-reperfusion injury using a pig lung transplant model.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
CONCLUSION: Transpulmonary thermodilution-cardiac output monitoring appeared to be safe and feasible. Using the cardiac output-guided algorithm led to excellent renal results with a trend towards less fluids in favor of norepinephrine. This article is protected by copyright. All rights reserved. PMID: 31309649 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
In this study, we identify a link between members of the genus Veillonella and exercise performance. We observed an increase in Veillonella relative abundance in marathon runners postmarathon and isolated a strain of Veillonella atypica from stool samples. Inoculation of this strain into mice significantly increased exhaustive treadmill run time. Veillonella utilize lactate as their sole carbon source, which prompted us to perform a shotgun metagenomic analysis in a cohort of elite athletes, finding that every gene in a major pathway metabolizing lactate to propionate is at higher relative abundance postexercise. Us...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Simple human dignity and self-ownership demands the right to end one's own life on one's own terms, and to be able to help others achieve this goal where they are not capable of doing so themselves. Yet these acts remain forbidden to most people in most parts of the world. Painless, effective euthanasia requires medical assistance, and providing that service remains largely illegal. This state of affairs is slowly starting to change in the US, however, and so late last year the first cryopreservation following voluntary euthanasia took place. Cryopreservation is the only presently available end of life option that o...
Source: Fight Aging! - Category: Research Authors: Tags: Of Interest Source Type: blogs
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