National lung transplant list urged
Lung disease experts are calling for a new national system to identify lungs for transplant which could double the number of procedures across the UK.
Publication date: January 2019Source: The Annals of Thoracic Surgery, Volume 107, Issue 1Author(s): Sarah Cullivan, Karen Redmond, Carole Ridge, Oisin J. O’ConnellA 21-year-old patient presented with a short history of fatigue and dyspnea on a background of double-lung transplantation for cystic fibrosis and preexisting chronic superior vena cava obstruction. Computed tomography of the chest demonstrated a 3-cm mass occluding the right pulmonary veins, with associated right upper and lower lobe pulmonary parenchymal infiltrates. Two invasive procedures were performed, with similar complications in both procedures.
Trial and registry data have reported mortality rates and causes of death in patients with left ventricular assist devices (LVADs); however, a more granular description is needed of end of life including location of death and quality of life (QOL) to better guide expectations and care.
Chronic lung allograft dysfunction (CLAD) is the single most important factor limiting long-term survival after lung transplantation (LTx). Azithromycin has been shown to improve CLAD-free and long-term survival, yet the possible impact on early lung allograft function is unclear.
While survival after pediatric heart transplantation (pHT) has improved in the past few decades and mechanical circulatory support is increasingly used to bridge children to transplantation, waiting list deaths remain a stark reality. To increase the donor pool, strategies such as ABO-incompatible transplantation or donation after cardiac death (DCD) have been attempted.1,2 The real question we have to ask is whether the current donor pool offers are appropriately being used. The article by Davies and colleagues in this issue of the journal looked at the rate of declines in donor offers for pediatric recipients and their consequences.
It's not the size of a man, but the size of his heart that matters.Evander Holyfield, American professional boxer (1962-)
Iatrogenic lymphoproliferative disorders have been described in patients receiving immunosuppressive/immunomodulatory agents outside the transplantation setting. Novel biological agents such as TNF-α blockers and JAK-inhibitors have also proven to be effective in many disorders including rheumatoid arthritis, inflammatory bowel disease (ulcerative colitis and Crohn disease), psoriasis, and others. A significant dilemma exists in those lymphoproliferative disorders associated with immunosuppressants and rheumatologic conditions, that relies on whether the association of the process is with the medication or the underl...
Conclusion: Early and frequent PT may be important for patients admitted to the intensive care unit while awaiting transplantation and can play an even greater role for the less than “ideal” transplant candidate. The PT interventions can be provided safely for this population in the hospital setting. A rehabilitation approach focused on maximizing a patient's functional capacity with strength and gait training activities may facilitate improved outcomes for lung transplant recipients deemed less than optimal candidates.
Christina VanDerVelden, 17, of Jacksonville, Florida, slipped into a week-long coma after her healthy rapidly declined. The cystic fibrosis sufferer now needs a double lung transplant to survive.
Conclusions: MB is an effective drug for the protection of nonischemic lungs against inflammation and apoptosis following unilateral lung transplantation in rats.RESUMO Objetivo: Avaliar se o azul de metileno (AM) pode minimizar os efeitos da les ão de isquemia-reperfusão sobre o pulmão não isquêmico em um modelo de transplante pulmonar em roedores. Métodos: Quarenta ratas Sprague-Dawley foram divididas em 20 doadoras e 20 receptoras. As 20 ratas receptoras foram divididas em dois grupos (n = 10) de acordo com o tratamento (solução salina a 0,9% vs. AM a 1%). Todos os ...
ABSTRACT The study of the human microbiome-and, more recently, that of the respiratory system-by means of sophisticated molecular biology techniques, has revealed the immense diversity of microbial colonization in humans, in human health, and in various diseases. Apparently, contrary to what has been believed, there can be nonpathogenic colonization of the lungs by microorganisms such as bacteria, fungi, and viruses. Although this physiological lung microbiome presents low colony density, it presents high diversity. However, some pathological conditions lead to a loss of that diversity, with increasing concentrations of so...