International Society for Heart and Lung Transplantation (ISHLT) 2016 Scientific SessionsInternational Society for Heart and Lung Transplantation (ISHLT) 2016 Scientific Sessions
Read clinically focused news coverage of key developments from ISHLT 2016. Medscape Transplantation
Claire Wineland vowed she wouldn't have a lung transplant, but her decline from cystic fibrosis made her reconsider. Now she's fighting for a chance at survival.
Mycophenolate mofetil (MMF) is commonly prescribed after transplantation and has important advantages over other immunosuppressive drugs but frequent gastrointestinal (GI) side effects limit its use. The mechanism(s) underlying MMF-related GI toxicity have yet to be elucidated.
A 67-year-old, non-Hispanic white male underwent bilateral lung transplantation in 2016 for idiopathic pulmonary fibrosis. The patient had good graft function after transplantation, with a peak forced expiratory volume in 1 second of 2.27 liters. Surveillance bronchoscopy and biopsies done at 1, 3, and 6 months post-transplantation did not show any evidence of acute rejection or infection. He was lost to follow-up until 15 months after transplantation, when he presented with 1 week of dyspnea, cough, and fever.
Rain splattered, blurring my view of the Massachusetts state highway. The rental car’s wipers squeaked as they dragged across the windshield. Though I was briefly tempted to turn back, I kept driving. The man with the battery-operated heart had invited me to his home, and I didn’t want to be late. I am a critical care doctor. Throughout the course of my training, I have learned how to manage a ventilator, how to treat sepsis, how to sort out the causes of renal failure. But what I didn’t learn is what comes after for those who do not die, whose lives are extended by days, months, or even years as a result...
Severe right ventricular failure necessitating a RVAD complicates 6-11% of LVAD implants. Patient outcomes for those receiving durable continuous-flow VADs in a biventricular configuration (i.e. BiVAD) have been reported in limited case series.
Purpose of review Within the United States, donor heart and lung procurement varies between institutions and among surgeons within the same institution sometimes. The purpose of this article is to review the history of donor heart and lung procurement, the surgical techniques, and pitfalls. Recent findings The current article covers the important intraoperative evaluation of the donor heart and lungs at the procurement hospital and the surgical pitfalls that can be prevented to ensure good procurement of donor heart and lungs. Summary The current article provides a review of the history of donor procurement. The ar...
By DAVID SHAYWITZ, MD Randomized control trials – RCTs – rose to prominence in the twentieth century as physicians and regulators sought to evaluate rigorously the performance of new medical therapies; by century’s end, RCTs had become, as medical historian Laura Bothwell has noted, “the gold standard of medical knowledge,” occupying the top position of the “methodologic heirarch[y].” The value of RCTs lies in the random, generally blinded, allocation of patients to treatment or control group, an approach that when properly executed minimizes confounders (based on the presumption t...