U.S. trial test machine that ‘reconditions’ lungs outside body
(Reuters) – A machine that ‘reconditions’ a donor’s lungs outside the body before being transplanted into a recipient is undergoing tests in the United States in the hope that it can radically improve survival rates for people with chronic respiratory diseases. The XPS, manufactured by Swedish company XVIVO Perfusion , is in clinical trials at 16 U.S. medical centers. Known as “the box,” it ventilates the lungs after removal from the donor and infuses them with a fluid mix of drugs and steroids, effectively drying them out and getting them in better shape for use in a transplant operation. The technology, which has not been used widely before, aims to increase the donor pool by reconditioning marginal lungs not suitable for transplant. “It allows the lungs to stay alive … and allows us as providers to assess the function of the organ in a unique, well-controlled environment,” said Dr. Varun Puri, an associate professor of cardiothoracic surgery at Washington University in St. Louis. The XPS, which is under test at Washington University, Duke University Medical Center, New York-Presbyterian Hospital and more than a dozen other U.S. sites, has been cleared for use in Europe and Canada and was approved for clinical trials by the U.S. Food and Drug Administration as a Humanitarian Use Device. Michele Coleman, 63, credits ‘the box’ with saving her life. A former smoker, she was diagnosed with chronic obstructive pu...
Discussion Normal kidneys regulate water balance to maintain a plasma osmolality of 275-290 mOsm/kg normally. Thirst and arginine vasopressin or antidiuretic hormone (ADH) are the primary regulators of plasma osmolality. ADH is made in the hypothalamus and released by the posterior pituitary gland. ADH acts on the kidney’s distal collecting duct to increase water reabsorption. ADH is appropriately released in hypovolemic states, such as dehydration caused by gastroenteritis. ADH has an ~10 minute half-life and therefore can respond to rapid changes in volume status. Sodium balance is regulated by aldosterone (as part...
CONCLUSIONS: Specialists had diverse perceptions and clinical practices regarding severe asthma and ACOS patients. This heterogeneity must be considered in future studies and strategy development for severe asthma and ACOS. PMID: 29676069 [PubMed]
Authors: Kapellos TS, Bassler K, Aschenbrenner AC, Fujii W, Schultze JL Abstract Chronic obstructive pulmonary disease (COPD) is a diverse respiratory disease characterised by bronchiolitis, small airway obstruction, and emphysema. Innate immune cells play a pivotal role in the disease's progression, and in particular, lung macrophages exploit their prevalence and strategic localisation to orchestrate immune responses. To date, alveolar and interstitial resident macrophages as well as blood monocytes have been described in the lungs of patients with COPD contributing to disease pathology by changes in their functio...
This study aimed to characterize patients initiating treatment with the LAMA tiotropium (TIO) and the fixed-dose LAMA/LABA combination therapy umeclidinium/vilanterol (UMEC/VI), and to compare rates of escalation to TT between patients receiving these therapies.
Before her passing earlier this week, former First Lady Barbara Bush announced that she would be spending her final days at home with her family utilizing “comfort care” in lieu of continued medical treatment for her congestive heart failure and COPD. She chose quality of life over quantity of life.
Objective. We evaluated the relationship between various risk scores (SYNTAX score (SS), SYNTAX score-II (SS-II), thrombolysis in myocardial infarction (TIMI) risk scores and Global Registry of Acute Coronary Events (GRACE) risk scores) and major adverse cardiovascular events (MACE) in non-ST-elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). Subjects and Methods: The study population were selected from among 589 patients who underwent coronary angiography with a diagnosis of NSTEMI. TIMI and GRACE risk scores were calculated. SS and SS-II were calculated in all patients,...
CONCLUSIONS: Heightened NK cytotoxicity against lung epithelial cells in COPD results primarily from lung DC-mediated priming via IL-15 trans-presentation on IL-15Rα. Future studies are required to test whether increased NK cytotoxicity contributes to COPD pathogenesis. PMID: 29676596 [PubMed - as supplied by publisher]
Publication date: 21–27 April 2018 Source:The Lancet, Volume 391, Issue 10130 Author(s): The Lancet
Annals of the American Thoracic Society,Volume 15, Issue Supplement_2, Page S122-S123, April 2018.
Annals of the American Thoracic Society,Volume 15, Issue Supplement_2, Page S132-S132, April 2018.
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