UCLA lung transplant program performs landmark 1000th surgery
TheUCLA Lung Transplant program performed its 1,000th transplant surgery in mid-September, becoming the first program on the West Coast, and one of only seven centers nationwide, to achieve this milestone.The recipient of the donor lungs was Elba De Contreras, 59, from Goleta, California, who suffered from idiopathic pulmonary fibrosis and pulmonary hypertension. The six-hour surgery took place at Ronald Reagan UCLA Medical Center, led by Dr. Abbas Ardehali, surgical director of the lung and heart transplant programs.De Contreras, who relied on an oxygen tank prior to her surgery, is recuperating well and said she feels happy and energetic. With three sons and four grandkids, De Contreras said she looks forward to resuming her social life. Her husband, Willy, said that the donor lungs have given his wife “new life” and she looks 20 years younger.“This is a big milestone for UCLA’s lung transplant program” said Ardehali, a professor of cardiothoracic surgery. “Achieving 1,000 lung transplants is a reflection of the experience and dedication of our team.”Lung transplantation has come a long way since UCLA performed its first operation in 1988. While the procedure used to have a significant morbidity rate, as new techniques were developed the 30-day survival rate improved dramatically, reaching 98 percent at UCLA currently, compared to the national average of 96.5 percent.These advances in patient outcomes are attributable to several fac...
Conclusions: In patients with FIP, PVR is a significant contributor of 6MWD, independently from the extent of fibrosis on HRCT. These results strengthen both the rationale to use 6MWD as endpoint in FIP and to target APH with specific therapies.Respiration
ConclusionsPatients with CS have similar post-transplant hemodynamics as patients without CS, without evidence of right ventricular dysfunction or pulmonary hypertension. Neither significant rejection nor recurrence of sarcoid in the allograft was observed in this cohort of patients with CS. Survival is similar between patients with CS and those without CS. Heart transplant is a viable strategy in selected patients with CS with excellent outcomes.RésuméIntroductionLa transplantation cardiaque orthotopique (TCO) est de plus en plus utilisée lors d’insuffisance cardiaque terminale liée &agra...
Repair of Hemi-Truncus with "Irreversible" Pulmonary Hypertension. Ann Thorac Surg. 2018 Jul 13;: Authors: Sha JM, Cao Y, Xu SS Abstract Anomalous origin of the pulmonary artery from the ascending aorta (AOPA) can lead to congestive heart failure in infancy and with advancing age many patients will develop severe pulmonary hypertension. Surgical intervention had high mortality/morbidity risk if this happens. Strategies to manage these patients seem only limited to heart-lung transplantation or lung transplantation. Here, we successfully carried out surgical intervention to in an adult patien...
Despite advances in targeted medical therapy, pulmonary arterial hypertension (PAH) remains a fatal disease because of progressive right ventricular dysfunction. For patients who are refractory to medical therapy, heart-lung and lung transplantation are important treatment options. Because of longer waiting time, surgical interventions including extracorporeal lung support and atrial septostomy can be used in PAH patients bridging to transplantation.
We examined safety and long-term outcomes of intravenous treprostinil administered via the implantable LENUS Pro ® pump in patients with severe pulmonary hypertension (PH).
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but severe complication of acute pulmonary embolism leading to right heart failure and premature mortality. Its cumulative incidence ranges from 0.1 –9.1% within the first 2 years after symptomatic acute pulmonary embolism, although probably underestimated due to the lack of systematic follow-up and screening in clinical routine.1–3
Chronic thromboembolic pulmonary hypertension (CTEPH) results from persistent pulmonary vascular obstructions, presumably due to inflammatory thrombosis. Because estimates of thrombus volume at diagnosis have no predictive value, we investigated the role of the thrombosis marker D-dimer and the inflammation marker C-reactive protein (CRP) for predicting outcomes in CTEPH.
The pathobiology of chronic thromboembolic pulmonary hypertension (CTEPH) is poorly understood. Metabolic dysregulation is prominent in idiopathic pulmonary arterial hypertension (IPAH). Using an “omics” approach, we sought to determine the metabolic fingerprint of CTEPH patients compared to IPAH and healthy controls.
We hypothesized that dynamic measures of pulmonary arterial compliance (Cpa), and elastance (Epa), RV elastance (Ees), and RV-PA coupling would improve prediction of post-op mean PA pressure (PAP), Length of Stay (LOS), ICU duration (ICUd) and need for inotropes (NFI) compared to prediction based solely on pre-op PAP, CO and PVR in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary thromboendaterectomy (PTE).
Exercise right heart catheterization (RHC), currently used to identify occult pulmonary hypertension (PH), may have additional applications. An elevated total pulmonary resistance (TPR), the change in mean pulmonary arterial pressure (mPAP) divided by the change in cardiac output during exercise, has been associated with worse clinical outcomes. We hypothesize that the combination of the TPR and the PCWP during exercise ( ∆TPRex) reflects pulmonary arterial disease and is a marker of outcomes.