Study: Process used to select lung transplant patients may need to be changed

(University of Maryland Medical Center) New research from the University of Maryland School of Medicine suggests that the system for choosing transplant recipients in chronic obstructive pulmonary disease (COPD) may underestimate how long a person might survive without a lung transplant and therefore, may mislead clinicians.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news

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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...
Source: Jornal Brasileiro de Pneumologia - Category: Respiratory Medicine Source Type: research
Conclusion: As for cardiac or hepatic transplantations, despite a strong immunosuppressive regimen, a high frequency of transient PF4/H Ab is observed in patients undergoing BLT. Their appareance is not related to thrombocytopenia and/or thrombotic events. However, they could be an early marker of a cellular reaction againts the graft.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - Category: Hematology Authors: Tags: 311. Disorders of Platelet Number or Function: Poster II Source Type: research
Authors: Slama A, Taube C, Kamler M, Aigner C Abstract Lung transplantation (LuTX) and lung volume reduction (LVR), either surgical (LVRS: lung volume reduction surgery) or endoscopic (ELVR: endoscopic lung volume reduction), are established therapies in the treatment of end-stage chronic obstructive pulmonary disease (COPD) patients. Careful patient selection is crucial for each intervention. If these techniques are sequentially applied there is a paucity of available data and individual center experiences vary depending on details in selection criteria and operative technique. This review aims to summarize the pu...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Authors: Santambrogio L, Tarsia P, Mendogni P, Tosi D Abstract Lung transplantation (LTx) in advanced stage chronic obstructive pulmonary disease (COPD) patients is associated with significant improvement in lung function and exercise capacity. However, demonstration that the procedure also provides a survival benefit has been more elusive compared to other respiratory conditions. Identification of patients with increased risk of mortality is crucial: a low forced expiratory volume in 1 second (FEV1) is perhaps the most common reason for referral to a lung transplant center, but in itself is insufficient to identif...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Authors: Minervini F, Kestenholz PB, Paolini V, Pesci A, Libretti L, Bertolaccini L, Scarci M Abstract Chronic obstructive pulmonary disease (COPD) is a very heterogeneous disease characterised by an obstructive lung pattern that constitutes worldwide a major cause of high morbidity and mortality. In the last decades, lung volume reduction surgery (LVRS) has demonstrated to be a potential good alternative to transplantation in patients affected by COPD. The trend toward minimally invasive techniques resulted not only in surgical procedures better tolerated by the patients but also in several endoscopic treatments m...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Conclusion: Study reveals a high prevalance of potentially treatable extra pulmonary and pulmonary comorbidities. We recommend a list of these treatable comorbidities be included as part of the standard work up of COPD patients undergoing CT as it would enable better patient outcomes.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Conclusion: LCI can be successfully measured in LTx patients, and changes with BOS grade. Longitudinal assessments will reveal whether abnormal LCI in those with preserved FEV1 predicts future clinical change.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
The effective intervention for selected patients with end-stage pulmonary disease is lung transplantation (LTx). Pulmonary rehabilitaion (PR), as a comprehensive, multidisplinary approach, is required not only pre-LTx but also post-LTx period. The aim of this study was to investigate the efficacy of outpatient, multidisplinary, comprehensive PR program in LTx recipients after discharge from hospital. The number of 23 LTx recipients were refered to PR center between 2013-2017. The previous diagnosis, age, history of smoking, the values of ISWT, ESWT, FEV1, FVC, MIP, MEP, MRC, SGRQ, CRQ, BMI, FFMI, HAD before and after PR we...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and Chronic Care Source Type: research
Bronchiectasis is present in a subset of patients with COPD and diagnosed on the mid-airway generations by HRCT. It is currently not known what happens to the numbers and dimensions of the smaller airway generations in patients with COPD-related bronchiectasis.Explant lungs of patients with COPD undergoing transplantation (n=14) and declined lungs of prospective donors (n=7) were collected. 5 donor, 5 COPD and 5 COPD-bronchiectasis lungs were inflated, frozen and scanned with HRCT (resolution 700µm), of which images were used to count airway bifurcations and measure diameters. The remaining donor (n=2), COPD (n=2) an...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Introduction: Surgically, the only treatment options for chronic obstructive pulmonary are lung transplantation and lung volume reduction surgery. Currently, no study exists in the medical literature on the feasibility of pneumostomy performed under local anaesthesia as an alternative treatment for advanced pulmonary emphysema.Materials and Methods: Nine patients met the following inclusion criteria: pulmonary emphysema, FEV1
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Thoracic Surgery Source Type: research
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