Conquering combined thoracic organ and liver transplantation: indications and outcomes for heart-liver and lung–liver transplantation

Purpose of review Combined thoracic organ and liver transplantation has been shown to be a viable treatment option for patients with end-stage disease lung or heart and disease. There are increasing number of cases reported in the literature, as the number of institutions utilizing this strategy is growing. Herein, we review the current literature of combined thoracic and liver transplantation. Recent findings A larger number of combined heart or lung and liver transplants (CHLT and CLLT) are being performed. A recent literature search showed approximately 231 CHLT and 89 CLLT and being described. One-year patient survival ranged from 71 to 80% for CLLT and 80–93% for CHLT, respectively. Indications for combined transplant and disease-specific outcomes are still being evaluated. Additionally, salvage modalities such as extracorporeal membrane oxygenation and ex-vivo lung perfusion are also being described. Summary Combined thoracic and liver transplant continues to be a viable treatment option for patients with end-stage disease that would likely not survive single transplant alone. Salvage modalities, such as extracorporeal membrane oxygenation and ex-vivo lung perfusion, may help in extending candidacy for this combined transplant. Outcomes, to date, are similar to results observed for solitary thoracic organ recipients, justifying CHLT and CLLT as a viable option for these patients. Continued identification of outcomes is needed to justify allocation of dual ...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: LIVER TRANSPLANTATION: Edited by R. Mark Ghobrial Source Type: research

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We present two cases of circulatory death donor (DCD) hearts recovered using NMP.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
This study aimed to investigate the effects of various perfusion temperatures on lung graft preservation during ex vivo lung perfusion (EVLP).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 583 Source Type: research
Human body is intertwined collection of lives of Individual organs.We believe death occurs when brain dies , respiration stops and circulation ceases . Curiously ,when life ends , these organs  don’t die as a single unit . These three events can happen in any of the six possible permutations.Each organ takes different times to die after loss of life.It is like a crashed computer , where the mother board /RAM memory may be transferred to another and be functional . Out of these three , heart function appears to be supreme as it can function without the need of brain (Science of brain-death) and keep the body...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Heart transplantation donor heart transport transmedics Source Type: blogs
Abstract Donors after brain death (DBD) have been the major source of organ donation due to good perfusion of the organs. However, owing to the mismatch in demand and supply of the organ donors and recipients, donors after circulatory death (DCDDs) has increased recently all over the world. Kidneys, liver, and lungs are being used for transplantation from DCDDs. Recently, heart transplantation from DCDDs has been started, which is under the firestorm of scrutiny by the ethicists. The ethical dilemma revolves around the question whether the donors are actually dead when they are declared dead by cardiocirculatory d...
Source: Indian Heart J - Category: Cardiology Authors: Tags: Indian Heart J Source Type: research
Authors: Salehi S, Tran K, Grayson WL Abstract In the past, a diagnosis of organ failure would essentially be a death sentence for patients. With improved techniques for organ procurement and surgical procedures, transplantations to treat organ failure have become standard medical practice. However, while the demand for organs has skyrocketed, the donor pool has not kept pace leading to long recipient waiting lists. Organ preservation provides a means to increase the number of available transplantable organs. However, there are significant drawbacks associated with cold storage, the current gold standard. To addres...
Source: The Yale Journal of Biology and Medicine - Category: Universities & Medical Training Tags: Yale J Biol Med Source Type: research
Publication date: Available online 20 August 2018Source: Indian Heart JournalAuthor(s): Shayan Marsia, Ariba Khan, Maryam Khan, Saba Ahmed, Javeria Hayat, Abdul Mannan Khan Minhas, Samir Mirza, Nisar Asmi, Jonathon ConstantinAbstractDonors after brain dead (DBD) have been the major source of organ donation due to good perfusion of the organs. However, due to the mismatch in demand and supply of the organ donors and recipients, organ donation after circulatory death has increased recently all over the world. Kidneys, liver and lungs are being used for transplantation from Donors after circulatory death (DCDDs). Recently, he...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
This study indicates that frailty and other age-related diseases could be prevented and significantly reduced in older adults. Getting our heart risk factors under control could lead to much healthier old ages. Unfortunately, the current obesity epidemic is moving the older population in the wrong direction, however our study underlines how even small reductions in risk are worthwhile." The study analysed data from more than 421,000 people aged 60-69 in both GP medical records and in the UK Biobank research study. Participants were followed up over ten years. The researchers analysed six factors that could impa...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
TransMedics said today that it won pre-market approval from the FDA for its OCD Lung transplant system, which is designed to keep donated human lungs in near-living condition until transplantation. The March 22 approval covers standard double-lung transplantation procedures, Andover, Mass.-based TransMedics said. The federal safety watchdog granted the PMA based on data from the 316-patient Inspire trial, the results from which were published this week in The Lancet Respiratory Medicine, comparing OCS lung with the standard of care – cold flush and storage. Inspire met its primary outcome – a composite of ...
Source: Mass Device - Category: Medical Devices Authors: Tags: Clinical Trials Regulatory/Compliance Respiratory Transplants Wall Street Beat transmedics Source Type: news
In conclusion, senescence of vascular cells promotes the development of age-related disorders, including heart failure, diabetes, and atherosclerotic diseases, while suppression of vascular cell senescence ameliorates phenotypic features of aging in various models. Recent findings have indicated that specific depletion of senescent cells reverses age-related changes. Although the biological networks contributing to maintenance of homeostasis are extremely complex, it seems reasonable to explore senolytic agents that can act on specific cellular components or tissues. Several clinical trials of senolytic agents are currentl...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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