'Molecular microscope' system safer, more effective in heart and lung transplant biopsies
(University of Alberta Faculty of Medicine&Dentistry) A transplant biopsy system that uses gene chips to read molecules is far safer and more effective than existing approaches used for heart transplant biopsies and is showing promising results for lung transplant biopsies, new University of Alberta-led research shows.
The diagnostic criteria for antibody-mediated rejection (AMR) after lung transplantation (LTx) includes immunohistochemistry (IHC) staining patterns for C4d but not C3d.1 Historically, C3d deposition is a recognized complication after LTx associated with primary graft dysfunction and early bronchiolitis obliterans syndrome (BOS)2,3 but is not widely used in LTx even though it's a result of complement deposition via the classical pathway.4 The International Society for Heart and Lung Transplantation Pathology Council established a threshold of>50% deposition of C4d in interstitial capillaries as diagnostic but emphasized...
Lung donor utilization rates remain low with many organs refused for donor quality. However, certain centers have successfully transplanted these organs despite multiple refusals for donor quality (RDQ) by other centers. We hypothesize that the number of refusals due to donor quality does not impact post-transplant outcomes.
Significant right ventricular failure accompanying left ventricular failure was treated by implantation of the fully magnetically levitated centrifugal HeartMate 3 ventricular assist device as bi-ventricular support in 14 patients in 6 medical centers worldwide. The clinical details of this first multi-center experience are described, with 9 of these patients (64%) being alive as of January 1, 2018 - 8 of them ongoing on BiVAD support for 95 - 636 (mean 266) days, 7 of them at home, and one successfully transplanted after 98 days of support.
Hepatitis C (HCV) donors are rarely used for cardiac transplantation due to historically poor outcomes. In 2015, nucleic acid testing (NAT) for viral load was added to the routine work-up of organ donors, allowing for the distinction between subjects who remain viremic (HCV Ab+/NAT+) and those who have cleared HCV and are no longer viremic (HCV Ab+/NAT –). The American Society of Transplantation recently recommended that HCV Ab+/NAT– donors be considered non-infectious and safe for transplantation.
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
Abstract Despite decades of formidable exploration, multi-organ ischemia-reperfusion injury (IRI) encountered, particularly amongst elderly patients with clinical scenarios, such as age-related arteriosclerotic vascular disease, heart surgery and organ transplantation, is still an unsettled conundrum that besets clinicians. Remote ischemic conditioning (RIC), delivered via transient, repetitive noninvasive IR interventions to distant organs or tissues, is regarded as an innovative approach against IRI. Based on the available evidence, RIC holds the potential of affording protection to multiple organs or tissues, w...
Jack Palmer, of Kansas City, Missouri, became the 20th infant under a year old to undergo a heart-lung transplant after he was born in January with a congenital heart defect.
We report that the disruption of excitation-contraction coupling contributes to impaired force generation in the mouse model of Sod1 deficiency. Briefly, we found a significant reduction in sarcoplasmic reticulum Ca2+ ATPase (SERCA) activity as well as reduced expression of proteins involved in calcium release and force generation. Another potential factor involved in EC uncoupling in Sod1-/- mice is oxidative damage to proteins involved in the contractile response. In summary, this study provides strong support for the coupling between increased oxidative stress and disruption of cellular excitation contraction mac...
With the development of medical technology, transplantation has prevailed and become an important tool in the treatment of disease. According to the WHO ’s statistics, as of 2015, approximately 120000 cases of solid organ transplantation have been performed globally. Renal transplantation is the most common, followed by liver transplantation, heart transplantation, lung transplantation, hematopoietic stem cell transplantation, etc. . And, in re cipients of transplantation, seizures usually occur during the postoperative period [2,3].
This thirty-fifth adult lung and heart –lung transplant report summarizes data from 64,803 adult lung and 4,054 adult heart-lung transplants performed through June 30, 2017 and reported to the International Thoracic Organ Transplant Registry. With each year's report we now also provide more detailed analyses on a particular focus theme . Since 2013, these have been donor and recipient age; retransplantation; early graft failure; indication for transplant; and allograft ischemic time; and in 2018, multiorgan transplantation.