Clues found to early lung transplant failure
(Washington University in St. Louis) Researchers at Washington University School of Medicine in St. Louis and Northwestern University have uncovered cells that flow into and harm the lung soon after transplant. The resulting dysfunction is the leading cause of early death after lung transplantation and contributes to organ rejection that can lead to death months or years later. The discovery, in mice, may lead to drug therapies that target the destructive cells.
The researchers have found a way to genetically modify tobacco plants to produce large quantities of collagen almost identical to the body ’s own.
We report the case of a 51-year-old patient who underwent bilateral lung transplantation and presented with an unstable condition and sepsis 6 days after transplantation. The performed contrast enhanced spectral detector computed tomography (CT) using a dual-layer detector showed absence of perfusion in the left lung on iodine maps, although branches of the pulmonary artery were patent. This prompted retrospective evaluation of CT images and total venous occlusion of the left pulmonary veins was found. Here, iodine maps helped in raising conspicuity of loss of lung perfusion.
ConclusionWith an experienced team, and the proper equipment, on-ECMO air transport of critical patients over thousands of kilometers is today safely feasible.
Authors: Bondeelle L, Bergeron A Abstract INTRODUCTION: Progress in allogeneic hematopoietic stem cell transplantation (HSCT) procedures have been associated with improved survival in HSCT recipients. However, they have also brought to light organ-specific complications, especially pulmonary complications. In this setting, pulmonary complications are consistently associated with poor outcomes, and improved management of these complications is required. Areas covered: We review the multiple infectious and noninfectious lung complications that occur both early and late after allogeneic HSCT. This includes the descrip...
This article aims to increase awareness of IPF among cardiologists, providing an overview for cardiologists on the differenti al diagnosis of IPF from HF, and describing the signs and symptoms that would warrant referral to a pulmonologist with expertise in ILD. Once patients with IPF have received a diagnosis, cardiologists can have an important role in managing patients who are candidates for a lung transplant or those w ho develop pulmonary hypertension (PH). Group 3 PH is one of the most common cardiovascular complications diagnosed in patients with IPF, its prevalence varying between reports but most often cited as be...
CONCLUSIONS: We generated a single cell atlas of pulmonary fibrosis. Using this atlas we demonstrated heterogeneity within alveolar macrophages and epithelial cells from subjects with pulmonary fibrosis. These results support the feasibility of discovery-based approaches using next generation sequencing technologies to identify signaling pathways for targeting in the development of personalized therapies for patients with pulmonary fibrosis. The dataset is available at https://nupulmonary.org/resources/. PMID: 30554520 [PubMed - as supplied by publisher]
Publication date: January 2019Source: The Annals of Thoracic Surgery, Volume 107, Issue 1Author(s): Sarah Cullivan, Karen Redmond, Carole Ridge, Oisin J. O’ConnellA 21-year-old patient presented with a short history of fatigue and dyspnea on a background of double-lung transplantation for cystic fibrosis and preexisting chronic superior vena cava obstruction. Computed tomography of the chest demonstrated a 3-cm mass occluding the right pulmonary veins, with associated right upper and lower lobe pulmonary parenchymal infiltrates. Two invasive procedures were performed, with similar complications in both procedures.