Lung donation after circulatory death.

Lung donation after circulatory death. Curr Opin Organ Transplant. 2019 Jun;24(3):288-296 Authors: Ceulemans LJ, Inci I, Van Raemdonck D Abstract PURPOSE OF REVIEW: The current review presents a concise update on published literature on donation after circulatory death (DCD) and lung transplantation (LTx). Worldwide an increasing need for lungs is evident, however the utilization rate of DCD lung donors is still considerably low. In this summary article, we reviewed both the experimental background and international clinical experience. RECENT FINDINGS: Our analysis confirmed satisfactory results for LTx from DCD donors, which equals the results from donation after brain death. Although most studies reported on short-term results, some confirmed these results on the long-term and development of chronic lung allograft dysfunction. Our review summarizes the different DCD categories and underlines the potential of the DCD V category. We analyze the barriers to implement a DCD program, discuss the more recent advances like ex-vivo lung perfusion and describe the future challenges. SUMMARY: Based on the current short-term and long-term clinical results, we believe that barriers for DCD utilization should be overcome, resulting in a safe implementation of more DCD LTx programs worldwide. VIDEO ABSTRACT. PMID: 31090638 [PubMed - in process]
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research

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Limited donor lung availability and prolonged wait times remain substantial barriers to lung transplant. According to the Scientific Registry of Transplant Recipients, 11% of patients were removed from the wait-list in 2017 because of death or clinical deterioration and 40% of patients waited longer than 1 year before transplant. Ex vivo lung perfusion (EVLP) provides the opportunity to expand the donor pool, but despite encouraging early posttransplant outcomes, the long-term effect of EVLP remains unclear. In this issue of JAMA Surgery, Divithotawela et al present 10-year outcomes of the Toronto Lung Transplant Group &rs...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Purpose of review The current review presents a concise update on published literature on donation after circulatory death (DCD) and lung transplantation (LTx). Worldwide an increasing need for lungs is evident, however the utilization rate of DCD lung donors is still considerably low. In this summary article, we reviewed both the experimental background and international clinical experience. Recent findings Our analysis confirmed satisfactory results for LTx from DCD donors, which equals the results from donation after brain death. Although most studies reported on short-term results, some confirmed these results on ...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: LUNG TRANSPLANTATION: Edited by Allan R. Glanville Source Type: research
Conclusions. Continuous administration of clopidogrel significantly improved tissue oxygenation, limited microvascular leakiness, and prevented airway ischemia. These data demonstrate that clopidogrel ameliorates microvascular injury during acute airway rejection, which is a known predisposing factor for the development of CLAD.
Source: Transplantation - Category: Transplant Surgery Tags: Original Basic Science—General Source Type: research
Abstract PURPOSE OF REVIEW: The current review presents a concise update on published literature on donation after circulatory death (DCD) and lung transplantation (LTx). Worldwide an increasing need for lungs is evident, however the utilization rate of DCD lung donors is still considerably low. In this summary article, we reviewed both the experimental background and international clinical experience. RECENT FINDINGS: Our analysis confirmed satisfactory results for LTx from DCD donors, which equals the results from donation after brain death. Although most studies reported on short-term results, some confirm...
Source: Current Opinion in Organ Transplantation - Category: Transplant Surgery Authors: Tags: Curr Opin Organ Transplant Source Type: research
The risk of post-transplant lymphoproliferative disorder (PTLD), a B-cell malignancy caused by Epstein-Barr virus (EBV), is highest when latent virus is transmitted from B-cells within the allograft to a na ïve recipient. Ex-vivo lung perfusion (EVLP) is a potential platform to modify grafts before transplantation. We hypothesized that EVLP-mediated delivery of Rituximab (RTX), an antibody targeting CD20+ B-cells, may safely clear latent EBV from donor lungs and attenuate viral transmission.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 110 Source Type: research
We present our protocol for perfusion of porcine lungs with human stem cells using our ex-vivo machine.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 452 Source Type: research
The lack of hearts available for transplant remains a major concern. Recent strategies including ex-vivo technology and DCD organs have been utilized to expand donor pool.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 431 Source Type: research
Efforts to increase the number of viable donors, such as ex vivo lung perfusion and donation after circulatory death, are likely to significantly alter allograft ischemic time distributions. As such, understanding the impact allograft ischemia has on short and long-term outcomes will be key in determining best practices going forward.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 815 Source Type: research
In the diagnosis of chronic lung allograft dysfunction (CLAD) after living-donor lobar lung transplantation (LDLLT), lung ventilation scintigraphy using 133Xe has been shown to be useful. However, the supply of 133Xe has been discontinued worldwide in 2016 and a new diagnostic tool is required for CLAD after LDLLT. Generally, because CLAD has been shown to develop predominantly on one side after bilateral LDLLT, lung perfusion scintigraphy (LPS) could show a perfusion shift to the unilateral healthy lung (Figure 1A).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 1030 Source Type: research
Abstract The field of lung transplant has made significant advances over the past several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overcome several stumbling blocks including: donor shortage, proper selection of candidates, primary graft dysfunction, and chronic lung allograft dysfunction. The advances and developments surrounding these factors will have a significant impact on shaping the field within the coming years. In thi...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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