Failure to rescue contributes to center-level differences in mortality after lung transplantation

Publication date: Available online 27 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Asishana A. Osho, Muath M. Bishawi, Michael S. Mulvihill, Andrea L. Axtell, Sameer A. Hirji, Philip J. Spencer, Elbert E. Heng, David A. D'Alessandro, Serguei Melnitchouk, Matthew G. Hartwig, Mauricio A. VillavicencioAbstractBackgroundThe clinical response to postoperative complications after lung transplantation (LTx) may contribute to mortality differences between transplant centers. The ability to avoid mortality following a complication – Failure to Rescue (FTR) – may be an effective quality metric in lung transplantation.MethodsThe United Network for Organ Sharing (UNOS) database was queried for adult, first-time, lung-only transplantations from 05/2005 to 12/2015. Transplantation centers were stratified into equal-sized terciles based on observed operative mortality rates. Several post-operative complications were identified including stroke, acute rejection, acute-kidney-injury requiring hemodialysis, airway dehiscence and extra-corporeal-membrane-oxygenation 72-hours after surgery. Rates of FTR were calculated as the number of operative mortalities in patient who suffered complications divided by the number of patients who suffered any postoperative complications.ResultsOur study population included 16,411 LTx performed at 69 transplant centers. LTx centers were stratified into terciles with average peri-operative mortality of 4.0% for low-mortality centers, 6...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
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In conclusion, the SynCardia temporary TAH is a reasonable bridge-to-transplant option for selected patients with either biventricular failure or special anatomical conditions.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
In conclusion, high-dose NR induces the onset of WAT dysfunction, which may in part explain the deterioration of metabolic health. Towards a Rigorous Definition of Cellular Senescence https://www.fightaging.org/archives/2019/11/towards-a-rigorous-definition-of-cellular-senescence/ The accumulation of lingering senescent cells is a significant cause of aging, disrupting tissue function and generating chronic inflammation throughout the body. Even while the first senolytic drugs capable of selectively destroying these cells already exist, and while a number of biotech companies are working on the productio...
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In this study, the enhanced mice live somewhat longer than their unmodified peers, though not as much longer as is the case for the application of telomerase gene therapy. The mice do also exhibit reduced cancer risk, however. The scientists here class telomere shortening as a cause of aging, which is not a point universally agreed upon. Reductions in average telomere length in tissues looks much more like a downstream consequence of reduced stem cell activity than an independent mechanism. Researchers obtain the first mice born with hyper-long telomeres and show that it is possible to extend life without any geneti...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Publication date: Available online 26 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Fanar Mourad, Natalia Cleve, Janine Nowak, Daniel Wendt, Andreas Sander, Ender Demircioglu, Mohamed El Gabry, Heinz Jakob, Sharaf-Eldin ShehadaABSTRACTBACKGROUNDPrevalence of dialysis-dependent chronic renal failure (DD-CRF) is growing worldwide. Such patients are exposed to a higher cardiovascular risk due to severe calcification and congestive heart failure caused by volume overload, which end up in poor outcomes. Therefore, we aimed to evaluate outcomes of DD-CRF patients undergoing cardiac surgery in our institute.METHO...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract BACKGROUND: Prevalence of dialysis-dependent chronic renal failure (DD-CRF) is growing worldwide. Such patients are exposed to a higher cardiovascular risk due to severe calcification and congestive heart failure caused by volume overload, which end up in poor outcomes. Therefore, we aimed to evaluate outcomes of DD-CRF patients undergoing cardiac surgery in our institute. METHODS: A retrospective evaluation of 241-consecutive patients presented with DD-CRF undergoing cardiac-surgery between 01/2000-12/2017. Endpoints were major adverse cardiac and cerebrovascular events and long-term survival. Addit...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
In this study, researchers studied 438,952 participants in the UK Biobank, who had a total of 24,980 major coronary events - defined as the first occurrence of non-fatal heart attack, ischaemic stroke, or death due to coronary heart disease. They used an approach called Mendelian randomisation, which uses naturally occurring genetic differences to randomly divide the participants into groups, mimicking the effects of running a clinical trial. People with genes associated with lower blood pressure, lower LDL cholesterol, and a combination of both were put into different groups, and compared against those without thes...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We examined human lung tissue from COPD patients and normal control subjects, and found a substantial increase in p16-expressing alveolar cells in COPD patients. Using a transgenic mouse deficient for p16, we demonstrated that lungs of mice lacking p16 were structurally and functionally resistant to CS-induced emphysema due to activation of IGF1/Akt regenerative and protective signaling. Fat Tissue Surrounds Skeletal Muscle to Accelerate Atrophy in Aging and Obesity https://www.fightaging.org/archives/2019/09/fat-tissue-surrounds-skeletal-muscle-to-accelerate-atrophy-in-aging-and-obesity/ Researchers her...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusions. The elevated baseline CVP, elevated baseline RVEDV after anesthesia induction, and decreased SvO2 during anhepatic phase were associated with postoperative AKI. Prospective trials are required to evaluate whether the optimization of these variables may decrease the risk of AKI after LDLT.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—Liver Source Type: research
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