Pennsylvania court case on organ donation guidelines put on hold
Girl at center of lawsuit over adult organ transplant rules, Sarah Murnaghan, received a set of adult lungs on Wednesday
This study aims to describe the features of patients who cannot be weaned from iNO, the reasons for this and its impact on postoperative outcomes.MethodsThis is a monocentric cohort study comprised all consecutive patients who underwent double ‐lung transplantation (DLT) between January 1st, 2012 and January 1, 2016. The impact of iNO dependency on postoperative outcomes was estimated using a boosted inverse probability of treatment weighting estimator.Results9.8% of the 173 patients included in the study could not be weaned from iNO at end ‐surgery stage. Body mass index (OR=2.03, 95%CI=1.14‐3.29, p=0.02) and intrao...
Lung transplantation has become an accepted therapy for most causes of end-stage lung disease. Between 30 to 50% of lung transplants require extracorporeal life support (ECLS). In many lung transplantation centers, extracorporeal membrane oxygenation (ECMO) is replacing cardiopulmonary bypass (CPB) as the primary choice for intraoperative ECLS. This review will discuss the evolving role of ECMO in lung transplantation and its implications for anesthetic management.
Publication date: December 2018Source: The Annals of Thoracic Surgery, Volume 106, Issue 6Author(s): Scott Chicotka, Felipe E. Pedroso, Cara L. Agerstrand, Erika B. Rosenzweig, Darryl Abrams, Tom Benson, Aimee Layton, Daniel Burkhoff, Daniel Brodie, Matthew D. BacchettaBackgroundExtracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation for end-stage interstitial lung disease (ILD) and pulmonary hypertension (PH) has varying results based on ECMO configuration. We compare our experience using venovenous (VV) and venoarterial (VA) ECMO bridge to transplantation for ILD with PH on survival to successful t...
ConclusionsThe trajectory of physical HRQOL in patients receiving SLT declines over time compared with DLT, indicating that, in the longer term, SLT recipients are more likely to have physical HRQOL scores that fall substantively below general population norms. Physical HRQOL after 5 years may be a consideration for lung allocation and patient counseling regarding expectations when recommending SLT or DLT.
ConclusionsDCD lung transplants remain underused in the United States. Nevertheless, survival is similar to DBD. Primary graft dysfunction metrics for DCDs are worse than DBDs on intensive care arrival but improved subsequently.Visual Abstract
AbstractMucopolysaccharidoses (MPS) are a group of hereditary disorders caused by lysosomal storage of glycosaminoglycans (GAGs) and characterized by a wide variability of phenotypes from severe fetal-neonatal forms to attenuated diseases diagnosed in adult individuals. The clinical picture generally worsens with age due to progressive storage involving mucosal tissue, upper airways and lungs, bones and joints, central and peripheral nervous system, heart, liver, eye, and ear. Cardiac storage of GAGs involves valves, heart muscle, and vessels (particularly the coronary arteries), and can be specific in relation to differen...
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