Artificial Lungs: Current Status and Future Directions
AbstractPurpose of ReviewAlthough lung transplantation can be used to treat lung failure, limited donor organ availability creates a pressing need for improved artificial lung technology. This review discusses recent developments and future research pathways for respiratory assist devices and regenerative therapies intended to treat advanced lung disease.Recent FindingsHollow fiber membrane gas exchangers can be used to bridge lung failure patients to transplantation. Engineering improvements to such devices are on the verge of enabling longer term wearable systems that simplify and improve support. Progress with microchannel-based devices provides hope of smaller, more biomimetic devices that may even enable implantation; however, further development and testing are needed. Advances in cell-based technologies and tissue engineering have enabled early proof of concept of bioartificial lungs with properties similar to the native organ.SummaryRecent progress with artificial lungs has enabled better treatment as a bridge therapy. Continued advances in both engineering and biology will be necessary to achieve a truly implantable artificial lung capable of destination therapy.
ConclusionsSarcopenia is prevalent in LTx patients. Neither sarcopenia nor 6MWD predicted mortality or short-term outcomes after LTx. This is in contrast to albumin levels, which were inversely associated with survival and complications. Albumin shows promise as an important predictor of mortality and short-term outcomes after LTx.
Condition: Transplantation Lung Interventions: Other: Tailored tacrolimus dosing; Other: Conventional tacrolimus dosing Sponsor: Philipps University Marburg Medical Center Not yet recruiting
Donor-to-host transmitted infections pose a challenge in the safety of solid organ transplantation.1 The lung is the solid organ with the highest probability of carrying a bacterial pathogen2. The lung is also the main site of donor colonization or infection, such as pneumonia2. We previously analyzed the incidence of donor-to-host transmitted infections in 210 lung transplant recipients between 1994 and 20023. Although 52% of donors had an infection, only 12 (5.7%) recipients were diagnosed with donor-derived bacterial infections (DDBI).
ConclusionsManagement of delivery in cases of suspected autosomal recessive renal polycystic kidney disease needs to be discussed because of the risk of abdominal dystocia. The route and timing of delivery depend on the size of the fetal abdominal circumference and the gestational age. The rate of kidney growth must also be taken into account.
Every organ in the body is capable, to some extent, of repairing itself after an injury. As part of this process, scar tissue forms and then recedes to make room for normal tissue when healing is complete.However, when healing is disrupted — whether by chronic injury or disease — the cells that make up scar tissue can go rogue, continuously dividing and spreading until the scar eventually strangles the organ it was intended to help heal, which can lead to organ failure.That progressive, out-of-control scarring is called fibrosis, and it can occur in any organ in the body. Fibrosis plays a major role in many dis...
Authors: Montgomery E, Macdonald PS, Jha SR, Newton PJ, Malouf M PMID: 31815560 [PubMed - as supplied by publisher]
AbstractThe calcineurin inhibitor tacrolimus is an effective immunosuppressant and is extensively used in solid organ transplantation. In the first week after heart and lung transplantation, tacrolimus dosing is difficult due to considerable physiological changes because of clinical instability, and toxicity often occurs, even when tacrolimus concentrations are within the therapeutic range. The physiological and pharmacokinetic changes are outlined. Excessive variability in bioavailability may lead to higher interoccasion (dose-to-dose) variability than interindividual variability of pharmacokinetic parameters. Intravenous...
Dylan Mortimer creates celestial and glittery interpretations of scars, lungs and operating rooms.
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