For lung transplant, researchers surprised to learn bigger appears to be better
(Johns Hopkins Medicine) Transplant teams have long tried to match the size of donor lungs to the size of the recipient as closely as possible, concerned that lungs of the wrong size could lead to poor lung function and poor outcomes. But new Johns Hopkins-led research suggests that oversized donor lungs may instead be the best option for patients, finding they are associated with a 30 percent increased chance of survival one year after the operation.
In this issue ofJAMA, Martinod and colleagues report the results of a prospective, single-institution safety and feasibility trial of airway transplantation to reconstruct long-segment defects of the trachea and central bronchi. Over 6.5 years, 13 of 20 patients with end-stage tracheal lesions or proximal lung tumors requiring a pneumonectomy were enrolled in the study and underwent airway reconstruction with cryopreserved aortic allografts following definitive resection. Custom-made stents to support the allografts were used initially to prevent airway collapse but were removed at a postoperative mean duration of 18 month...
This case series describes 90-day mortality of patients who required tracheal, bronchial, or carinal reconstruction using stented aortic allografts supported by muscle flaps for treatment of inoperable airway disease including lung cancer, tracheal stenosis, or tracheomalacia.
In this study, we identified a novel anti-inflammatory effect of miR-199b-5p (miR-199b) through the GSK3 β and NF-κB pathways. THP-1 monocytes treated with LPS showed a significant decrease in miR-199b that is inversely correlated to GSK3β expression and NF-κB activation. Furthermore, the NF-κB-associated inflammatory response was reduced due to the overexpression of miR-199b targeting GSK3β, whi ch was rescued by the inhibition of miR-199b. These results indicated that miR-199b attenuated the inflammatory response at least partly through the GSK3β/NF-κB signaling pathways in mon...
In conclusion, toxic cytokine and HMGB1 released from failing small-for-size grafts leads to pulmonary adhesion molecule expression, leukocyte infiltration and injury. IP prevents DAMP release and toxic cytokine formation in small-for-size grafts, thereby attenuating ALI. PMID: 29755641 [PubMed]
DEEP VENOUS THROMBOSIS (DVT) and pulmonary embolism (PE) are relatively common postoperative complications in the surgical patient population. Estimates of the incidence of DVT and/or PE in the lung transplant population vary significantly. A recent Nationwide Inpatient Sample inquiry estimated that venous thromboembolism (VTE) is diagnosed in 6.3% of lung transplant recipients during their index admission for transplantation, with DVT alone diagnosed in 5.4%, or concurrent with PE in 1.1%.1 However, this statistic is based primarily on reported diagnosis codes and may not capture all cases of interest.
Clinical Transplantation, EarlyView.
Severe right ventricular failure necessitating a RVAD complicates 6-11% of LVAD implants. Patient outcomes for those receiving durable continuous-flow VADs in a biventricular configuration (i.e. BiVAD) have been reported in limited case series.
Conditions: Cognitive Impairment; Pulmonary Rehabilitation Intervention: Other: Pulmonary Rehabilitation Sponsor: Istanbul Medipol University Hospital Not yet recruiting
Abstract Intestinal ischemia-reperfusion (I/R) occurs in various clinical settings, such as transplantation, acute mesenteric arterial occlusion, trauma and shock. I/R injury causes severe systemic inflammation, leading to multiple organ dysfunction associated with high mortality. The ubiquitin proteasome pathway has been indicated in the regulation of inflammation, particularly through NF-κB signaling pathway. PYR-41 is a small molecular compound that selectively inhibits ubiquitin-activating enzyme E1. A mouse model of intestinal I/R injury by clamping the superior mesenteric artery for 45 minutes was perf...
Conclusions Well-controlled maximum back strength testing is feasible and reliable, and the scores are highly correlated with grip strength in lung transplant recipients shortly before hospital discharge. The Biering-Sørensen test should be limited to patients without dominant weakness and/or fear. Future research should investigate whether grip instead of back extension strength can safely be used for proper exercise prescription.