Lung Transplantation for Interstitial Lung DiseasesLung Transplantation for Interstitial Lung Diseases

Select patients with interstitial lung diseases and pulmonary hypertension may benefit from lung transplantation, even though the number of transplants performed is limited by the supply of donor organs. Which patients should be on the waiting list? Seminars in Respiratory and Critical Care Medicine
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Pulmonary Medicine Journal Article Source Type: news

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Primary graft dysfunction (PGD) is a major cause of morbidity and mortality after lung transplantation. Its incidence has decreased with optimization of lung preservation strategies. It remains, however, an important problem, particularly in patients with pulmonary fibrosis and pulmonary hypertension.1 Its development is generally multifactorial and thus referred to as a syndrome. Biologically, activation of the innate immune system and increased endothelial permeability are the main drivers of pulmonary capillary leak after reperfusion.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Editorial Source Type: research
We present a series of patients with sarcoidosis associated PH and describe correlation between the pre-transplant hemodynamic data from a right heart catheterization (RHC) and vascular morphologic changes in the native explanted lungs.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 117 Source Type: research
Central veno-arterial (VA) ECMO provides reliable cardiopulmonary support in selected patients with end-stage lung diseases and severe pulmonary hypertension or cardiac instability. Ambulation dramatically improves patient outcomes. We investigated the outcomes of a new technique of ambulatory central VA ECMO via tunneled cannula insertion and right thoracotomy.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 113 Source Type: research
Pre-transplant irreversible pulmonary hypertension (PH) is a contraindication to heart transplantation (HTx) due to the high risk of post-transplant right ventricular (RV) dysfunction. When ventricular assist devices (VAD) are not available, HTx may be considered in selected patients PH.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 35 Source Type: research
There is a lack of evidence to guide appropriate donor sizing in recipients with moderate pulmonary hypertension (PH) awaiting transplant. Best practice suggests to oversize hearts for such recipients to prevent post-operative right ventricular failure.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 249 Source Type: research
Cardiac allograft vasculopathy (CAV) is a highly prevalent vaso-occlusive disease that is a leading cause of graft failure and mortality after heart transplantation. While the pathogenesis of CAV remains incompletely understood, histologic evidence suggests that macrophages, which constitute an important part of the innate immune response, may play an important role. Prior studies in pulmonary hypertension have shown that macrophage-derived leukotriene B4 (LTB4) induces proliferation and hypertrophy of human pulmonary artery smooth muscle cells.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 218 Source Type: research
ISHLT guidelines recommend serial right heart catheterization (RHC) to survey pulmonary hypertension in patients awaiting heart transplant. In LVAD as BTT patients the ideal surveillance frequency is unknown in those without prior pulmonary hypertension or whose pre-LVAD PVR normalized after surgery. Here, we review the utility of our surveillance RHC protocol.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 350 Source Type: research
Pulmonary hypertension (PH) is frequent in HT candidates; identifying patients (pts) with urgent need of HT is challenging. Guidelines suggest diastolic transpulmonary gradient (DPG) ≥ 7 mmHg to differentiate combined (CpC) and isolated (IpC) post-capillary PH, but its clinical relevance in this setting is unknown. The aim of our study is to analyze the prognostic impact of PH classification in pts referred for HT, and the interplay of CpC and IpC with markers of ventricular f unction.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 322 Source Type: research
We examined our single-center experience using ECLS as bridge to recovery (BTR), non-transplant surgery (BTNTS), or lung transplantation (BTT) in patients with PH.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 300 Source Type: research
Although the surgical level of disease in chronic thromboembolic pulmonary hypertension (CTEPH) is routinely described, no study has systematically correlated the preoperative computed tomography pulmonary angiogram (CTPA) with surgical level.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 299 Source Type: research
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