Lung Transplant Pathology

Alloimmune reactions are, besides various infections, the major cause for impaired lung allograft function following transplant. Acute cellular rejection is not only a major trigger of acute allograft failure but also contributes to development of chronic lung allograft dysfunction. Analogous to other solid organ transplants, acute antibody-mediated rejection has become a recognized entity in lung transplant pathology. Adequate sensitivity and specificity in the diagnosis of alloimmune reactions in the lung can only be achieved by synoptic analysis of histopathologic, clinical, and radiological findings together with serologic and microbiologic findings.
Source: Surgical Pathology Clinics - Category: Pathology Authors: Source Type: research

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Over the past four decades, cardiac transplantation has achieved considerable success in patients with end-stage heart disease; however, the incidence of antibody-mediated rejection (AMR) remains high and is considered to be an important cause of life-threatening cardiac allograft dysfunction.1-3
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
We read with great interest the article by Van Keer et al. assessing the long term outcomes of cardiac allograft vasculopathy (CAV).1 We commend the authors on their large well-characterized dataset over a 25-year period, and for contributing knowledge on an important disease we do not yet fully understand. Importantly, this is one of the largest analysis and external validation of the ISHLT CAV classification system.2 We believe a few points merit further consideration.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Long-term survival following heart transplantation (HTx) is compromised by cardiac allograft vasculopathy (CAV) characterized by coronary macro and microvascular disease. The pathogenesis of CAV is unclear and may involve coronary thrombosis. We investigated whether HTx patients with CAV had higher platelet aggregation and turnover than HTx patients without CAV and healthy controls. Furthermore, we investigated the antiplatelet effect of low-dose aspirin in HTx patients.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Allograft vasculopathy (AV) is the main limiting factor for long-term graft survival. Increased activity of matrix metalloproteinases (MMPs) contributes to neointima formation in AV and represents a potential therapeutic target. Adeno associated viral (AAV) gene therapy comprises a potentially benign vector model for long-term expression of MMP antagonists.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
AbstractBackgroundWe previously demonstrated high diagnostic accuracy of Rubidium-82 positron emission tomography (PET) myocardial blood flow (MBF) quantification for CAV. The purpose of this study was to validate multiparametric PET detection of CAV by combined rate-pressure-product-corrected myocardial flow reserve (cMFR), stress MBF, and coronary vascular resistance (CVR) assessment.Methods and ResultsDiagnostic CAV cut-offs of cMFR  
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
AbstractBackgroundA low level of evidence exists regarding the choice of calcineurin inhibitor (CNI) for immunosuppression after lung transplantation (LTx). Therefore, we designed a randomized clinical trial according to good clinical practice rules to compare tacrolimus with cyclosporine after LTx.MethodsThe ScanCLAD study is an investigator-initiated, pragmatic, controlled, randomized, open-label, multicenter study evaluating if an immunosuppressive protocol based on anti-thymocyte globulin (ATG) induction, once-daily tacrolimus dose, mycophenolate mofetil, and corticosteroid reduces the incidence of chronic lung allogra...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
In this study, we determined whether symptomatic respiratory viral infections in post-lung transplantation induce circulating exosomes that contain lung-associated self-antigens, and to assess whether these exosomes activate immune responses to self-antigens.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
In this study, we determined whether symptomatic respiratory viral infections after lung transplantation induce circulating exosomes that contain lung-associated self-antigens and assessed whether these exosomes activate immune responses to self-antigens.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL PRE-CLINICAL SCIENCE Source Type: research
Authors: Mombelli M, Kampouri E, Manuel O Abstract Introduction: In solid organ transplant (SOT) recipients, influenza is associated with significant morbidity, including high hospital admission and mortality rates. Influenza may also impair allograft outcomes, in particular in lung transplant recipients. Early treatment with antivirals and seasonal vaccination contribute to reduce influenza-associated morbidity in this population.Areas covered: We selected a number of publications by searching into Pubmed to review the epidemiology, clinical presentation, and outcomes of influenza in SOT recipients. We discuss cur...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
ConclusionDLT followed by percutaneous ASD closure is an efficient therapeutic approach in patients with end-stage ASD associated PAH that may offer an alternative option to HLT.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
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