scholarly journals Lung transplantation: how we do it

2021 ◽  
Author(s):  
John Santosh Murala ◽  
Hashim Muhammad Hanif ◽  
Matthias Peltz ◽  
Sreekanth Reddy Cheruku ◽  
Lynn Custer Huffman ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Median Survival ◽  
Gold Standard ◽  
Lung Transplant ◽  
Transplant Program ◽  
The World ◽  
End Stage

AbstractLung transplantation is considered the gold standard for patients with chronic end-stage pulmonary disease. However, due to the complexity of management and relatively lower median survival as compared to other solid organs, many programs across the world have been slow to adopt the same. In our institution, we started lung transplantation in September 1990. And since then, we performed close to 900 lung transplantations. Here, we describe in detail the operative steps adopted in our institution for a successful lung transplantation. There have been very few variations over the years. We believe that having a standardized technique is one of the important features for success of a lung transplant program.

Clinical characteristics and epidemiology survey of lung transplantation recipients accepting surgeries during COVID-19 pandemic：from area near Hubei Province (Preprint)

2020 ◽  
Author(s):  
Lingxiao Qiu ◽  
Shanshan Chen ◽  
Cong Wang ◽  
Caihong Liu ◽  
Huaqi Wang ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Clinical Characteristics ◽  
Lung Transplant ◽  
The Novel ◽  
Web Based ◽  
Transplant Program ◽  
Medical Institutions ◽  
Survey Results ◽  
Wbc Count ◽  
Novel Coronavirus

BACKGROUND Lung transplantation recipients (LTx) are more susceptible to severe acute respiratory syndrome-corona virus-2 (SARS-Cov-2) and suffer severer outcomes than healthy subjects. OBJECTIVE Here we aim to analyze whether it was appropriate to maintain lung transplant programs in medical institutions accepting coronavirus disease 2019 (COVID-19) patients. METHODS Methods: the clinical characteristics, laboratory testing, and epidemiology survey results of 10 LTx recipients undergoing allograft lung transplantation surgeries in the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic were collected. A web-based epidemiology questionnaire was used to collect the information of LTx recipients after discharge. RESULTS A total of 10 LTx recipients were identified. The main cause of lung transplantation was idiopathic interstitial pneumonia (60%), with another rare case of cystic fibrosis. Comorbidities involved hyperlipidemia, subclinical hyperthyroidism, diabetes, viral hepatitis of type B. The average white blood cell (WBC) count and average lymphocyte count were 9.5±3.9×109 cells/liter and 1.7±1.1×109 cells/liter, respectively. 40% of the LTx recipients had lymphopenia. Impaired alanine aminotransferase (ALT) and aspartate transaminase (AST) were observed in LTx recipients. Good habitats of hand hygiene (100%), wearing protective masks behaviors (100%), indoor ventilation behaviors (100%), indoor disinfection measures (83%), personal tableware (67%), separate room (100%), personal bedsheets/ quilts (100%) and drinking glasses (100%) were observed during the follow-up. None of the LTx recipients or their family members get infected with SARS-CoV-2 during the novel coronavirus pandemic. CONCLUSIONS Under the premise of taking appropriate preventive measures during hospitalization and after discharge, the lung transplant program can be maintained in the medical institution that accepts patients with COVID-19. INTERNATIONAL REGISTERED REPORT RR2-doi: https://doi.org/10.1101/2020.07.06.20147264

P0591 : HBV vaccination status in patients with end stage pulmonary disease evaluated for lung transplantation

2015 ◽  
Vol 62 ◽  
pp. S537-S538
Author(s):  
A. Wald ◽  
L. Deterding ◽  
M. Maier ◽  
U.G. Liebert ◽  
T. Berg ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Vaccination Status ◽  
Hbv Vaccination ◽  
End Stage

Role of autoimmunity in organ allograft rejection: a focus on immunity to type V collagen in the pathogenesis of lung transplant rejection

2004 ◽  
Vol 286 (6) ◽  
pp. L1129-L1139 ◽  
Author(s):  
Tina L. Sumpter ◽  
David S. Wilkes
Keyword(s):  
Lung Transplantation ◽  
Lung Transplant ◽  
Transplant Rejection ◽  
Survival Rates ◽  
Definitive Treatment ◽  
Solid Organ ◽  
Type V Collagen ◽  
End Stage ◽  
Type V

Lung transplantation is the only definitive treatment modality for many forms of end-stage lung disease. However, the lung is rejected more often than any other type of solid organ allograft due to chronic rejection known as bronchiolitis obliterans (BO). Indeed, BO is the primary reason why the 5- and 7-yr survival rates are worse for the lung than for any other transplanted organ. Alloimmunity to donor antigens is established as the primary mechanism that mediates rejection responses. However, newer immunosuppressive regimens designed to abrogate alloimmune activation have not improved survival. Therefore, these data suggest that other antigens, unrelated to donor transplantation antigens, are involved in rejection. Utilizing human and rodent studies of lung transplantation, our laboratory has documented that a native collagen, type V collagen [col(V)], is a target of the rejection response. Col(V) is highly conserved; therefore, these data indicate that transplant rejection involves both alloimmune and autoimmune responses. The role of col(V) in lung transplant rejection is described in this review article. In addition, the potential role of regulatory T cells that are crucial to modulating autoimmunity and alloimmunity is also discussed.

Dietary Support to Underweight Patients with End-Stage Pulmonary Disease Assessed for Lung Transplantation

Respiration ◽  
2001 ◽  
Vol 68 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Liv Førli ◽  
Jan I. Pedersen ◽  
Øystein Bjørtuft ◽  
Morten Vatn ◽  
Jacob Boe
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Underweight Patients ◽  
End Stage

Anesthesia for Lung Transplantation

2019 ◽  
pp. 322-329
Author(s):  
J. Devin Roberts
Keyword(s):  
Lung Transplantation ◽  
Transesophageal Echocardiography ◽  
Gold Standard ◽  
Anesthetic Management ◽  
Survival Rates ◽  
Anesthesia Care ◽  
Lung Isolation ◽  
The Past ◽  
Lung Transplants ◽  
End Stage

Since the first human procedure in 1963, lung transplantation has become the gold standard treatment of a variety of end-stage lung diseases. With over 4000 lung transplants performed in 2015 and steadily improving survival rates over the past three decades, anesthetic management of patients undergoing lung transplant can significantly contribute to patient outcomes. Anesthesia care for lung transplantation can be both complex and clinically challenging. Anesthesiologists taking part in these procedures need to have specific skills regarding thoracic and cardiac anesthesia. There are both technical and physiological challenges, such as achieving adequate lung isolation and oxygenation, interpretation and use of transesophageal echocardiography, and the management of respiratory and myocardial impairments. This chapter provides an overview of these perioperative anesthetic management considerations utilizing a problem-based format.

scholarly journals Chronic Pulmonary Silicone Embolism from Breast Augmentation Is Not a Common Finding in Explanted Lungs

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Jarmanjeet Singh ◽  
Hanine Inaty ◽  
Sanjay Mukhopadhyay ◽  
Atul C. Mehta
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Breast Augmentation ◽  
Lung Transplant ◽  
Common Finding ◽  
Transplant Recipients ◽  
Chronic Lung Diseases ◽  
Pathologic Features ◽  
History Of ◽  
Lung Transplant Recipients

Objective. Acute pulmonary silicone embolism (APSE) related to subcutaneous silicone injections is a well-known entity. Recently, a few cases of pathologically confirmed chronic pulmonary silicone embolism (CPSE) from breast implants have been reported. The prevalence of CPSE in women with breast augmentation is unknown. This study was done to determine the prevalence of CPSE in female lung transplant recipients with a history of breast augmentation and to determine whether breast augmentation plays a role in chronic lung diseases requiring lung transplantation. Methods. A retrospective chart review was performed to identify female lung transplant recipients with a history of breast augmentation prior to or at the time of lung transplantation. Ten patients meeting these criteria were identified. The pathologic features of the explanted lungs of these patients were reexamined for CPSE by a board-certified pathologist with expertise in lung transplantation and pulmonary embolism. Results. Of 1518 lung transplant recipients at Cleveland Clinic, 578 were females. Of 578 females, 10 (1.73%) had history of breast augmentation. A total of 84 H&E-stained slides from the explanted lungs from 10 cases were examined. No pathologic evidence of chronic silicone embolism was seen in any of the 10 cases. Conclusions. CPSE is not associated with pulmonary disease leading to lung transplantation. Breast augmentation is not a significant contributor to pulmonary disease requiring lung transplantation. Further studies are required to ascertain the prevalence of CPSE in the general breast augmentation populace and to define the relationship between breast augmentation and pulmonary disease.

Isolated Lung Transplantation for End-Stage Pulmonary Disease

1998 ◽  
Vol 30 (4) ◽  
pp. 1521-1522 ◽  
Author(s):  
F Venuta ◽  
E.A Rendina ◽  
T De Giacomo ◽  
G Della Rocca ◽  
A.M Ciccone ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Isolated Lung ◽  
End Stage

scholarly journals Neuropsychological dysfunction in patients with end-stage pulmonary disease: lung transplant evaluation

2003 ◽  
Vol 18 (4) ◽  
pp. 353-362 ◽  
Author(s):  
W.D. Crews ◽  
A. L. Jefferson ◽  
D. K. Broshek ◽  
R. D. Rhodes ◽  
J. Williamson ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Lung Transplant ◽  
Neuropsychological Dysfunction ◽  
Transplant Evaluation ◽  
End Stage

scholarly journals Hepatitis B Vaccination in End-Stage Pulmonary Disease Patients Evaluated for Lung Transplantation: A Retrospective Single-Center Evaluation

2016 ◽  
Vol 21 ◽  
pp. 368-372 ◽  
Author(s):  
Alexandra Wald ◽  
Lea Deterding ◽  
Melanie Maier ◽  
Uwe G. Liebert ◽  
Thomas Berg ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Hepatitis B Vaccination ◽  
Single Center ◽  
End Stage

Escalation of extracorporeal life support as a bridge to lung transplantation in end-stage lung disease

Perfusion ◽  
2017 ◽  
Vol 32 (7) ◽  
pp. 606-608
Author(s):  
Prashant N. Mohite ◽  
Alexander Rosenberg ◽  
Clara Hernández Caballero ◽  
Simona Soresi ◽  
Javid Fatullayev ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Failure ◽  
Lung Function ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Postoperative Course ◽  
End Stage ◽  
Vv Ecmo

Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplant (LTx) is not uncommon, but it is not commonplace yet. We present a case of a 45-year-old man with cystic fibrosis with recent deterioration in lung function who was initially supported with veno-venous (VV) ECMO. However, he subsequently required conversion to veno-veno-arterial (VVA) ECMO. After 21 days of support, he underwent double lung transplantation, with an uneventful postoperative course. This case shows that, in patients with end-stage respiratory failure awaiting lung transplantation, extracorporeal life support may require escalation to improve gas exchange and address circulatory requirements.

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