RESULTS OF LUNG TRANSPLANTATION ASSISTED WITH EXTRACORPOREAL MEMBRANE OXYGENATOR (ECMO)

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
R J Burgos Lázaro ◽  
N Burgos Frías ◽  
J Rivas Oyarzabal ◽  
A Sánchez Calle ◽  
A Macías Sotuel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Interstitial Fibrosis ◽  
Organ Transplant ◽  
Perioperative Period ◽  
Membrane Oxygenator ◽  
Grade Ii ◽  
Lung Transplants ◽  
Respiratory Assistance

Abstract INTRODUCTION According to the registry of the “International Society for Heart and Lung Transplantation” (ISHLT), 32% of lung transplants (Tx P) will require respiratory assistance in the perioperative period. The aim of the study is to compare the results of the Tx P that required ECMO, versus those that did not require respiratory assistance. MATERIAL AND METHODS Between January 2015 and December 31th 2018, 184 lung transplants were performed in the organ transplant unit. In 119 (64.7%) of the transplants, they did not need respiratory assistance and in 65 (35.3%) they required ECMO either intraoperatively and/or postoperatively. The indications for lung transplantation were: interstitial fibrosis 77 (41.8%), pulmonary emphysema 64 (34.7%), cystic fibrosis 28 (15.3%), others 15 (8.2%). RESULTS Patients with Mean Pulmonary Pressure (MPP) greater than 54 mmHg required assistance with ECMO during transplantation (p < 0.03). 83% of transplanted patients remained in NYHA grade I and grade II. Hospital mortality was 21/184 (11.4%); ECMO mortality 14/67 (20.9%) vs NO-ECMO mortality 6/117 (5.1%), significantly higher (p < 0.005 OR = 4.98). Survival and quality of life at 5 years were similar in both groups (p = 0.09). CONCLUSIONS ECMO has proven to be safe and effective in Tx P. Patients with PMP> 54 mmHg required ECMO (p < 0.03). After the hospital postoperative period, the quality of life and survival at five years were similar in both groups.

Lung Transplantation 1: An Overview - Recipient Evaluation and Procedures

2019 ◽  
Author(s):  
Hilary J Goldberg
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Therapeutic Option ◽  
Organ Transplant ◽  
Therapeutic Interventions ◽  
Solid Organ ◽  
Progression Of Disease ◽  
Potential Benefits ◽  
Prognostic Data

Lung transplantation is a potential therapeutic option for select candidates with advanced lung disease who have exhausted other therapeutic interventions and in whom survival and/or quality of life are threatened by the progression of disease. Although lung transplantation may confer substantial benefits on recipients, the median survival after lung transplantation according to the most recent registry data is only 5.7 years, substantially shorter than that for other solid-organ transplant cohorts. As a result, the available prognostic data for potential recipients in the absence of lung transplantation, the risks of transplantation, and the potential benefits in terms of survival and quality of life should be reviewed in detail when considering this intervention. This review discusses candidates for lung transplantation, timing of transplantation, organ donors and donor-recipient matching, transplantation procedures, and transplantation outcomes.  This review contains 4 figures, 7 tables, and 70 references. Keyword: Lung transplant, recipient, donor, brain-dead donor, cadaver, cystic fibrosis, bronchiectasis

scholarly journals Lung transplantation

2015 ◽  
Vol 13 (2) ◽  
pp. 297-304 ◽  
Author(s):  
José Eduardo Afonso Júnior ◽  
Eduardo de Campos Werebe ◽  
Rafael Medeiros Carraro ◽  
Ricardo Henrique de Oliveira Braga Teixeira ◽  
Lucas Matos Fernandes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
New Technologies ◽  
Life Support ◽  
Ex Vivo ◽  
Perioperative Period ◽  
Graft Dysfunction ◽  
Bridge To Transplant

ABSTRACT Lung transplantation is a globally accepted treatment for some advanced lung diseases, giving the recipients longer survival and better quality of life. Since the first transplant successfully performed in 1983, more than 40 thousand transplants have been performed worldwide. Of these, about seven hundred were in Brazil. However, survival of the transplant is less than desired, with a high mortality rate related to primary graft dysfunction, infection, and chronic graft dysfunction, particularly in the form of bronchiolitis obliterans syndrome. New technologies have been developed to improve the various stages of lung transplant. To increase the supply of lungs, ex vivo lung reconditioning has been used in some countries, including Brazil. For advanced life support in the perioperative period, extracorporeal membrane oxygenation and hemodynamic support equipment have been used as a bridge to transplant in critically ill patients on the waiting list, and to keep patients alive until resolution of the primary dysfunction after graft transplant. There are patients requiring lung transplant in Brazil who do not even come to the point of being referred to a transplant center because there are only seven such centers active in the country. It is urgent to create new centers capable of performing lung transplantation to provide patients with some advanced forms of lung disease a chance to live longer and with better quality of life.

scholarly journals Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1387
Author(s):  
Radouane El Ayachy ◽  
Roger Sun ◽  
Kanta Ka ◽  
Adrien Laville ◽  
Anne-Sophie Duhamel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Dose Rate ◽  
Therapeutic Option ◽  
Local Control Rate ◽  
Local Failure ◽  
Life Assessment ◽  
Grade Ii ◽  
Lip Carcinoma ◽  
Pulsed Dose Rate

Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.

Pre-transplant Quality of Life Does Not Predict Survival After Lung Transplantation

2008 ◽  
Vol 27 (6) ◽  
pp. 623-627 ◽  
Author(s):  
Karin M. Vermeulen ◽  
Elisabeth M. TenVergert ◽  
Erik A.M. Verschuuren ◽  
Michiel E. Erasmus ◽  
Wim van der Bij
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation

Prospective Study of Functional Status and Quality of Life Before and After Lung Transplantation

CHEST Journal ◽  
2000 ◽  
Vol 118 (1) ◽  
pp. 115-122 ◽  
Author(s):  
Dorothy M. Lanuza ◽  
Cheryl Lefaiver ◽  
Mary Mc Cabe ◽  
Gabriella A. Farcas ◽  
Edward Garrity
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Lung Transplantation ◽  
Functional Status ◽  
Before And After

Baseline Quality of Life and Anxiety in Solid Organ Transplant Recipients: A Pilot Study

2006 ◽  
Vol 32 (12) ◽  
pp. 1480-1485 ◽  
Author(s):  
FIONA O'REILLY ◽  
CARMEN TRAYWICK ◽  
MICHELLE L. PENNIE ◽  
JOVONNE K. FOSTER ◽  
SUEPHY C. CHEN
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Quality of Life before and after Lung Transplantation in Patients with Emphysema versus other Indications

2001 ◽  
Vol 89 (3) ◽  
pp. 707-717 ◽  
Author(s):  
E. M. TenVergert ◽  
K. M. Vermeulen ◽  
A. Geertsma ◽  
P. J. van Enckevort ◽  
W. J. de Boer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Nottingham Health Profile ◽  
Well Being ◽  
Health Profile ◽  
Health Related Quality ◽  
Before And After ◽  
Related Quality ◽  
Health Related

Whether lung transplantation improves Health-related Quality of Life in patients with emphysema and other end-stage lung diseases before and after lung transplantation was examined. Berween 1992 and 1999, 23 patients with emphysema and 19 patients with other indications completed self-administered questionnaires before lung transplantation, and at 4, 7, 13, and 25 mo. after transplantation. The questionnaire included the Nottingham Health Profile, the State-Trait Anxiety Inventory, the Self-rating Depression Scale, the Index of Well-being, the self-report Karnofsky Index, and four respiratory-specific questions. Neither before nor after transplantation were significant differences found on most dimensions of Health-related Quality of Life between patients with emphysema and other indications. Before transplantation, both groups report major restrictions on the dimensions Energy and Mobility of the Nottingham Health Profile, low experienced well-being, depressive symptoms, and high dyspnea. About 4 mo. after transplantation, most Health-related Quality of Life measures improved significantly in both groups. These improvements were maintained in the following 21 mo.

Effect of Rapid Rehabilitation Concepts on Quality of Life and Pain in Patients Undergoing Radical Breast Cancer Surgery in Perioperative Period

2021 ◽  
Vol 7 (5) ◽  
pp. 1538-1544
Author(s):  
Xin Li ◽  
Hai-yan An ◽  
Yi Zhao ◽  
Mingli Ji ◽  
Jing An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Significant Difference

To study the effect of rapid rehabilitation nursing on patients’ quality of life and pain level during the perioperative period of radical breast cancer surgery. Methods: 126 patients who were hospitalized in our hospital from January 2018 to February 2020 and underwent radical breast cancer surgery were divided into control group and rapid rehabilitation group according to the perioperative period intervention method. Routine nursing intervention and rapid rehabilitation nursing intervention were used respectively. The general conditions of the two groups were recorded, and the differences of T cell subsets before operation and 3 days after operation were detected. Visual analogue pain (VAS) score was used to evaluate the changes of pain degree at 1 day, 3 days and 5 days after operation and on the day of discharge. Postoperative complications and satisfaction were compared between the two groups. Quality of life (QOL) was assessed at 1 month and 3 months after operation using the CARES-SF score. Results: Anesthesia waking time (26.12 ± 5.77) min, off-bed activity time (14.25 ± 2.87) h and hospital stay (7.82 ± 2.15) d in the rapid rehabilitation group were shorter than those in the control group (P < 0.05). The operation time (92.02 ± 14.78) min and intraoperative blood loss (57.96 ± 13.96) mL in the rapid rehabilitation group were not significantly different from those in the control group (P > 0.05). In the control group, 3d after operation, T lymphocyte subsets were decreased gradually than that before operation (P < 0.05), CD3+ was decreased 3d after operation than that before operation in the rapid rehabilitation group (P < 0.05), but CD4+, CD8+, CD4+ / CD8 + 3d after operation had no significant difference than that before operation (P > 0.05). In rapid rehabilitation group, T lymphocyte subsets at 3d after operation were higher than those in the control group (P < 0.05). The postoperative complication rate of the rapid rehabilitation group was lower than that of the control group, and the satisfaction degree was higher than that of the control group, with significant difference (P < 0.05). After follow-up, it was found that the scores of qualities of life, such as physiology, psychosocial, marriage, sexual life and relationship with medical staff in the rapid rehabilitation group were lower than those in the control group at 1 month and 3 months after operation (P < 0.05). Conclusion: The concept of rapid rehabilitation nursing can stabilize the immune function of patients after radical breast cancer surgery, promote the postoperative rehabilitation and improve the quality of life after operation.

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