scholarly journals Current status of lung transplantation

2018 ◽  
pp. 241-262
Author(s):  
Varun Puri ◽  
G. Alexander Patterson
Keyword(s):  
Lung Transplantation ◽  
Causes Of Death ◽  
Surgical Techniques ◽  
Bronchiolitis Obliterans Syndrome ◽  
Current Status ◽  
First Year ◽  
Full Potential ◽  
Optimal Outcomes ◽  
Donor Shortage ◽  
End Stage

Lung transplantation is well established as a viable therapy for end-stage lung disease. Appropriate patient and donor selection, meticulous attention to technique, and continued improvement in the postoperative care of these patients will lead to optimal outcomes. Donor shortage and chronic allograft rejection continue to be the biggest hurdles preventing lung transplantation from reaching its full potential. Indications, recipient selection, donor procurement, surgical techniques, and postoperative outcomes are reviewed. The major identified causes of death in the first 30 days postoperatively are graft failure and non-cytomegalovirus (CMV) infections. After the first year, bronchiolitis obliterans syndrome and non-CMV infections were the predominant causes of death. Death caused by malignancies rises consistently until the 10-year mark, accounting for 12% of all deaths between 5 and 10 years after transplant.

Heart and Heart-Lung Transplantation: An Update

1996 ◽  
Vol 4 (1) ◽  
pp. 4-13
Author(s):  
David D Yuh ◽  
Robert C Robbins ◽  
Bruce A Reitz
Keyword(s):  
Lung Transplantation ◽  
Postoperative Care ◽  
Organ Preservation ◽  
Surgical Techniques ◽  
Organ Shortage ◽  
Transplant Recipients ◽  
Donor Organ ◽  
The West ◽  
Thoracic Transplantation ◽  
End Stage

Heart and heart-lung transplantation have been established as effective treatments for a wide variety of end-stage cardiopulmonary diseases. Recent years have seen refinements in surgical techniques for cardiopulmonary replacement as well as the selection and postoperative care of thoracic transplant recipients. Despite substantial clinical progress, however, significant problems remain, particularly donor organ shortage, graft rejection, opportunistic infection, and limited organ preservation techniques. Basic and clinical research are currently addressing these problems. In this brief review, we provide an update of our experiences with heart and heart-lung transplantation in the West (particularly at Stanford University), an outline of the active issues in the field, and some thoughts about the development of thoracic transplantation in Asia.

Current status of heart transplantation

2018 ◽  
pp. 223-240
Author(s):  
Ayyaz Ali ◽  
Robert L. Kormos
Keyword(s):  
Heart Transplantation ◽  
Cardiac Transplantation ◽  
Organ Procurement ◽  
Severe Heart Failure ◽  
Surgical Techniques ◽  
Current Status ◽  
Definitive Treatment ◽  
Term Survival ◽  
The Many ◽  
End Stage

Cardiac transplantation has extended and improved the lives of patients suffering from severe heart failure over many decades. Despite advances in medical therapy, cardiac transplantation remains the definitive treatment for end-stage heart disease. Surgical techniques for organ procurement and implantation, development of appropriate methods for preserving the heart, and understanding the immunological challenges associated with transplantation were among the many areas which required focused investigation. In the current era, heart transplantation is associated with a low operative mortality and excellent long-term survival, however, the major obstacle of shortage of suitable donor organs remains. In the following chapter, recipient selection and management, donor organ procurement and preservation, and surgical techniques of heart transplantation are described in detail.

Chronic Lung Allograft Dysfunction: Evolving Concepts and Therapies

2018 ◽  
Vol 39 (02) ◽  
pp. 155-171 ◽  
Author(s):  
Ariss DerHovanessian ◽  
W. Wallace ◽  
Joseph Lynch ◽  
John Belperio ◽  
S. Weigt
Keyword(s):  
Lung Transplantation ◽  
Therapeutic Option ◽  
Bronchiolitis Obliterans Syndrome ◽  
Term Survival ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Restrictive Allograft Syndrome ◽  
Technical Advances ◽  
End Stage

AbstractLung transplantation has become an established therapeutic option for a variety of end-stage lung diseases. Technical advances in graft procurement, implantation, perioperative care, immunosuppression, and posttransplant medical management have led to significant improvements in 1-year survival, but outcomes after the first year have improved minimally over the last two decades. The main limitation to better long-term survival after lung transplantation is chronic lung allograft dysfunction (CLAD). CLAD also impairs quality of life and increases the costs of medical care. Our understanding of CLAD manifestations, risk factors, and mechanisms is rapidly evolving. Recognition of different CLAD phenotypes (e.g., bronchiolitis obliterans syndrome and restrictive allograft syndrome) and the unique pathogenic mechanisms will be important for developing novel therapies. In addition to alloimmune-mediated rejection, we now recognize the importance of alloimmune-independent mechanisms of injury to the allograft. CLAD is the consequence of dysregulated repair of allograft injury. Unfortunately, currently available therapies for CLAD are usually not effective. However, the advances in knowledge, reviewed in this manuscript, should lead to novel strategies for CLAD prevention and treatment, as well as improvement in long-term outcomes after lung transplantation. We provide an overview of the evolving terminology related to CLAD, its varying clinical phenotypes and their diagnosis, natural history, pathogenesis, and potential treatments.

Paediatric heart transplantation: an update

2019 ◽  
Vol 104 (12) ◽  
pp. 1216-1222
Author(s):  
Zdenka Reinhardt
Keyword(s):  
Heart Transplantation ◽  
Organ Procurement ◽  
Surgical Techniques ◽  
Immunosuppressive Drugs ◽  
Lymphoproliferative Disease ◽  
Current Status ◽  
Term Survival ◽  
Post Transplant ◽  
Monitoring Strategies ◽  
End Stage

Heart transplantation is a standard treatment for selected paediatric patients with end-stage heart disease. With improvement in surgical techniques, organ procurement and preservation strategies, immunosuppressive drugs, and more sophisticated monitoring strategies, survival following transplantation has increased over time. However, rejection, infection, renal failure, post-transplant lymphoproliferative disease and post-transplant cardiac allograft vasculopathy still preclude long-term survival. Therefore, continued multidisciplinary scientific efforts are needed for future gains. This review focuses on the current status, outcomes and ongoing challenges including patient selection, indications and contraindications, national and international survivals, post-transplant complications and quality of life.

Clinical Lung Transplantation - Current Status

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 216-222 ◽  
Author(s):  
de Perrot
Keyword(s):  
Lung Transplantation ◽  
Lung Diseases ◽  
Postoperative Management ◽  
Current Status ◽  
Lung Preservation ◽  
Technical Details ◽  
End Stage ◽  
Transplant Procedure ◽  
Made In

Since 1983, lung transplantation has enjoyed increasing success and has become the mainstay of therapy for most end-stage lung diseases. While the first decade of clinical lung transplantation focused on technical details of the transplant procedure, the second decade was characterized by improvements in techniques of lung preservation and in the postoperative management. This review will focus on the recent improvements made in lung preservation and postoperative management.

scholarly journals Spirometric assessment of lung transplanted patients: one year follow-up

2008 ◽  
Vol 11 (4) ◽  
pp. 1014-1019
Author(s):  
Paulo Pêgo-Fernandes ◽  
Fernando Conrado Abrão ◽  
Frederico Leon Arrabal Fernandes ◽  
Marlova Caramori ◽  
Marcos Naoyuki Samano ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Statistical Difference ◽  
Therapeutic Option ◽  
Surgical Techniques ◽  
First Year ◽  
One Year ◽  
Transplant Procedure

Purpose: The purpose of this study was to compare spirometric data between patients submitted to single-lung and double-lung transplantation along the first year after the transplant procedure. Introduction: Lung transplant was first described as an experimental method in 1963; it became a therapeutic option for patients with advanced pulmonary diseases due to improvements in the organ conservation, surgical techniques, immunosuppressive therapy, and treatment of post-operative infections. Methods: We retrospectively reviewed records of 39 patients, who received lung transplantation in our institution between August, 2003 and August, 2006. The Post-transplant survival after 1 year occurred in 29 patients, and all of them were followed-up. Results: Increase of the lung function in double-lung transplant group occurred earlier, presenting statistical difference after the 1st month both in the FEV1 and FVC compared to pre-transplant values (p <0.05). As to the group of patients with emphysema, comparison between two groups showed from the 3rd month a difference of the lung function. Discussion: Both analysis of the whole group added to the subgroup of emphysema patients supplied relevant data that points out the advantage of the bilateral over the unilateral transplantation. Although values of pre-transplant lung function were worse in the double-lung group, such difference did not occur again in the subsequent months to the surgery. Conclusion: There was a clear tendency to higher and earlier improvement in FVC and FEV1 in the bilateral transplant group.

Learning Analytics Considered Harmful

2012 ◽  
Vol 16 (3) ◽  
Author(s):  
Laurie P Dringus
Keyword(s):  
Big Data ◽  
Online Learning ◽  
Learning Analytics ◽  
Online Courses ◽  
Research Community ◽  
Current Status ◽  
Online Course ◽  
Full Potential

This essay is written to present a prospective stance on how learning analytics, as a core evaluative approach, must help instructors uncover the important trends and evidence of quality learner data in the online course. A critique is presented of strategic and tactical issues of learning analytics. The approach to the critique is taken through the lens of questioning the current status of applying learning analytics to online courses. The goal of the discussion is twofold: (1) to inform online learning practitioners (e.g., instructors and administrators) of the potential of learning analytics in online courses and (2) to broaden discussion in the research community about the advancement of learning analytics in online learning. In recognizing the full potential of formalizing big data in online coures, the community must address this issue also in the context of the potentially "harmful" application of learning analytics.

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