scholarly journals Exacerbation of Pulmonary Fibrosis Following Single Lung Transplantation

2012 ◽  
Vol 19 (1) ◽  
pp. e3-e4 ◽  
Author(s):  
Dawei Yang ◽  
Jennifer M Wilson ◽  
Chunxue Bai ◽  
John Yee ◽  
Pearce G Wilcox ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Acute Exacerbation ◽  
Thromboembolic Disease ◽  
Single Lung Transplantation ◽  
Maintenance Immunosuppression ◽  
Native Lung ◽  
Acute Exacerbations

Acute exacerbations of interstitial lung disease present as clinical deteriorations, with progressive hypoxemia and parenchymal consolidation not related to infection, heart failure or thromboembolic disease. Following single lung transplantation, patients receive maintenance immunosuppression, which could mitigate the development of acute exacerbations in the native lung. A 66-year-old man with fibrotic, nonspecific interstitial pneumonitis presented with fever, hypoxemia and parenchymal consolidation limited to the native lung four years after single lung transplantation. Investigations were negative for infection, heart failure and thromboembolic disease. The patient worsened over the course of one week despite broad-spectrum antimicrobial therapy, but subsequently improved promptly with augmentation of prednisone dosed to 50 mg daily and addition of N-acetylcysteine. Hence, the patient fulfilled the criteria for a diagnosis of an acute exacerbation of pulmonary fibrosis in his native lung. Clinicians should consider acute exacerbation of parenchymal lung disease of the native lung in the differential diagnosis of progressive respiratory deterioration following single lung transplantation for pulmonary fibrosis.

Acute Exacerbation Of Pulmonary Fibrosis Following Single Lung Transplantation

2011 ◽  
Author(s):  
Da-wei Yang ◽  
Jennifer M. Wilson ◽  
Chun-xue Bai ◽  
John Yee ◽  
Pearce G. Wilcox ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Acute Exacerbation ◽  
Single Lung Transplantation

scholarly journals Acute worsening of native lung fibrosis after single lung transplantation for pulmonary fibrosis: two case reports

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Tiphaine Goletto ◽  
Sixtine Decaux ◽  
Vincent Bunel ◽  
Gaëlle Weisenburger ◽  
Jonathan Messika ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Viral Infection ◽  
Lung Fibrosis ◽  
Case Reports ◽  
Rapid Progression ◽  
Single Lung Transplantation ◽  
Native Lung

Abstract Background In patients receiving single lung transplantation for idiopathic pulmonary fibrosis, worsening of fibrosis of the native lung is usually progressive over time, with no significant effects on gas exchange. Case presentation Here, we describe the cases of two Caucasian male recipients of single lung transplants for idiopathic pulmonary fibrosis, 65 and 62 years of age, who exhibited acute worsening of lung fibrosis after an episode of serious viral infection (cytomegalovirus primo-infection in one case and COVID-19 in the other). In both cases, along with opacification of the native lung over several days, the patients presented acute respiratory failure that required the use of high-flow nasal oxygen therapy. Eventually, hypoxemic respiratory failure resolved, but with rapid progression of fibrosis of the native lung. Conclusion We conclude that acute worsening of fibrosis on the native lung secondary to a severe viral infection should be added to the list of potential complications developing on the native lung after single lung transplantation for idiopathic pulmonary fibrosis.

Pharmacotherapy of Lung Transplantation

2012 ◽  
Vol 26 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Melissa L. Thompson ◽  
Jeremy D. Flynn ◽  
Timothy M. Clifford
Keyword(s):  
T Cell ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Lung Disease ◽  
T Cell Activation ◽  
Chronic Obstructive ◽  
Induction Agent ◽  
High Dose ◽  
Maintenance Immunosuppression ◽  
End Stage

Lung transplantation has become a viable treatment therapy for end-stage lung disease patients. The most common etiologies of end-stage lung disease, which can require a transplant are chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), pulmonary arterial hypertension (PAH), and pulmonary fibrosis (PF). Listing criteria are institution and program specific. Approximately 1500 lung transplants were performed in 2008; and at 5 years post transplant, one-half are expected to survive. The surgery itself is associated with various complications, including surgical, infectious, and mechanical. Immunosuppression is paramount to the management of these patients, the goal being prevention of T cell activation to prevent rejection of the new organ. The patients commonly receive an induction agent with a T cell depleting antibody and high-dose corticosteroids. Maintenance immunosuppression begins immediately after the surgery, consisting of a combination of a calcineurin inhibitor, antimetabolite, and corticosteroids. Side effect profiles from the various agents will determine the choice of agents, and patients may have modifications throughout the therapy. The role of the pharmacist spans the inpatient management of acute complications to medication selection, management of maintenance immunosuppression, as well as monitoring for adverse drug reactions and drug–drug interactions. A multidisciplinary collaborative approach must be taken to ensure the best outcomes for this patient population.

Cardiopulmonary Exercise Responses after Single Lung Transplantation for Severe Obstructive Lung Disease

CHEST Journal ◽  
1991 ◽  
Vol 100 (1) ◽  
pp. 106-111 ◽  
Author(s):  
William J. Gibbons ◽  
Stephanie M. Levine ◽  
Charles L. Bryan ◽  
Jay Segarra ◽  
John H. Calhoon ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Single Lung Transplantation ◽  
Cardiopulmonary Exercise

Thoracoscopic Volume Reduction of the Native Lung after Single Lung Transplantation for Emphysema

1998 ◽  
Vol 157 (1) ◽  
pp. 292-293 ◽  
Author(s):  
FEDERICO VENUTA ◽  
TIZIANO DE GIACOMO ◽  
ERINO A. RENDINA ◽  
GIORGIO DELLA ROCCA ◽  
ISAC FLAISHMAN ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Volume Reduction ◽  
Single Lung Transplantation ◽  
Native Lung

scholarly journals Lung transplantation for patients with severe COVID-19

2020 ◽  
Vol 12 (574) ◽  
pp. eabe4282 ◽  
Author(s):  
Ankit Bharat ◽  
Melissa Querrey ◽  
Nikolay S. Markov ◽  
Samuel Kim ◽  
Chitaru Kurihara ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Single Cell ◽  
Rna Sequencing ◽  
Lung Tissue ◽  
Single Molecule ◽  
Sequencing Data ◽  
Native Lung ◽  
Single Cell Rna Sequencing

Lung transplantation can potentially be a life-saving treatment for patients with nonresolving COVID-19–associated respiratory failure. Concerns limiting lung transplantation include recurrence of SARS-CoV-2 infection in the allograft, technical challenges imposed by viral-mediated injury to the native lung, and the potential risk for allograft infection by pathogens causing ventilator-associated pneumonia in the native lung. Additionally, the native lung might recover, resulting in long-term outcomes preferable to those of transplant. Here, we report the results of lung transplantation in three patients with nonresolving COVID-19–associated respiratory failure. We performed single-molecule fluorescence in situ hybridization (smFISH) to detect both positive and negative strands of SARS-CoV-2 RNA in explanted lung tissue from the three patients and in additional control lung tissue samples. We conducted extracellular matrix imaging and single-cell RNA sequencing on explanted lung tissue from the three patients who underwent transplantation and on warm postmortem lung biopsies from two patients who had died from COVID-19–associated pneumonia. Lungs from these five patients with prolonged COVID-19 disease were free of SARS-CoV-2 as detected by smFISH, but pathology showed extensive evidence of injury and fibrosis that resembled end-stage pulmonary fibrosis. Using machine learning, we compared single-cell RNA sequencing data from the lungs of patients with late-stage COVID-19 to that from the lungs of patients with pulmonary fibrosis and identified similarities in gene expression across cell lineages. Our findings suggest that some patients with severe COVID-19 develop fibrotic lung disease for which lung transplantation is their only option for survival.

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