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.

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.

Pediatric Recipients of Living Donor Lobar Lung Transplants: Postoperative Care

2002 ◽  
Vol 12 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Monica V. Horn ◽  
Felicia A. Schenkel ◽  
Marlyn S. Woo ◽  
Vaughn A. Starnes
Keyword(s):  
Postoperative Care ◽  
Living Donor ◽  
Lung Transplant ◽  
Fluid Management ◽  
Transplant Recipients ◽  
Intraoperative Management ◽  
Lung Transplants ◽  
Tube Suction ◽  
Lung Transplant Recipients ◽  
End Stage

Bilateral living donor lobar lung transplantation is a treatment option for selected children and adults with end-stage lung disease. Careful donor evaluation, skilled intraoperative management and surgical technique, and diligent immediate postoperative care and follow-up all contribute to better outcomes. Although medical management of whole lung transplant recipients in the immediate postoperative period is similar to that of lobar lung transplant recipients, there are specific differences. Anatomical distinctions, such as the entire cardiac output flowing to 2 lobes instead of 5, and thoracic space issues with simultaneous mechanical ventilation and chest tube suction, contribute to these differences. Early postoperative care, including initial postoperative stabilization, ventilation, fluid management, rejection/infection surveillance and prophylaxis, and beginning rehabilitation, can be adapted to ensure successful outcomes in these patients.

scholarly journals Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2884
Author(s):  
Mara Weber Gulling ◽  
Monica Schaefer ◽  
Laura Bishop-Simo ◽  
Brian C. Keller
Keyword(s):  
Body Composition ◽  
Lung Transplantation ◽  
Body Mass ◽  
Lung Transplant ◽  
Assessment Tools ◽  
Transplant Recipients ◽  
Body Composition Assessment ◽  
Lung Transplant Recipients ◽  
End Stage

Lung transplantation offers patients with end-stage lung disease an opportunity for a better quality of life, but with limited organ availability it is paramount that selected patients have the best opportunity for successful outcomes. Nutrition plays a central role in post-surgical outcomes and, historically, body mass index (BMI) has been used as the de facto method of assessing a lung transplant candidate’s nutritional status. Here, we review the historical origins of BMI in lung transplantation, summarize the current BMI literature, and review studies of alternative/complementary body composition assessment tools, including lean psoas area, creatinine-height index, leptin, and dual x-ray absorptiometry. These body composition measures quantify lean body mass versus fat mass and may provide a more comprehensive analysis of a patient’s nutritional state than BMI alone.

Intensive care management in lung transplantation

2016 ◽  
Author(s):  
Keshava Rajagopal ◽  
Bartley P. Griffith
Keyword(s):  
Transplant Recipient ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Care Management ◽  
Transplant Recipients ◽  
Acute Allograft Rejection ◽  
Donor Organ ◽  
System Review ◽  
Lung Transplant Recipients ◽  
Transplantation Procedures

Lung transplant recipients are among the most complex critically-ill patients in the peri-transplant phase. In this chapter, a comprehensive multi-organ system review of lung transplant recipient management is undertaken, after a brief summary of the pre-implantation donor organ management and the conduct of the transplantation procedures themselves. Specific issues addressed that are unique to the transplant recipient include technical complications, primary allograft dysfunction, and hyperacute and acute allograft rejection. Since issues in heart and lung transplantation are reviewed separately, heart-lung transplantation is not discussed as an independent topic.

Intensive care management in cardiac transplantation

2016 ◽  
Author(s):  
Keshava Rajagopal ◽  
Bartley P. Griffith
Keyword(s):  
Transplant Recipient ◽  
Lung Transplantation ◽  
Care Management ◽  
Heart Transplant Recipient ◽  
Cardiac Transplant ◽  
Transplant Recipients ◽  
Acute Allograft Rejection ◽  
Donor Organ ◽  
System Review ◽  
Transplantation Procedures

Cardiac transplant recipients are among the most complex critically-ill patients in the peri-transplant phase. In this chapter, a comprehensive multi-organ system review of heart transplant recipient management is undertaken, after a brief summary of the pre-implantation donor organ management and the conduct of the transplantation procedures themselves. Specific issues addressed that are unique to the transplant recipient include technical complications, primary allograft dysfunction, and hyperacute and acute allograft rejection. Since issues in heart and lung transplantation are reviewed separately, heart–lung transplantation is not discussed as an independent topic.

scholarly journals Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

2019 ◽  
Author(s):  
Mara Weber Gulling ◽  
Monica Schaefer ◽  
Laura Bishop-Simo ◽  
Brian C. Keller
Keyword(s):  
Body Composition ◽  
Lung Transplantation ◽  
Body Mass ◽  
Lung Transplant ◽  
Assessment Tools ◽  
Transplant Recipients ◽  
Body Composition Assessment ◽  
Lung Transplant Recipients ◽  
End Stage

Lung transplantation offers patients with end stage lung disease an opportunity for a better quality of life, but with limited organ availability it is paramount that selected patients have the best opportunity for successful outcomes. Nutrition plays a central role in post-surgical outcomes and historically, body mass index (BMI) has been used as the de facto method of assessing a lung transplant candidate’s nutritional status. Here we review the historical origins of BMI in lung transplantation, summarize the current BMI literature, and review studies of alternative/complementary body composition assessment tools, including lean psoas area, creatinine-height index, leptin, and dual x-ray absorptometry. These body composition measures quantify lean body mass versus fat mass and may provide a more comprehensive analysis of a patient’s nutritional state than BMI alone.

Size-reduced lung transplantation: An advanced operative strategy to alleviate donor organ shortage

2004 ◽  
Vol 36 (9) ◽  
pp. 2801-2805 ◽  
Author(s):  
C. Aigner ◽  
G. Winkler ◽  
P. Jaksch ◽  
J. Ankersmit ◽  
G. Marta ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Organ Shortage ◽  
Donor Organ ◽  
Operative Strategy

Health Literacy Among Swedish Lung Transplant Recipients 1 to 5 Years After Transplantation

2018 ◽  
Vol 28 (4) ◽  
pp. 338-342 ◽  
Author(s):  
Annette Lennerling ◽  
Annika M. Kisch ◽  
Anna Forsberg
Keyword(s):  
Health Literacy ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Medical Information ◽  
Self Management ◽  
Transplant Recipients ◽  
Cross Sectional ◽  
Work Health ◽  
Lung Transplant Recipients ◽  
Thoracic Transplantation

Introduction: Understanding medical information and self-management ability is vital for good quality of life among transplant recipients. However, health literacy (HL) has never been investigated among lung transplant recipients. Objective: This study investigated HL among Swedish lung transplant recipients 1 to 5 years after lung transplantation in relation to recovery, fatigue, adherence, cognitive function (CF), and relevant demographic variables. Method: This study was part of a cross-sectional, Swedish multicenter study 1 to 5 years post lung transplantation called Self-Management after Thoracic Transplantation. In total, 117 (57%) of 204 eligible lung recipients due for their yearly follow-up were included; 1 year (n = 35), 2 years (n = 28), 3 years (n = 23), 4 years (n = 20) or 5 years (n = 11) after transplantation. The newest vital sign (NVS) instrument was used to measure the level of HL and contained 6 interview questions. The total scores ranged from 0 to 6 with 0 to 1= inadequate/low, 2 to 3 = marginal, 4 to 6 = adequate/good HL. Results: Twenty-one percent reported an NVS score of 0 to 3 indicating low or marginal HL and 79% scored 4 to 6 indicating adequate HL. Recipients scoring low or marginal were represented in all 5 years posttransplant, and the majority were not able to work. Health literacy was not related to age, sex, fatigue, adherence, recovery, marital status, or self-reported CF. Discussion: Health literacy was good among Swedish lung recipients. Providers should be aware that patients with low HL might present at any time posttransplant, and screening will help identify patients who need extra support.

scholarly journals The Lived Experiences of Caregivers of Lung Transplant Recipients

2021 ◽  
pp. 152692482110460
Author(s):  
Joy A. Glaze ◽  
Dorothy Brooten ◽  
Jo Anne Youngblut ◽  
Jean Hannan ◽  
Timothy Page
Keyword(s):  
Lung Transplantation ◽  
Lung Transplant ◽  
Healthcare Providers ◽  
The Elderly ◽  
Lifestyle Changes ◽  
Basic Knowledge ◽  
Transplant Recipients ◽  
Data Saturation ◽  
Lung Transplant Recipients ◽  
End Stage

Introduction Lung transplantation is a treatment crucial for the survival of patients with end-stage lung diseases. An identified caregiver is obligatory for a patient to be eligible for a lung transplant and plays an essential role in the transplant recipient's care. Most caregiver research, however, has been on caregivers of persons with Alzheimer's disease or the elderly, with limited research on caregivers’ experiences caring for transplant recipients. This study examined the experiences of caregivers of recipient's pre- and post-lung transplantation. Methods/Approach Caregivers of lung transplant recipients were recruited using purposeful sampling. Audiotaped semi-structured open ended interviews were conducted until data saturation. Each interview was transcribed verbatim, and conventional content analysis performed to extract significant themes and subthemes. Findings Four main themes and 12 sub-themes were identified. The former included (1) establishing the diagnosis, (2) caregiver roles, (3) caregiver psychological and psychosocial issues, and (4) support. Caregivers lacked basic knowledge related to lung transplantation. The caregivers’ roles necessitated rearranging priorities, lifestyle changes, and redirecting emotional and physical energy. Support played an important role in caregiving experiences. Discussion Each caregiver shared their unique caregiving experiences. Caregivers lack knowledge about transplantation, experience dramatic changes in their family life, social activities, employment, and often financial status. Healthcare providers can use the findings of this study in developing informational, and psychological interventions to alleviate caregivers’ stress and anxiety.

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