scholarly journals Imaging indications and findings in evaluation of lung transplant graft dysfunction and rejection

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Mnahi Bin Saeedan ◽  
Sanjay Mukhopadhyay ◽  
C. Randall Lane ◽  
Rahul D. Renapurkar
Keyword(s):  
Differential Diagnosis ◽  
Lung Transplant ◽  
Imaging Features ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Contrast Imaging ◽  
Post Transplantation ◽  
Post Transplant ◽  
End Stage

AbstractLung transplantation is a treatment option in end-stage lung disease. Complications can develop along a continuum in the immediate or longer post-transplant period, including surgical and technical complications, primary graft dysfunction, rejection, infections, post-transplant lymphoproliferative disorder, and recurrence of the primary disease. These complications have overlapping clinical and imaging features and often co-exist. Time of onset after transplant is helpful in narrowing the differential diagnosis. In the early post transplantation period, imaging findings are non-specific and need to be interpreted in the context of the clinical picture and other investigations. In contrast, imaging plays a key role in diagnosing and monitoring patients with chronic lung allograft dysfunction. The goal of this article is to review primary graft dysfunction, acute rejection, and chronic rejection with emphasis on the role of imaging, pathology findings, and differential diagnosis.

scholarly journals Recent advances in lung transplantation

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1684 ◽  
Author(s):  
Keith C Meyer
Keyword(s):  
Lung Transplantation ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Donor Pool ◽  
Post Transplant ◽  
Antibody Mediated Rejection ◽  
The Past ◽  
End Stage ◽  
Transplant Complications

Lung transplantation can improve quality of life and prolong survival for individuals with end-stage lung disease, and many advances in the realms of both basic science and clinical research aspects of lung transplantation have emerged over the past few decades. However, many challenges must yet be overcome to increase post-transplant survival. These include successfully bridging patients to transplant, expanding the lung donor pool, inducing tolerance, and preventing a myriad of post-transplant complications that include primary graft dysfunction, forms of cellular and antibody-mediated rejection, chronic lung allograft dysfunction, and infections. The goal of this manuscript is to review salient recent and evolving advances in the field of lung transplantation.

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.

scholarly journals Liver transplantation in Jehovah's Witnesses: a case series

1969 ◽  
Vol 48 (2) ◽  
pp. 85-90
Author(s):  
Fredy Ariza ◽  
Daniel Arboleda-Palacios ◽  
Sebastian Rosales Hooker-Herrera ◽  
Eliana Manzi-Tarapués ◽  
Luis Armando Caicedo-Rusca
Keyword(s):  
Liver Transplantation ◽  
Cell Mass ◽  
Case Series ◽  
Graft Dysfunction ◽  
Post Transplantation ◽  
Jehovah’S Witnesses ◽  
Intraoperative Bleeding ◽  
Jehovah's Witnesses ◽  
End Stage ◽  
To Receive

Introduction: Orthotopic liver transplantation (OLT) is a procedure characterized by high bleeding rates and a significant likelihood of exposure to blood products. Objectives: This case series shows the experience at a referral center for Jehovah's Witnesses (JW) with end-stage liver disease, undergoing OLT. Materials and methods: A search was conducted in our database of JW undergoing OLT between July 2007 and August 2012. The information about their pre-operative condition and progress up to 30 days post-transplantation. Results: Four subjects were identified (3F/1M) with an average age of 42 years (range 22-55). All of them received a multidisciplinary management which included pre-operative optimization of red cell mass, antifibrinolytic prophylaxis, and cell salvage (mean volume of 344mL [range 113-520]). The average intraoperative bleeding volume was of 625mL (range 300-1000). One of the patients presented with a primary graft dysfunction and died, while the rest had a normal postoperative course. Conclusion: It is possible to offer OLT to patients who refuse to receive allogeneic blood transfusions, through a comprehensive approach that includes perioperative hematologic optimization and the use of blood conservation measures, without a significant impact on the outcomes.

scholarly journals Heart transplantation in the era of COVID-19 pandemic: delirium, post-transplant depression, and visitor restrictions; the role of liaison and inpatient psychosomatic treatment—a case report

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Monika Sadlonova ◽  
Birgit Gerecke ◽  
Christoph Herrmann-Lingen ◽  
Ingo Kutschka
Keyword(s):  
Social Isolation ◽  
Mental Health Professionals ◽  
Heart Transplant ◽  
Oral Intake ◽  
Psychotic Symptoms ◽  
Orthotopic Heart Transplant ◽  
Post Transplant ◽  
Increased Risk ◽  
End Stage

Abstract Background Heart transplant recipients show a high risk of developing major depression with an increased risk of post-transplant morbidity and mortality. Heart transplant specialists and patients face unprecedented challenges during the COVID-19 pandemic, which have enormous clinical implications such as the increased risk of COVID-19 as well as visitor restrictions with social isolation during the post-transplant inpatient treatment. Case summary We present a case of a 64-year-old woman with end-stage heart failure caused by non-compaction cardiomyopathy who received an orthotopic heart transplant (OHT) without any intra-operative complications. Post-operatively, she showed acute psychotic symptoms in the intensive care unit (ICU) with improvement after switching intravenous tacrolimus treatment to an oral intake. Furthermore, the patient developed severe depressive symptoms with malnutrition and had a prolonged hospitalization. Standard medical care was complemented by intensive psychocardiological treatment to overcome the crisis. Conclusion High complexity of the post-transplant management after OHT underlines the importance of multidisciplinary teamwork, involving heart transplant specialists and allied mental health professionals. This collaboration led to an excellent long-term result. Facing the COVID-19 pandemic, the hospital visitor policies may be scrutinized, carefully looking at the role of social isolation, post-operative experience in the ICU, and medical complications after OHT.

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