Left lower lobar lung transplant

2021 ◽  
Keyword(s):  
Lung Transplant ◽  
Therapeutic Option ◽  
Small Body ◽  
Lower Lobe ◽  
Left Upper Lobectomy ◽  
Life Saving ◽  
Effective Therapeutic Option ◽  
Body Sizes ◽  
Size Discrepancy ◽  
End Stage

A lung transplant is an effective therapeutic option for selected patients with end-stage lung diseases. The shortage of donors is a major limitation for this life-saving therapy, especially in patients with small body sizes or with reduced thoracic cavities, who usually wait longer for grafts with adequate dimensions. Nonanatomic or sublobar graft resections can be sufficient in cases of a small size discrepancy between the donor and the recipient; however, in cases of a greater size mismatch, lobar reduction is mandatory but, because of the associated technical difficulties, only a few centers have adopted this procedure as part of their routine clinical practice. We describe a left upper lobectomy performed at the back table and the subsequent implantation of the left lower lobe in the recipient’s chest cavity.

scholarly journals Convalescent Plasma Therapy: An Effective Therapeutic Option to Treat COVID-19? A Narrative Review

2020 ◽  
Vol Volume 8 ◽  
pp. 7-21
Author(s):  
Ishita Ray ◽  
Diana Fiorela Sánchez ◽  
Chris Andrea Robert ◽  
Mary Phyllis Robert
Keyword(s):  
Therapeutic Option ◽  
Narrative Review ◽  
Plasma Therapy ◽  
Effective Therapeutic Option

scholarly journals Patient profiles as an aim to optimize selection in the second line setting: the role of aflibercept

2021 ◽  
Author(s):  
B. González Astorga ◽  
F. Salvà Ballabrera ◽  
E. Aranda Aguilar ◽  
E. Élez Fernández ◽  
P. García-Alfonso ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Therapeutic Option ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Effective Therapeutic Option ◽  
Line Setting ◽  
First Line Treatment

AbstractColorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient’s profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.

scholarly journals Zebrafish as a New Tool in Heart Preservation Research

2021 ◽  
Vol 8 (4) ◽  
pp. 39
Author(s):  
Luciana Da Silveira Cavalcante ◽  
Shannon N. Tessier
Keyword(s):  
New Technologies ◽  
Ex Vivo ◽  
Machine Perfusion ◽  
Life Saving ◽  
First Choice ◽  
Heart Preservation ◽  
End Stage Heart Failure ◽  
Ischemia Tolerance ◽  
The 1960S ◽  
End Stage

Heart transplantation became a reality at the end of the 1960s as a life-saving option for patients with end-stage heart failure. Static cold storage (SCS) at 4–6 °C has remained the standard for heart preservation for decades. However, SCS only allows for short-term storage that precludes optimal matching programs, requires emergency surgeries, and results in the unnecessary discard of organs. Among the alternatives seeking to extend ex vivo lifespan and mitigate the shortage of organs are sub-zero or machine perfusion modalities. Sub-zero approaches aim to prolong cold ischemia tolerance by deepening metabolic stasis, while machine perfusion aims to support metabolism through the continuous delivery of oxygen and nutrients. Each of these approaches hold promise; however, complex barriers must be overcome before their potential can be fully realized. We suggest that one barrier facing all experimental efforts to extend ex vivo lifespan are limited research tools. Mammalian models are usually the first choice due to translational aspects, yet experimentation can be restricted by expertise, time, and resources. Instead, there are instances when smaller vertebrate models, like the zebrafish, could fill critical experimental gaps in the field. Taken together, this review provides a summary of the current gold standard for heart preservation as well as new technologies in ex vivo lifespan extension. Furthermore, we describe how existing tools in zebrafish research, including isolated organ, cell specific and functional assays, as well as molecular tools, could complement and elevate heart preservation research.

scholarly journals Preparedness for transplantation during COVID-19 outbreak: how to manage?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Valdi ◽  
G Varadi ◽  
A Panzera ◽  
M Parpinel ◽  
R Peressutti
Keyword(s):  
Organ Transplantation ◽  
Task Force ◽  
Emergency Situation ◽  
Donor Pool ◽  
Surge Capacity ◽  
Emergency Procedures ◽  
Life Saving ◽  
Critical Patients ◽  
End Stage ◽  
Assessment Procedures

Abstract Problem When WHO declared COVID-19 “international”, it was important not to damage some critical patients who need emergency procedures like organ transplantation, due to end stage organ disease. In 2003 SARS outbreak demonstrated the vulnerability of organ transplantation services o network. Descritption If transplantation is required as a life-saving procedure, it can be conducted with appropriate risk infection assessment. It is crucial during these emergencies to assess donor pool, as it is expected to decrease. A crucial point is to organize and evaluate the surge capacity, in terms of understaffing and lack of supplies, especially in ICU. The research methods were literature review using Pub Med, CDC, ECDC, WHO, TTS, searching as key words “SARS-CoV-2”, “COVID-19”, “transplantation”, “preparedness”. The analysis has been conducted between Feb 26th 2020 and March 5th 2020. Results As happened during SARS breakout in 2003, it is essential to establish a task force for crisis, currently updated and skilled for this particular management. Preparedness should regard especially the adoption of donor safety assessment procedures, ICU capability, the availability of covid-19 test for all the donors, and the adoption of specific post-transplant care. It is essential in this case establish preparedness in several points: education and training of the staff, practice drills, inspection of supplies, evaluation of surge capacity, relocation of patients. Lessons SARS-CoV-2 imposed in public health to establish new protocols and guidelines, which should be regularly updated to be useful in other epidemics outbreaks or other emergency situation. These protocols should focus on donor pool and ICU capability in order to carry on transplantation activities. Key messages This outbreak has tested the resilience of the whole system by day-by-day updating for transplantation teams and preparedness of the staff involved in transplantation management. During outbreak, seems to be useful a task force for crisis in order to support organ transplantation services.

The Need for Consensus About Liver Transplantation For Patients With Neuropsychiatric Wilson’s Disease

2021 ◽  
pp. 152692482110028
Author(s):  
Alberto Ferrarese ◽  
Patrizia Burra
Keyword(s):  
Liver Transplantation ◽  
Patient Outcomes ◽  
Wilson’S Disease ◽  
Therapeutic Option ◽  
Copper Metabolism ◽  
Wilson's Disease ◽  
Published Data ◽  
Neurological Improvement ◽  
Effective Therapeutic Option

Liver transplantation is considered an effective therapeutic option for Wilson’s disease (WD) patients with hepatic phenotype, since it removes the inherited defects of copper metabolism, and is associated with excellent graft and patient outcomes. The role of liver transplantation in WD patients with mixed hepatic and neuropsychiatric phenotype has remained controversial over time, mainly because of high post-operative complications, reduced survival and a variable, unpredictable rate of neurological improvement. This article critically discusses the recently published data in this field, focussing in more detail on isolated neuropsychiatric phenotype as a potential indication for liver transplantation in WD patients.

scholarly journals Protection of Residual Renal Function and Nutritional Treatment: First Step Strategy for Reduction of Uremic Toxins in End-Stage Kidney Disease Patients

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 289
Author(s):  
Adamasco Cupisti ◽  
Piergiorgio Bolasco ◽  
Claudia D’Alessandro ◽  
Domenico Giannese ◽  
Alice Sabatino ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Residual Renal Function ◽  
The Body ◽  
Uremic Toxins ◽  
End Stage Kidney Disease ◽  
Waste Products ◽  
Hemodialysis Treatment ◽  
Life Saving ◽  
Kidney Replacement Therapy ◽  
End Stage

The retention of uremic toxins and their pathological effects occurs in the advanced phases of chronic kidney disease (CKD), mainly in stage 5, when the implementation of conventional thrice-weekly hemodialysis is the prevalent and life-saving treatment. However, the start of hemodialysis is associated with both an acceleration of the loss of residual kidney function (RKF) and the shift to an increased intake of proteins, which are precursors of uremic toxins. In this phase, hemodialysis treatment is the only way to remove toxins from the body, but it can be largely inefficient in the case of high molecular weight and/or protein-bound molecules. Instead, even very low levels of RKF are crucial for uremic toxins excretion, which in most cases are protein-derived waste products generated by the intestinal microbiota. Protection of RKF can be obtained even in patients with end-stage kidney disease (ESKD) by a gradual and soft shift to kidney replacement therapy (KRT), for example by combining a once-a-week hemodialysis program with a low or very low-protein diet on the extra-dialysis days. This approach could represent a tailored strategy aimed at limiting the retention of both inorganic and organic toxins. In this paper, we discuss the combination of upstream (i.e., reduced production) and downstream (i.e., increased removal) strategies to reduce the concentration of uremic toxins in patients with ESKD during the transition phase from pure conservative management to full hemodialysis treatment.

scholarly journals Anti-neoplastic Potential of Flavonoids and Polysaccharide Phytochemicals in Glioblastoma

Molecules ◽  
2020 ◽  
Vol 25 (21) ◽  
pp. 4895
Author(s):  
Ayesha Atiq ◽  
Ishwar Parhar
Keyword(s):  
Cancer Progression ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Current Standard ◽  
Pharmacological Agents ◽  
Initiation Phase ◽  
Therapeutic Outcomes ◽  
Effective Therapeutic Option ◽  
Patient Prognosis

Clinically, gliomas are classified into four grades, with grade IV glioblastoma multiforme being the most malignant and deadly, which accounts for 50% of all gliomas. Characteristically, glioblastoma involves the aggressive proliferation of cells and invasion of normal brain tissue, outcomes as poor patient prognosis. With the current standard therapy of glioblastoma; surgical resection and radiotherapy followed by adjuvant chemotherapy with temozolomide, it remains fatal, because of the development of drug resistance, tumor recurrence, and metastasis. Therefore, the need for the effective therapeutic option for glioblastoma remains elusive. Previous studies have demonstrated the chemopreventive role of naturally occurring pharmacological agents through preventing or reversing the initiation phase of carcinogenesis or arresting the cancer progression phase. In this review, we discuss the role of natural phytochemicals in the amelioration of glioblastoma, with the aim to improve therapeutic outcomes, and minimize the adverse side effects to improve patient’s prognosis and enhancing their quality of life.

Topical Kanamycin: an Effective Therapeutic Option in Aerobic Vaginitis

2006 ◽  
Vol 18 (4) ◽  
pp. 409-414 ◽  
Author(s):  
G. Tempera ◽  
G. Abbadessa ◽  
G. Bonfiglio ◽  
E. Cammarata ◽  
A. Cianci ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Aerobic Vaginitis ◽  
Effective Therapeutic Option

scholarly journals Innovative Biotechnology for Generation of Cardiac Tissue

2021 ◽  
Vol 11 (12) ◽  
pp. 5603
Author(s):  
Greta Ionela Barbulescu ◽  
Florina Maria Bojin ◽  
Valentin Laurentiu Ordodi ◽  
Iacob Daniel Goje ◽  
Taddeus Paul Buica ◽  
...  
Keyword(s):  
Stem Cells ◽  
Electric Field ◽  
Cardiac Tissue ◽  
Sodium Dodecyl ◽  
Human Mesenchymal Stem Cells ◽  
Coronary Perfusion ◽  
Decellularized Extracellular Matrix ◽  
Life Saving ◽  
Cellular Debris ◽  
End Stage

Heart transplantation remains the only curative treatment for end-stage heart failure. This life-saving option continues to be limited by the low number of organ donors, graft rejection and adverse effects of immunosuppressants. Engineering bioartificial hearts from acellular native-derived scaffolds and stem cells has gained attention because of its potential to overcome these limitations. In this study, rat hearts (n = 20) were decellularized by means of coronary perfusion with 1% sodium dodecyl sulfate (SDS) in a modified Langendorff device. The electrical field behavior of the SDS molecule was studied and it was assumed that when applying an alternating current, the exposure time of the tissue to the detergent might decrease. To repopulate the decellularized extracellular matrix (ECM), human mesenchymal stem cells (hMSCs) were used, induced to differentiate into cardiomyocytes (CMs) with 5-azacytidine (5-aza). The results showed no cellular debris and an intact ECM following decellularization. Decellularization in the presence of an electric field proved to be faster, decreasing the potential risk of ECM damage due to the detergent. After cell seeding and culturing of eight scaffolds with hMSCs, the recellularization process was analyzed using optic microscopy (OM), which showed cells suggestive for CMs. This study presents a novel and efficient decellularization protocol using an electric field and suggests that hMSCs can be useful in the generation of a bioartificial heart.

Pancreas Allograft Biopsies in the Management of Pancreas Transplant Recipients: Histopathologic Review and Clinical Correlations

2007 ◽  
Vol 131 (8) ◽  
pp. 1192-1199
Author(s):  
Lillian W. Gaber
Keyword(s):  
Pancreas Transplantation ◽  
Therapeutic Option ◽  
Pancreas Transplant ◽  
Close Monitoring ◽  
Transplant Recipients ◽  
Systemic Complications ◽  
Histologic Evaluation ◽  
Insulin Dependent ◽  
Pancreas Allograft ◽  
End Stage

Abstract Context.—Pancreas transplantation has become a therapeutic option for patients with type 1 diabetes mellitus who are in end-stage renal failure. It also is indicated for a subset of nonuremic, insulin-dependent diabetics who experience extreme difficulties in maintaining proper glucose homeostasis by insulin therapy that compromises their productivity and safety. Objective.—To provide a review of the literature and expert experiences for understanding the histologic findings in pancreas transplantation. Data Sources.—The published literature between 1990 and 2005 was reviewed for this report. Additionally, personal files of the author were used, along with biopsy slides that were used for figures. Conclusions.—Pancreas transplantation reestablishes the physiologic state of insulin secretion, and pancreas transplant recipients are able to maintain a state of long-term euglycemia and are less likely to be exposed to hyperglycemia and its systemic complications. Key to the success of transplantation is the scrupulous management and close monitoring of the pancreas transplant recipients. To that end, histologic evaluation of pancreas allografts assumed a pivotal role in management of pancreas allograft dysfunction episodes, and in some centers surveillance biopsies are used to monitor immunologically high-risk situations.

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