scholarly journals Lung transplantation

2015 ◽  
Vol 13 (2) ◽  
pp. 297-304 ◽  
Author(s):  
José Eduardo Afonso Júnior ◽  
Eduardo de Campos Werebe ◽  
Rafael Medeiros Carraro ◽  
Ricardo Henrique de Oliveira Braga Teixeira ◽  
Lucas Matos Fernandes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
New Technologies ◽  
Life Support ◽  
Ex Vivo ◽  
Perioperative Period ◽  
Graft Dysfunction ◽  
Bridge To Transplant

ABSTRACT Lung transplantation is a globally accepted treatment for some advanced lung diseases, giving the recipients longer survival and better quality of life. Since the first transplant successfully performed in 1983, more than 40 thousand transplants have been performed worldwide. Of these, about seven hundred were in Brazil. However, survival of the transplant is less than desired, with a high mortality rate related to primary graft dysfunction, infection, and chronic graft dysfunction, particularly in the form of bronchiolitis obliterans syndrome. New technologies have been developed to improve the various stages of lung transplant. To increase the supply of lungs, ex vivo lung reconditioning has been used in some countries, including Brazil. For advanced life support in the perioperative period, extracorporeal membrane oxygenation and hemodynamic support equipment have been used as a bridge to transplant in critically ill patients on the waiting list, and to keep patients alive until resolution of the primary dysfunction after graft transplant. There are patients requiring lung transplant in Brazil who do not even come to the point of being referred to a transplant center because there are only seven such centers active in the country. It is urgent to create new centers capable of performing lung transplantation to provide patients with some advanced forms of lung disease a chance to live longer and with better quality of life.

Functional outcomes and quality of life after normothermic ex vivo lung perfusion lung transplantation

2015 ◽  
Vol 34 (4) ◽  
pp. 547-556 ◽  
Author(s):  
Jussi M. Tikkanen ◽  
Marcelo Cypel ◽  
Tiago N. Machuca ◽  
Sassan Azad ◽  
Matthew Binnie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Functional Outcomes ◽  
Ex Vivo ◽  
Lung Perfusion ◽  
Ex Vivo Lung Perfusion

Extracorporeal Life Support as a Bridge to Lung Transplantation: A Single-Center Experience With an Emphasis on Health-Related Quality of Life

2017 ◽  
Vol 62 (5) ◽  
pp. 588-594 ◽  
Author(s):  
Annemieke Oude Lansink-Hartgring ◽  
Wim van der Bij ◽  
Erik A Verschuuren ◽  
Michiel E Erasmus ◽  
Adrianus J de Vries ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Health Related Quality ◽  
Single Center ◽  
Single Center Experience ◽  
Related Quality ◽  
Health Related

An Integrative Review of the Role of Palliative Care in Lung Transplantation

2020 ◽  
Vol 30 (2) ◽  
pp. 147-154
Author(s):  
Patricia C. Pawlow ◽  
Caroline L. Doherty ◽  
Nancy P. Blumenthal ◽  
Lea Ann Matura ◽  
Jason D. Christie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Lung Transplantation ◽  
Symptom Management ◽  
Lung Transplant ◽  
Integrative Review ◽  
Care Needs ◽  
Transplant Patients ◽  
Palliative Care Needs

Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.

Lung Transplantation for Pulmonary Hypertension and Strategies to Bridge to Transplant

2017 ◽  
Vol 38 (05) ◽  
pp. 701-710
Author(s):  
Timothy Baillie ◽  
John Granton
Keyword(s):  
Lung Transplantation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Premature Mortality ◽  
Perioperative Period ◽  
Safety Net ◽  
Bronchiolitis Obliterans Syndrome ◽  
Term Survival ◽  
Bridge To Transplant

AbstractDespite an expanded armamentarium of medical therapies, pulmonary arterial hypertension (PAH) remains a progressive disease associated with significant morbidity and premature mortality. Lung transplantation (LT) is the last safety net for patients failing medical therapy, providing excellent overall long-term survival and health-related quality-of-life outcomes in line with more common parenchymal lung disease indications. Waitlist mortality remains disproportionally elevated, however, reflecting an inability of the lung allocation score to completely capture PAH disease severity, and a propensity for PAH to deteriorate rapidly without warning, even in patients who appear externally “well.” Early referral to a LT center can mitigate these risks and facilitate rapid listing if necessary. Several bridging therapies are available to support severely unwell patients to LT, such as extracorporeal life support (ECLS) and atrial septostomy. Unique perioperative considerations include higher rates of primary graft dysfunction and dynamic right ventricular outflow obstruction which may, at least in part, reflect rapid afterload reduction in the face of a conditioned right ventricle. Extending ECLS into the perioperative period may ameliorate these risks by allowing more gradual adaptation of both ventricles to their new loading conditions. Chronic lung allograft dysfunction, particularly bronchiolitis obliterans syndrome, remains a major cause of long-term morbidity and mortality, and complications from corticosteroid and immunosuppressive therapy are common. Nevertheless, the morbidity, mortality, and burden of disease management after LT continue to improve and compare favorably to that of refractory PAH in carefully selected patients.

RESULTS OF LUNG TRANSPLANTATION ASSISTED WITH EXTRACORPOREAL MEMBRANE OXYGENATOR (ECMO)

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
R J Burgos Lázaro ◽  
N Burgos Frías ◽  
J Rivas Oyarzabal ◽  
A Sánchez Calle ◽  
A Macías Sotuel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Transplantation ◽  
Interstitial Fibrosis ◽  
Organ Transplant ◽  
Perioperative Period ◽  
Membrane Oxygenator ◽  
Grade Ii ◽  
Lung Transplants ◽  
Respiratory Assistance

Abstract INTRODUCTION According to the registry of the “International Society for Heart and Lung Transplantation” (ISHLT), 32% of lung transplants (Tx P) will require respiratory assistance in the perioperative period. The aim of the study is to compare the results of the Tx P that required ECMO, versus those that did not require respiratory assistance. MATERIAL AND METHODS Between January 2015 and December 31th 2018, 184 lung transplants were performed in the organ transplant unit. In 119 (64.7%) of the transplants, they did not need respiratory assistance and in 65 (35.3%) they required ECMO either intraoperatively and/or postoperatively. The indications for lung transplantation were: interstitial fibrosis 77 (41.8%), pulmonary emphysema 64 (34.7%), cystic fibrosis 28 (15.3%), others 15 (8.2%). RESULTS Patients with Mean Pulmonary Pressure (MPP) greater than 54 mmHg required assistance with ECMO during transplantation (p < 0.03). 83% of transplanted patients remained in NYHA grade I and grade II. Hospital mortality was 21/184 (11.4%); ECMO mortality 14/67 (20.9%) vs NO-ECMO mortality 6/117 (5.1%), significantly higher (p < 0.005 OR = 4.98). Survival and quality of life at 5 years were similar in both groups (p = 0.09). CONCLUSIONS ECMO has proven to be safe and effective in Tx P. Patients with PMP> 54 mmHg required ECMO (p < 0.03). After the hospital postoperative period, the quality of life and survival at five years were similar in both groups.

Risks and economic security of the life support system of citizens in the field of housing and communal services

2020 ◽  
Vol 19 (3) ◽  
pp. 175-191
Author(s):  
Vladimir M. Yakovlev
Keyword(s):  
Quality Of Life ◽  
Russian Federation ◽  
Support System ◽  
Internal Control ◽  
Life Support ◽  
Economic Security ◽  
Security System ◽  
Life Support System ◽  
The Russian Federation

The article analyzes the problems of the manifestation of risks of shadow and criminal activity in the life support system of citizens of the Russian Federation, the dissemination of which requires the development of effective measures to prevent and eliminate them. The most important issue is the formation of an effective economic security system with an emphasis on the new quality of life support for citizens of the Russian Federation in an adequate combination with the high growth rate of NTP in the Russian economy. The new technological structure emerging from the new achievements of scientific and technological progress involves the harmonization of the pace of scientific and technological development, combined with an adequate improvement in the quality of life support for citizens performing such achievements. Owing to this fact formation of new quality of the housing and communal services (HCS) as bases of life support of citizens becomes a prerequisite of increase in performance and intellectualization of human work. With this in mind, early recognition, prevention and elimination of risks of shadow and criminal activities in the housing and communal services system (housing and communal services) is considered as a significant mechanism to increase the effectiveness of the system of comfortable life support for citizens of the Russian Federation. The existing lag in the development of a high-quality and comfortable system for providing citizens of Russia on the basis of housing and communal services, the subject of which is the provision of quality and comfortable services, influenced by numerous risks of shadow and criminal influence, becomes a condition for intensifying economic development and increasing labor productivity on this basis. The need to develop and use modern scientific and technical achievements, especially in the field of digitalization, is emphasized in order to increase the efficiency of the economic security system of housing and communal services organizations based on innovative control mechanisms - internal control, audit, compliance control, taking into account financial investigations in order to prevent and eliminate the risks of shadow and criminal activities in the housing and communal services system.

scholarly journals Quality of life support in advanced cancer—web and technological interventions: systematic review and narrative synthesis

2021 ◽  
pp. bmjspcare-2020-002820
Author(s):  
Kathleen Kane ◽  
Fiona Kennedy ◽  
Kate L Absolom ◽  
Clare Harley ◽  
Galina Velikova
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Life Support ◽  
Well Being ◽  
Narrative Synthesis ◽  
Monitoring Tools ◽  
Technological Interventions ◽  
Cancer Trajectory ◽  
Interactive Health Communication

BackgroundAs treatments continue to progress, patients with advanced cancer are living longer. However, ongoing physical side-effects and psychosocial concerns can compromise quality of life (QoL). Patients and physicians increasingly look to the internet and other technologies to address diverse supportive needs encountered across this evolving cancer trajectory.Objectives1. To examine the features and delivery of web and technological interventions supporting patients with advanced cancer. 2. To explore their efficacy relating to QoL and psychosocial well-being.MethodsRelevant studies were identified through electronic database searches (MEDLINE, PsychINFO, Embase, CINAHL, CENTRAL, Web of Science and ProQuest) and handsearching. Findings were collated and explored through narrative synthesis.ResultsOf 5274 identified records, 37 articles were included. Interventions were evaluated within studies targeting advanced cancer (13) or encompassing all stages (24). Five subtypes emerged: Interactive Health Communication Applications (n=12), virtual programmes of support (n=11), symptom monitoring tools (n=8), communication conduits (n=3) and information websites (n=3). Modes of delivery ranged from self-management to clinically integrated. Support largely targeted psychosocial well-being, alongside symptom management and healthy living. Most studies (78%) evidenced varying degrees of efficacy through QoL and psychosocial measures. Intervention complexity made it challenging to distinguish the most effective components. Incomplete reporting limited risk of bias assessment.ConclusionWhile complex and varied in their content, features and delivery, most interventions led to improvements in QoL or psychosocial well-being across the cancer trajectory. Ongoing development and evaluation of such innovations should specifically target patients requiring longer-term support for later-stage cancer.PROSPERO registration numberCRD42018089153.

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