The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Feb 2015
Multicenter StudyLung size mismatch and primary graft dysfunction after bilateral lung transplantation.
Donor-to-recipient lung size matching at lung transplantation (LTx) can be estimated by the predicted total lung capacity (pTLC) ratio (donor pTLC/recipient pTLC). We aimed to determine whether the pTLC ratio is associated with the risk of primary graft dysfunction (PGD) after bilateral LTx (BLT). ⋯ Oversized allografts are associated with a decreased risk of PGD3 after BLT; this effect appears most apparent in non-COPD patients.
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J. Heart Lung Transplant. · Feb 2015
Obese patients with idiopathic pulmonary fibrosis have a higher 90-day mortality risk with bilateral lung transplantation.
Obese patients with idiopathic pulmonary fibrosis (IPF) have higher 90-day mortality after lung transplantation. We sought to determine whether body mass index (BMI) differentially modified the effect of transplant procedure type on 90-day mortality in IPF patients. ⋯ Our results suggest that obese patients who receive a BLT may be at higher risk of 90-day mortality compared with patients of normal weight. Further study is needed to obtain more detailed information about comorbidities and other risk factors for early death that are not included in the OPTN database.
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J. Heart Lung Transplant. · Feb 2015
Human recombinant apyrase therapy protects against canine pulmonary ischemia-reperfusion injury.
There is accumulating evidence that extracellular adenosine triphosphate (eATP) promotes many of the underlying mechanisms that exacerbate acute lung injury. However, much of these data are from inbred rodent models, indicating the need for further investigation in higher vertebrates to better establish clinical relevance. To this end we evaluated a human recombinant apyrase therapy in a canine warm pulmonary ischemia-reperfusion injury (IRI) model and measured eATP levels in human lung recipients with or without primary lung graft dysfunction (PGD). ⋯ Extracellular ATP accumulates in acutely injured canine and human lungs. Strategies that target eATP reduction may help protect lung recipients from IRI.
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J. Heart Lung Transplant. · Feb 2015
Multicenter StudyEmergency medical services knowledge and attitudes about non-heart-beating donors: effect of an educational intervention.
More than 750,000 people die of sudden death each year, and many are potential non-heart-beating donors (NHBDs) for lung transplant. Although critical, the role of emergency medical services (EMS) personnel in assisting with recovery of NHBD lungs has not been studied. The purpose of this study was to assess knowledge of and attitudes about NHBDs among EMS personnel, evaluate the extent to which knowledge and personal experience with organ donation is associated with attitude, and ascertain the effectiveness of an intervention designed to teach EMS professionals about NHBDs. ⋯ Lung recovery from NHBDs offers the potential of a very large supply for transplantation. This research suggests that with additional training, EMS professionals may be willing to be part of a NHBD recovery team.
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J. Heart Lung Transplant. · Jan 2015
Outcome of cardiac transplantation in patients requiring prolonged continuous-flow left ventricular assist device support.
This study assessed the early and late outcomes after cardiac transplantation in patients receiving long-term continuous-flow left ventricular assist device (CF-LVAD) support. ⋯ The overall short-term and long-term cardiac transplant outcomes of patients supported with CF-LVAD are satisfactory. However, patients who require prolonged CF-LVAD support may have diminished post-transplant survival due to adverse events occurring during device support.