The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
-
J. Heart Lung Transplant. · Jul 2011
Usefulness of extracorporeal membrane oxygenation for early cardiac allograft dysfunction.
Owing to persisting donor shortages, the use of "marginal hearts" has increased. Because patients who receive a marginal heart may require hemodynamic support in the early post-operative period, extracorporeal membrane oxygenation (ECMO) may be used until recovery of acute graft dysfunction. ⋯ ECMO allows for salvage of acute graft dysfunction and may allow use of marginal donor hearts. Survival rates are lower in patients who require ECMO compared with optimal donors, but early cardiac dysfunction normalizes in most without long-term cardiac or renal sequelae. Despite longer ventilation times, overall hospitalization is not prolonged.
-
J. Heart Lung Transplant. · Jun 2011
Randomized Controlled Trial Multicenter Study Comparative StudyLow-dose intradermal versus intramuscular trivalent inactivated seasonal influenza vaccine in lung transplant recipients.
In this study we compared the immunogenicity of influenza vaccine administered intradermally to the standard intramuscular vaccination in lung transplant recipients. ⋯ Immunogenicity of the 2008-9 influenza vaccine given intradermally or intramuscularly was overall poor in lung transplant recipients. Novel strategies for influenza vaccination in this population are needed.
-
J. Heart Lung Transplant. · Jun 2011
Chimerism of dendritic cell subsets in peripheral blood after lung transplantation.
Passenger leukocytes of donor origin are transferred to the patient resulting in circulatory microchimerism after lung transplantation (LTx). This chimeric state has been shown to occur in the total leukocyte fraction as well as unseparated peripheral blood mononuclear cells (PBMCs). In this study we determined the microchimerism levels of B cells, monocytes, natural killer (NK) and T cells and dendritic cell (DC) subsets (mDC1, mDC2 and pDC) during the first year after lung transplantation. ⋯ In the first year after lung transplantation a stable microchimerism was detected for all cell types investigated. However, donor pDCs were consistently absent in all samples investigated, which may be linked with graft rejection often observed after LTx.
-
J. Heart Lung Transplant. · Jun 2011
Randomized Controlled TrialTadalafil monotherapy and as add-on to background bosentan in patients with pulmonary arterial hypertension.
Tadalafil 40 mg orally once daily, was shown to be well-tolerated and efficacious for pulmonary arterial hypertension in a 16-week, double-blind, placebo (PBO)-controlled trial. Inclusion criteria included the option for background bosentan. Analyses of tadalafil in treatment-naive patients and as add-on to bosentan were pre-specified. Objectives were to provide safety and efficacy data for both groups. ⋯ Tadalafil 40 mg was well-tolerated and provided clinical benefit in patients as monotherapy. It was also well-tolerated when added to background bosentan, but data are insufficient to conclude additional benefit.
-
J. Heart Lung Transplant. · May 2011
A novel approach to the assessment of lymphocytic bronchiolitis after lung transplantation--transbronchial brush.
Lymphocytic bronchiolitis (LB) is the strongest risk factor for subsequent allograft loss due to bronchiolitis obliterative syndrome (BOS); however, it is poorly assessed by transbronchial biopsy (TBBx) because of sampling error, interpretation error and the presence of non-alloimmune airway inflammation. We hypothesized that flow cytometric evaluation of bronchiolar brushings (transbronchial brush, TBBr) may be a better approach. ⋯ TBBr is simple to obtain, low risk, quantitative, and can discriminate between infective and alloimmune LB. It may be a valuable addition to current lung allograft assessment.