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. · Nov 2005
Comparative StudyMulti-organ transplantation: is there a protective effect against acute and chronic rejection?
Heart-lung transplantation (Tx) is known to offer a protective effect against acute cardiac rejection. This study was undertaken to evaluate acute and chronic heart and/or lung rejection in the setting of multiple-transplanted organs from the same donor compared with single-organ transplantation. ⋯ Recipients of multiple organs from a single donor undergo less acute rejection of the heart or lungs compared with isolated heart or lung transplant recipients. Cardiac allograft vasculopathy is decreased significantly when cardiac transplantation is combined with a lung allograft. A lower incidence of cardiac allograft vasculopathy is observed when cardiac transplantation is combined with a renal allograft, and may prove statistically significant when more cases have been accumulated. These phenomena may result from immune modulation of the recipient by simultaneous transplant of disparate tissues or introduction of immune-modulating hematopoietic elements.
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J. Heart Lung Transplant. · Nov 2005
High donor age, low donor oxygenation, and high recipient inotrope requirements predict early graft dysfunction in lung transplant recipients.
Early dysfunction in lung transplants is characterized by poor oxygenation, which may then lead to prolonged mechanical ventilation. This may be due to a combination of donor, recipient, and management factors. Our aim was to determine the incidence and severity of hypoxia and graft dysfunction and which factors were directly associated with poor oxygenation within the first 24 hours after lung transplantation. ⋯ A low PAO2/FIO2 ratio is a common finding in the first 24 hours after lung transplantation. Donor factors such as age and PAO2, and the need for increasing inotrope requirements in ICU predict early graft dysfunction and hypoxia.
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J. Heart Lung Transplant. · Nov 2005
Development of a reliable automatic speed control system for rotary blood pumps.
Axial blood pumps have been very successfully introduced into the arena of prolonged clinical support. However, they do not offer inherent load-responsive mechanisms for adjusting pumping performance to venous return and changes in physiologic requirements of the patient. To provide for these adjustments we developed an algorithm for demand-responsive pump control based on a reliable suction detection system. ⋯ A closed-loop control system equipped with an expert system for reliable suction detection was developed that improves response to change in venous return for rotary pump recipients. The system was robust, stable and safe under a wide range of everyday living conditions.
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J. Heart Lung Transplant. · Nov 2005
The Copenhagen National Lung Transplant Group: survival after single lung, double lung, and heart-lung transplantation.
To review the 13-year clinical experience of a single center's adult lung transplantation program. ⋯ This center has 1-, 3-, and 5-year survival rates comparable to other high volume centers. Recipient age, pre-operative body mass index, and donor age significantly influence outcome after lung transplantation.
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J. Heart Lung Transplant. · Nov 2005
Editorial CommentThe revised ISHLT heart biopsy grading scale.