American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
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Both carbon monoxide (CO) and biliverdin, products of heme degradation by heme oxygenase, have been shown to attenuate ischemia/reperfusion (I/R) injury. We hypothesized in this study that dual-treatment with CO and biliverdin would induce enhanced protective effects against cold I/R injury. Heterotopic heart and orthotopic kidney transplantation were performed in syngeneic Lewis rats after 24-h cold preservation in UW solution. ⋯ TNF-alpha, iNOS) and extravasation of inflammatory infiltrates were significantly less with dual-treatment than untreated controls. In addition, dual-treatment was effective in decreasing lipid peroxidation and improving graft blood flow through the distinctive action of biliverdin and CO, respectively. The study shows that the addition of byproducts of heme degradation with different mechanisms of action provides enhanced protection against transplant-associated cold I/R injury of heart and kidney grafts.
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Bronchiolitis obliterans syndrome (BOS) is associated with poor health-related quality of life (HRQL) following lung and heart-lung transplantation, but few other determinants of HRQL have been described. We performed a cross-sectional study of standard gamble utility, a preference-based measure of HRQL, in 90 stable lung and heart-lung transplant recipients. ⋯ Multivariable analysis showed that female sex, absence of BOS, better renal function and longer time since transplantation were associated with higher utility scores, and that there were utility differences across diagnostic groups. Although BOS is a major determinant of utility following lung and heart-lung transplantation, other demographic and clinical factors are also associated with significant differences in this measure of HRQL.