The 1-year survival rate approaches 80% for patients
|
|
- Derek Morton
- 5 years ago
- Views:
Transcription
1 Lung Transplantation for Respiratory Failure Resulting From Systemic Disease Frank A. Pigula, MD, Bartley P. Griffith, MD, Marco A. Zenati, MD, James H. Dauber, MD, Samuel A. Yousem, MD, and Robert J. Keenan, MD Division of Cardiothoracic Surgery, Presbyterian University Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Background. Lung transplantation for pulmonary failure resulting from systemic disease is controversial. We reviewed our transplant experience in patients with sarcoidosis, scleroderma, lymphangioleiomyomatosis, and graft-versus-host disease. Methods. This retrospective review examined the outcome of 23 patients who underwent pulmonary transplantation for these systemic diseases. Group 1 included 15 patients with pulmonary hypertension who underwent transplantation (9 for sarcoidosis, 6 for scleroderma), and group 2 included 8 patients with normal pulmonary artery pressures who underwent transplantation (5 for lymphangioleiomyomatosis, 3 for graft-versus-host disease). The incidences of infection and rejection, pulmonary function, and survival were measured and compared with those of patients who underwent transplantation for isolated pulmonary disease. Results. Although there were no differences in the rate of infection between patients who underwent transplantation for systemic versus isolated disease, patients with pulmonary hypertension who underwent transplantation for systemic disease had significantly lower rates of rejection. Four patients with sarcoidosis and 2 with lymphangioleiomyomatosis demonstrated recurrence in the allograft. Survival was similar between patients who underwent transplantation for systemic versus isolated disease. Conclusions. Patients with respiratory failure resulting from these systemic diseases can undergo transplantation with outcomes comparable to those obtained in patients who undergo transplantation for isolated pulmonary disease. (Ann Thorac Surg 1997;64:1630 4) 1997 by The Society of Thoracic Surgeons The 1-year survival rate approaches 80% for patients who receive lung transplants for isolated pulmonary diseases such as emphysema, pulmonary fibrosis, and pulmonary hypertension [1]. Transplantation for patients who have pulmonary failure secondary to systemic diseases remains controversial. These unconventional indications include pulmonary involvement resulting from sarcoidosis, scleroderma, lymphangioleiomyomatosis (LAM), and graft-versus-host disease (GVHD). This retrospective review examines the outcome of lung transplantation as a treatment option for these patients, and compares it to that of patients who undergo transplantation for conventional, isolated pulmonary pathology. As of December 1996, 468 lung transplantations have been performed at the University of Pittsburgh. Twentythree (5%) have been performed for unconventional indications: 9 for sarcoidosis, 6 for scleroderma, 5 for LAM, and 3 for GVHD. Although these patients represent a small percentage of all those evaluated for lung transplantation, they frequently are referred to transplant centers for consideration. Candidates for transplantation were less than 60 years old and were functionally limited (New York Heart Association class III and IV) by Accepted for publication June 26, Address reprint requests to Dr Keenan, Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, Suite c-700, Pittsburgh, PA respiratory symptoms. Candidates had to be free of evidence of significant involvement of extrapulmonary organ systems. Pretransplantation evaluation included spirometry, arterial blood gases, exercise oxygen titration, 6-minute walk, cardiac echocardiography, quantitative left and right perfusion lung scans, and right heart catheterization with measurement of pulmonary artery pressures. Pulmonary hypertension (defined as a mean pulmonary artery pressure 30 mm Hg) is a common physiology affecting patients being considered for lung transplantation. Accordingly, the patients in our review were divided into two groups. Group 1 contained 15 patients (9 with sarcoidosis, 6 with scleroderma) who had pulmonary hypertension, and group 2 contained 8 patients (5 with LAM, 3 with GVHD) who had normal pulmonary artery pressures. Twelve single-lung transplantations, 2 heart-lung transplantations, and 1 double-lung transplantation were performed in group 1. Eight single-lung transplantations and 1 double-lung transplantation were performed in group 2, including a second single-lung transplantation performed 18 days postoperatively because of primary graft failure. A contemporaneous group of patients undergoing single-lung transplantation for isolated pulmonary disease was identified. Group 1C consisted of 17 patients with pulmonary hypertension (10 with primary pulmonary 1997 by The Society of Thoracic Surgeons /97/$17.00 Published by Elsevier Science Inc PII S (97)
2 Ann Thorac Surg PIGULA ET AL 1997;64: LUNG TRANSPLANTATION IN SYSTEMIC DISEASE 1631 hypertension, 7 with pulmonary fibrosis), and group 2C included 66 patients without pulmonary hypertension who underwent transplantation for emphysema. The outcomes, including survival, rates of rejection and infection, and pulmonary function, of patients who underwent transplantation for systemic versus isolated disease were compared. Material and Methods Donor Selection and Organ Preservation Details of the procurement procedure have been described elsewhere [2]. Briefly, lungs were considered suitable for transplantation if the donor was less than 55 years old and had no history of pulmonary disease, a normal chest radiograph, adequate gas exchange (ie, arterial oxygen tension 400 mm Hg on an inspired oxygen fraction of 1.0) and negative antibody titers for hepatitis B and C and human immunodeficiency virus. Recipients were matched with donors by body size and ABO blood group. Operation Patients were anesthetized and interfaced with appropriate hemodynamic monitoring devices, including arterial and pulmonary artery catheters. The side transplanted was determined by quantitative ventilation and perfusion of each lung as determined by preoperative evaluation, previous thoracotomy or pleurodesis, and donor availability. Cardiopulmonary bypass was used when intraoperative hypoxemia or hemodynamic instability could not be managed pharmacologically. Telescoping bronchial anastomoses usually were performed. The completed atrial and pulmonary artery anastomoses were examined with intraoperative transesophageal ultrasound for technical complications after weaning from cardiopulmonary bypass and before chest closure. Immunosuppression Postoperative immunosuppression usually was accomplished with triple-drug therapy including azathioprine, corticosteroids, and either cyclosporine or tacrolimus. The cyclosporine dose was titrated to maintain a whole blood level by the Abbott TDx method of 700 to 1,000 ng/dl, and the tacrolimus dose was titrated to maintain a level of 20 to 25 ng/dl. When a patient remained hemodynamically unstable after transplantation or had evidence of significant renal dysfunction early in the postoperative period, induction therapy with antithymocyte globulin was administered for 5 days, instead of cyclosporine or tacrolimus. The dose of azathioprine was titrated to maintain a white blood cell count greater than 5,000/ L. Patients generally were maintained on lowdose corticosteroids (prednisone, 10 to 20 mg/d) after operation. Postoperative Care Transplant recipients were evaluated every 3 months during the first year after transplantation and whenever infection or rejection was suspected. Each evaluation consisted of an interval history, physical examination, chest radiograph, spirometry, arterial blood gases, and bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. Hematologic evaluation included a complete blood count and blood urea nitrogen, creatinine, electrolyte, and cyclosporine or tacrolimus levels. Statistical Analysis Linearized rates of rejection and infection, presented as treated episodes per 100 days, were compared using the two-tailed t-test. Survival comparisons were performed using the log-rank test and Kaplan-Meier survival curves. Forced expiratory capacity in 1 second and forced vital capacity were analyzed using repeated measures of variance. All data are presented as means standard deviation. A p value of less than 0.05 was considered statistically significant. Results Twenty-three patients underwent transplantation for respiratory failure resulting from systemic disease. Group 1 included 15 patients with pulmonary hypertension (9 with sarcoidosis, 6 with scleroderma). Group 2 included 8 patients (5 with LAM, 3 with GVHD) with normal pulmonary artery pressures. Although the average length of follow-up for both groups 1 and 2 tended to be longer than for groups 1C and 2C, this was not statistically different (Table 1). Twenty single-lung transplantations were performed in 19 patients (group 1 12, group 2 8). One patient (with LAM) underwent a second transplantation 18 days postoperatively because of primary graft failure and multiple pulmonary emboli. Two heart-lung and 1 double-lung transplantations were performed in group 1 patients, and 1 double-lung transplantation was performed in a patient with GVHD. In the early postoperative period, mean pulmonary artery pressures in group 1 dropped from to mm Hg (p 0.05) and were equivalent to those in group 2 (23 4mmHg) (Table 2). Six (50%) of 12 patients in group 1 who underwent single-lung transplantation required cardiopulmonary bypass, compared with no patients in group 2. Mortality The actuarial survival rates for group 1 were 53% (8/15) at 1 year and 47% (7/15) at 2 years. This was similar to group 1C, which had respective rates of 63% (12/19) and 53% (10/19) (Fig 1). The causes of death in group 1 included infection in 6 patients, hemorrhage after transbronchial biopsy in 1 patient, and postoperative multisystem organ failure in 1 patient. The survival rates for group 2 were 75% (6/8) at 1 year and 63% (5/8) at 2 years. Again, these rates were similar to those of group 2C (79% [52/66] and 65% [43/66], respectively) (Fig 2). The cause of death in group 2 was infection in all 3 cases. Four (44%) of the 9 patients who underwent transplantation for sarcoidosis died within 1 year (at 1 week, 2
3 1632 PIGULA ET AL Ann Thorac Surg LUNG TRANSPLANTATION IN SYSTEMIC DISEASE 1997;64: Table 1. Results Parameter Group 1 (n 15) Group 1C (n 17) Group 2 (n 8) Group 2C (n 65) p Value Follow-up (mo) NS Acute cellular rejection (episodes/100 d) a a Obliterative bronchiolitis 13% (2/15) 18% (3/17) 25% (2/8) 18% (12/66) NS Infections (episodes/100 d) NS Bacterial (%) Viral (%) Fungal (%) a p 0.05, group 1 versus group 1C. NS not significant. months, 8 months, and 11 months, respectively). The early death occurred in a patient who received a heartlung transplant early in our transplant experience (1984) and died of multisystem organ failure. The survivors (5/9) remain alive at 6, 21, 23, 34, and 44 months, respectively, after transplantation. Five of 6 patients who underwent transplantation for scleroderma are alive 6 to 60 months after transplantation. One death occurred at 22 days as a result of bacterial pneumonia and pancreatitis. The 3 patients who underwent transplantation for GVHD after bone marrow transplantation are alive at 14, 19, and 40 months, respectively, after transplantation. Three of the 5 patients who underwent transplantation for LAM have died of infection at 2, 25, and 30 months, respectively, after transplantation. Two survivors remain alive at 8 and 34 months, respectively, after transplantation. Infection Six deaths in group 1 were related to infection (40%), as were 3 in group 2 (38%). Episodes of infection were Table 2. Clinical Characteristics of Patients With (Group 1) and Without (Group 2) Pulmonary Hypertension Who Underwent Transplantation for Systemic Disease Characteristic Group 1 Group 2 Sex Male 5 1 Female 10 7 Age (y) Mean pulmonary artery pressure (mm Hg) Before transplantation After transplantation Type of disease Sarcoidosis 9... Scleroderma 6... Lymphangioleiomyomatosis 5 Graft-versus-host disease 3 Type of transplant Single-lung 12 8 Double-lung 1 1 Heart-lung 2 0 linearized to the number of episodes per 100 days and presented as means SD. Although group 1 tended to have more frequent infections than group 2, this did not reach statistical significance (Table 1). Invasive pulmonary aspergillosis was identified in 5 patients in group 1 (4 with sarcoidosis, 1 with scleroderma), and 1 died of a Nocardia brain abscess 11 months after transplantation. Invasive pulmonary Aspergillus with brain abscess was identified at autopsy in 2 patients with LAM in group 2. Three patients in group 1 had gastrointestinal cytomegalovirus infection, and 1 patient in group 2 had cytomegalovirus pneumonia. When the frequency of infection in patients with pulmonary hypertension who underwent transplantation for isolated pulmonary disease (group 1C) was compared with that in patients who underwent transplantation for systemic diseases (group 1), no differences were found (Table 1). Likewise, the frequency of infection was similar among the two groups of patients without pulmonary hypertension (groups 2 and 2C) who underwent transplantation. The relative frequencies of bacterial, viral, and fungal infections are shown in Table 1. Although group 2 had a Fig 1. Kaplan-Meier survival curves for patients with sarcoidosis and scleroderma (group 1, solid line) versus control patients with pulmonary hypertension (group 1C, broken line). One-year (53% and 63%, respectively) and 2-year (47% and 53%, respectively) survival rates were similar in the two groups (p 0.05, log-rank test).
4 Ann Thorac Surg PIGULA ET AL 1997;64: LUNG TRANSPLANTATION IN SYSTEMIC DISEASE 1633 Recurrence Six patients had biopsy-proven recurrence of the primary disease. Four patients with sarcoidosis had granulomas identified in the allograft by transbronchial biopsy. Two patients with LAM had recurrent disease in the allograft identified at autopsy, at 2 months and 30 months, respectively, after transplantation. These patients died of infectious causes (herpes pneumonia and disseminated aspergillosis, respectively). In no case was recurrence suspected clinically, nor did it appear to contribute significantly to mortality. Fig 2. Kaplan-Meier survival curves for patients with LAM and GVHD, (group 2, solid line) versus control patients with emphysema (group 2C, broken line). One-year (75% and 79%, respectively) and 2-year (63% and 65%, respectively) survival rates were similar in the two groups (p 0.05, log-rank test). preponderance of fungal infections and a lower percentage of viral infections, no clear etiologic pattern is apparent. Rejection Patients underwent routine biopsy every 3 months during the first year and whenever rejection was suspected on clinical grounds. Sixty-six percent (10/15) of the patients in group 1 were receiving steroids before transplantation, as were 50% (4/8) of the patients in group 2. Rejection was treated on the basis of tissue obtained by transbronchial biopsy and clinical evaluation. Linearized rates of treated acute cellular rejection per 100 days were similar between the two groups (Table 1). Compared with the patients in group 1C, those in group 1 had a significantly lower frequency of rejection. The patients in group 2 had a lower frequency of rejection than those in group 2C, but this did not reach statistical significance. The incidence of obliterative bronchiolitis, determined on the basis of biopsy results, was similar for all groups (Table 1). Pulmonary Function Early pulmonary function tests (3 months) showed similar results between groups 1 and 1C and groups 2 and 2C (Table 3). Pulmonary function measured at 12 months also was similar and showed no intergroup differences. In general, there tended to be slight, clinically insignificant improvement in most parameters over time. Comment Lung transplantation for the treatment of respiratory failure stemming from systemic diseases remains controversial. The fact that mortality rates approach 20% for patients on the waiting list for lung transplantation emphasizes the need for information regarding the allocation of scarce transplant resources [3]. Survival analysis has shown no differences in 1- and 2-year survival rates between patients who undergo transplantation for the systemic diseases considered here and those who undergo transplantation for isolated pulmonary disease. Clearly, patients without pulmonary hypertension tend to do better, as has been suggested by previous studies [4]. Survival results for all groups are comparable to those obtained in other series [4, 5]. Although there appears to be equivalent survival between groups of patients who undergo transplantation for systemic and isolated diseases, a consideration unique to those with systemic diseases is the possibility of recurrence. The primary systemic disease is not cured by transplantation, and the allograft may be vulnerable to recurrent damage. Evidence of recurrent disease has been demonstrated in 4 (44%) of 9 patients with sarcoidosis and 2 (40%) of 5 patients with LAM. Although this is a concern, we were unable to discern any clinical effect of this phenomenon. Lung transplantation for the treatment of end-stage sarcoidosis specifically was reviewed by Johnson and colleagues in 1993 [6]. Survival, pulmonary function, and the incidence of bronchiolitis obliterans were similar to those of contemporary patients undergoing transplantation for other indications. These investigators found that, although recurrence was documented in 4 patients, no clinical effect of the recurrence could be discerned. Recurrent LAM in pulmonary allografts has been described previously by O Brien and associates [7], and Table 3. Pulmonary Function Test Results a Time of Test FVC (% predicted) FEV 1 (% predicted) 3 Months after transplantation Group 1 (n 11) Group 1C (n 16) Group 2 (n 8) Group 2C (n 54) Months after transplantation Group 1 (n 9) Group 1C (n 11) Group 2 (n 7) Group 2C (n 40) a All p values were nonsignificant. FEV 1 forced expiratory volume in 1 second; capacity. FVC forced vital
5 1634 PIGULA ET AL Ann Thorac Surg LUNG TRANSPLANTATION IN SYSTEMIC DISEASE 1997;64: there is evidence that it stems from cells of donor origin [8]. Recurrence in our 2 patients was noted at autopsy after death resulting from infectious causes, and appears to be unrelated to their clinical outcome. Anecdotal reports of transplantation for scleroderma have emerged [9], but the 5 patients presented here comprise one of the largest series. Although this disease often is responsive to medical treatment, refractory disease with pulmonary involvement carries a 7-year mortality rate of 50% [10]. Transplantation is considered the final treatment option. Graft-versus-host disease is a systemic disease, but pulmonary manifestations often predominate. Pulmonary fibrosis occurs in nearly 20% of these patients, with the mortality rate approaching 50%. In 1992, Calhoon and co-workers [11] reported the first successful lung transplant for GVHD. The 3 patients reported here are alive and have marked improvement in their pulmonary function and minimal infection- and rejection-related complications. Our use of treated episodes of infection or rejection per 100 days reflects the clinical considerations present in the care of transplant recipients. Perceived threats to the allograft or patient prompted a thorough search for infection or rejection. Therapy then was directed at the most likely cause. There were no demonstrable differences in the frequency of infection between patients who underwent transplantation for systemic versus isolated pulmonary disease. In addition, no differences were seen between patients with and without pulmonary hypertension who underwent transplantation. The reason for the lower incidence of rejection in patients with pulmonary hypertension who underwent transplantation for systemic diseases is unclear. Although 56% of the patients in group 1 were treated with steroids before transplantation, so were 50% of the patients in group 1C. The inherent involvement of the immune system in these systemic diseases may contribute. Conversely, patients in group 1 tended to have more episodes of treated infection, suggesting an underlying immunosuppression from the disease itself. Despite the lack of differences in measured parameters, lower levels of induced immunosuppression in these patients should be considered. Patients who undergo transplantation for these systemic diseases have acceptable morbidity and satisfactory survival. However, although these are systemic diseases, pulmonary manifestations have been their predominant clinical feature. This experience, although limited, suggests that lung transplantation need not necessarily be denied to patients with respiratory failure resulting from these systemic diseases. Rather, morbidity and mortality seem to be a reflection of the presence of pulmonary hypertension before transplantation. Clearly, the concern regarding extrapulmonary involvement in systemic disease is important. In considering the transplant candidacy of patients with systemic diseases, an exhaustive pretransplant evaluation directed at collateral organ systems is required. In the absence of significant extrapulmonary organ dysfunction in an otherwise acceptable candidate, lung transplantation can be offered to patients with these systemic diseases. These patients can undergo transplantation with expectations of results comparable to those obtained in patients who undergo transplantation for more traditional, isolated pulmonary diseases. References 1. Al Kattan K, Tadjkarimi S, Cox A, et al. Evaluation of the long-term results of single lung versus heart lung transplantation for emphysema. J Heart Lung Transplant 1995;14: Sundaresan S, Trachiotis G, Aoe M, Patterson A, Cooper J. Donor lung procurement: assessment and operative technique. Ann Thorac Surg 1993;56: Harper AM, Baker AS. The UNOS OPTN waiting list: Clinical Transplants 1995: Bando K, Keenan RJ, Paradis IL, et al. Impact of pulmonary hypertension on outcome after single lung transplantation. Ann Thorac Surg 1994;58: Bando K, Paradis IL, Keenan RJ, et al. Comparison of outcomes after single and bilateral lung transplantation for obstructive lung disease. J Heart Lung Transplant 1995;14: Johnson BA, Duncan SR, Ohori NP, et al. Recurrence of sarcoidosis in pulmonary allograft recipients. Am Rev Respir Dis 1993;148: O Brien JD, Lium JH, Parosa JF, et al. Lymphangiomyomatosis recurrence in the allograft after single lung transplantation. Am J Respir Crit Care Med 1995;151: Nine JS, Yousem SA, Paradis IL, et al. Lymphangioleiomyomatosis: recurrence after lung transplantation. J Heart Lung Transplant 1994;13: Levine SM, Anzueto A, Peters JI, et al. Single lung transplantation in patients with systemic disease. Chest 1994;105: Arroliga AC, Podell DN, Matthay RA. Pulmonary manifestations of scleroderma. J Thorac Imaging 1992;7: Calhoon JH, Levine SM, Anzueto A, Bryan CL, Trinkle JK. Lung transplantation in a patient with a prior bone marrow transplant. Chest 1992;102:948.
INTERNET-BASED HOME MONITORING OF PULMONARY FUNCTION AFTER LUNG TRANSPLANTATION. 2000, 25 patients underwent heart lung (HLT) or bilateral-lung (BLT)
Online Supplement for: INTERNET-BASED HOME MONITORING OF PULMONARY FUNCTION AFTER LUNG TRANSPLANTATION METHODS Patients Between the start of the study in June 1998 and the end of the study in September
More informationSingle-lung transplantation in the setting of aborted bilateral lung transplantation
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2011 Single-lung transplantation in the setting of aborted bilateral lung transplantation Varun Puri Tracey Guthrie
More informationAnalysis of time-dependent risks for infection, rejection, and death after pulmonary transplantation
Cardiac and Pulmonary Replacement Analysis of time-dependent risks for infection, rejection, and death after pulmonary transplantation Infection and rejection remain the greatest threats to the survival
More informationDoes the Presence of Preoperative Mild or Moderate Coronary Artery Disease Affect the Outcomes of Lung Transplantation?
Does the Presence of Preoperative Mild or Moderate Coronary Artery Disease Affect the Outcomes of Lung Transplantation? Cliff K. Choong, FRACS, Bryan F. Meyers, MD, Tracey J. Guthrie, BSN, Elbert P. Trulock,
More informationThirteen-Year Experience in Lung Transplantation for Emphysema
Thirteen-Year Experience in Lung Transplantation for Emphysema Stephen D. Cassivi, MD, Bryan F. Meyers, MD, Richard J. Battafarano, MD, Tracey J. Guthrie, RN, Elbert P. Trulock, MD, John P. Lynch, MD,
More informationEvolution of Surgical Therapies for End-Stage Cardiopulmonary Failure. Heart Failure at the Shoe XI October 5, 2012
Evolution of Surgical Therapies for End-Stage Cardiopulmonary Failure Heart Failure at the Shoe XI October 5, 2012 Robert S.D. Higgins, MD, MSHA Executive Director, Comprehensive Transplant Center Evolution
More informationBILATERAL VERSUS SINGLE LUNG TRANSPLANTATION FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE
BILATERAL VERSUS SINGLE LUNG TRANSPLANTATION FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE Joseph E. Bavaria, MD Robert Kotloff, MD Harold Palevsky, MD Bruce Rosengard, MD John R. Roberts, MD Peter M. Wahl,
More informationReperfusion Injury Significantly Impacts Clinical Outcome After Pulmonary Transplantation
Reperfusion Injury Significantly Impacts Clinical Outcome After Pulmonary Transplantation Robert C. King, MD, Oliver A. R. Binns, MD, Filiberto Rodriguez, MD, R. Chai Kanithanon, BA, Thomas M. Daniel,
More informationTREATMENT OF REFRACTORY ACUTE ALLOGRAFT REJECTION WITH AEROSOLIZED CYCLOSPORINE IN LUNG TRANSPLANT RECIPIENTS
TREATMENT OF REFRACTORY ACUTE ALLOGRAFT REJECTION WITH AEROSOLIZED CYCLOSPORINE IN LUNG TRANSPLANT RECIPIENTS Robert J. Keenan, MD Aldo Iacono, MD James H. Dauber, MD Adriana Zeevi, PhD Samuel A. Yousem,
More information06/04/2013 ISHLT. 2 International Conference on Respiratory Physiotherapy ARIR Genova, March 21 23, 2013
LUNG TRANSPLANTS The Journal of Heart and Lung Transplantation, 2012 2 International Conference on Respiratory Physiotherapy ARIR Genova, March 21 23, 2013 LUNG TRANSPLANTATION:STATE OF THE ART L. Santambrogio
More informationPredictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
Pediatr Transplantation 2013: 17: 436 440 2013 John Wiley & Sons A/S. Pediatric Transplantation DOI: 10.1111/petr.12095 Predictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
More informationWe have no disclosures
Pulmonary Artery Pressure Changes Differentially Effect Survival in Lung Transplant Patients with COPD and Pulmonary Hypertension: An Analysis of the UNOS Registry Kathryn L. O Keefe MD, Ahmet Kilic MD,
More informationLung transplantation has become a feasible option. Bronchiolitis Obliterans Syndrome and Additional Costs of Lung Transplantation*
Bronchiolitis Obliterans Syndrome and Additional Costs of Lung Transplantation* Jan W. K. van den Berg, MD, PhD; Petra J. van Enckevort, PhD; Elisabeth M. TenVergert, PhD; Dirkje S. Postma, MD, PhD; Wim
More informationTransplant Hepatology
Transplant Hepatology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified
More informationInova Transplant Center
Inova Transplant Center I think I am a great candidate! Out with the old! in with the new! Help us help you! Pretransplant evaluation: goals Determine suitability as candidate Nature of surgery Optimize
More informationLung Transplantation for Primary and Secondary Pulmonary Hypertension
Lung Transplantation for Primary and Secondary Pulmonary Hypertension John V. Conte, MD, Marvin J. Borja, BS, Chandrahas B. Patel, BS, Steven C. Yang, MD, Rajiv M. Jhaveri, MD, and Jonathan B. Orens, MD
More informationPost Operative Management in Heart Transplant นพ พ ชร อ องจร ต ศ ลยศาสตร ห วใจและทรวงอก จ ฬาลงกรณ
Post Operative Management in Heart Transplant นพ พ ชร อ องจร ต ศ ลยศาสตร ห วใจและทรวงอก จ ฬาลงกรณ Art of Good Cooking Good Ingredient Good donor + OK recipient Good technique Good team Good timing Good
More informationPressure to expand the donor pool has affected all
Effect of Donor Age and Ischemic Time on Intermediate Survival and Morbidity After Lung Transplantation* Dan M. Meyer, MD; Leah E. Bennett, PhD; Richard J. Novick, MD; and Jeffrey D. Hosenpud, MD Background:
More information1. Discuss the basic pathophysiology of end-stage liver and kidney failure.
TRANSPLANT SURGERY ROTATION (PGY1, 2) A. Medical Knowledge Goal: The resident will achieve a detailed knowledge of the evaluation and treatment of a variety of disease processes. The resident will be exposed
More informationIndex. Crit Care Clin 19 (2003)
Crit Care Clin 19 (2003) 331 335 Index A ACVECC. See American College of Veterinary Emergency and Critical Care (ACVECC). Aging. See also Elderly; Geriatric critical care. respiratory function effects
More informationCitation for published version (APA): Ouwens, J. P. (2002). The Groningen lung transplant program: 10 years of experience Groningen: s.n.
University of Groningen The Groningen lung transplant program Ouwens, Jan Paul IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check
More informationHeart/Lung Transplant
Medical Policy Manual Transplant, Policy No. 03 Heart/Lung Transplant Next Review: March 2019 Last Review: April 2018 Effective: June 1, 2018 IMPORTANT REMINDER Medical Policies are developed to provide
More informationIdiopathic pulmonary fibrosis (IPF) is a major type. A New Treatment Strategy for Advanced Idiopathic Interstitial Pneumonia*
A New Treatment Strategy for Advanced Idiopathic Interstitial Pneumonia* Living-Donor Lobar Lung Transplantation Hiroshi Date, MD; Yasushi Tanimoto, MD; Keiji Goto, MD; Ichiro Yamadori, MD; Motoi Aoe,
More informationOriginal Policy Date
MP 7.03.07 Heart/Lung Transplant Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical Policy Index
More informationHeart Transplantation ACC Middle East Conference Dubai UAE October 21, 2017
Heart Transplantation ACC Middle East Conference Dubai UAE October 21, 2017 Randall C Starling MD MPH FACC FAHA FESC FHFSA Professor of Medicine Kaufman Center for Heart Failure Department of Cardiovascular
More informationSingle-lung retransplantation for late graft failure.
Eur Resplr J, 1993, 6, 1202-1206 Printed in UK all rights reserved Copyright ERS Journals Ltd 1993 European Respiratory Journal ISSN 0903 1936 Single-lung retransplantation for late graft failure M. Foumier*,
More informationJohns Hopkins Hospital Comprehensive Transplant Center Informed Consent Form for Thoracic Organ Recipient Evaluation
Johns Hopkins Hospital Comprehensive Transplant Center Informed Consent Form for Thoracic Organ Recipient Evaluation The decision to undergo transplantation can be extremely difficult and often confusing.
More informationCandidates about. Lung Allocation Policy. for Transplant. Questions & A n s we r s TA L K I N G A B O U T T R A N S P L A N TAT I O N
TA L K I N G A B O U T T R A N S P L A N TAT I O N Questions & A n s we r s for Transplant Candidates about Lung Allocation Policy U N I T E D N E T W O R K F O R O R G A N S H A R I N G What are the OPTN
More informationPUO in the Immunocompromised Host: CMV and beyond
PUO in the Immunocompromised Host: CMV and beyond PUO in the immunocompromised host: role of viral infections Nature of host defect T cell defects Underlying disease Treatment Nature of clinical presentation
More informationClinical Outcomes of Lung Transplantation: Experience at Asan Medical Center
Korean J Thorac Cardiovasc Surg 2018;51:22-28 ISSN: 2233-601X (Print) ISSN: 2093-6516 (Online) CLINICAL RESEARCH https://doi.org/10.5090/kjtcs.2018.51.1.22 Clinical Outcomes of Lung Transplantation: Experience
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine
Specific Basic Standards for Osteopathic Fellowship Training in Pulmonary / Critical Care Medicine American Osteopathic Association and American College of Osteopathic Internists BOT Rev. 2/2011 These
More informationTransplant in Pediatric Heart Failure
Transplant in Pediatric Heart Failure Francis Fynn-Thompson, MD Co-Director, Center for Airway Disorders Surgical Director, Pediatric Mechanical Support Program Surgical Director, Heart and Lung Transplantation
More informationPredicting Postoperative Pulmonary Function in Patients Undergoing Lung Resection*
Predicting Postoperative Pulmonary Function in Patients Undergoing Lung Resection* Bernhardt G. Zeiher, MD; Thomas ]. Gross, MD; Jeffery A. Kern, MD, FCCP; Louis A. Lanza, MD, FCCP; and Michael W. Peterson,
More informationCitation for published version (APA): Ouwens, J. P. (2002). The Groningen lung transplant program: 10 years of experience Groningen: s.n.
University of Groningen The Groningen lung transplant program Ouwens, Jan Paul IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check
More informationIndex. Note: Page numbers of article titles are in boldface type
Index Note: Page numbers of article titles are in boldface type A Acute coronary syndrome, perioperative oxygen in, 599 600 Acute lung injury (ALI). See Lung injury and Acute respiratory distress syndrome.
More informationDéjà vu all over again
Disclosures Déjà vu all over again None Jonathan Singer MD MS University of California, San Francisco HPI 49 y/o woman presents for lung transplant evaluation for Hypersensitivity Pneumonitis Exposures:
More informationOntario s Referral and Listing Criteria for Adult Lung Transplantation
Ontario s Referral and Listing Criteria for Adult Lung Transplantation Version 3.0 Trillium Gift of Life Network Adult Lung Transplantation Referral & Listing Criteria PATIENT REFERRAL CRITERIA: The patient
More informationInduction Immunosuppression for Lung Transplantation With OKT3
Induction Immunosuppression for Lung Transplantation With OKT3 John C. Wain, MD, Cameron D. Wright, MD, Daniel P. Ryan, MD, Susan L. Zorb, RN, Douglas J. Mathisen, MD, and Leo C. Ginns, MD Thoracic Surgical,
More informationPrevalence and Outcome of Bronchiolitis Obliterans Syndrome After Lung Transplantation
Prevalence and Outcome of Bronchiolitis Obliterans Syndrome After Lung Transplantation Sudhir Sundaresan, MD, Elbert P. Trulock, MD, Thallachallour Mohanakumar, PhD, Joel D. Cooper, MD, G. Alexander Patterson,
More informationMODERATOR Felix Rapaport, other members of this
The First Lung Transplant in Man (1963) and the First Heart Transplant in Man (1964) J.D. Hardy MODERATOR Felix Rapaport, other members of this distinguished panel, and members of the audience, I will
More informationResults of single and bilateral lung transplantation in 131 consecutive recipients
Results of single and bilateral lung transplantation in 131 consecutive recipients We reviewed results of the first 131 recipients who received a single or bilateral sequential lung transplant at Barnes
More informationLung and Lobar Lung Transplant. Populations Interventions Comparators Outcomes Individuals: With end-stage pulmonary disease
Protocol Lung and Lobar Lung Transplant (70307) Medical Benefit Effective Date: 07/01/14 Next Review Date: 03/19 Preauthorization Yes Review Dates: 09/09, 09/10, 09/11, 07/12, 03/13, 03/14, 03/15, 03/16,
More informationCorporate Medical Policy
Corporate Medical Policy Lung and Lobar Lung Transplantation File Name: Origination: Last CAP Review: Next CAP Review: Last Review: lung_and_lobar_lung_transplantation 3/1997 3/2017 3/2018 9/2017 Description
More informationInterventional procedures guidance Published: 20 December 2017 nice.org.uk/guidance/ipg600
Endobronchial valve insertion to reduce lung volume in emphysema Interventional procedures guidance Published: 20 December 2017 nice.org.uk/guidance/ipg600 Your responsibility This guidance represents
More informationPolicy Specific Section: May 16, 1984 April 9, 2014
Medical Policy Heart Transplant Type: Medical Necessity and Investigational / Experimental Policy Specific Section: Transplant Original Policy Date: Effective Date: May 16, 1984 April 9, 2014 Definitions
More informationLung Transplantation A look Inside A Surgeon s Perspective
Lung Transplantation A look Inside A Surgeon s Perspective Hassan Nemeh, MD Henry Ford Hospital Michigan Society of Respiratory Care Spring Conference 2016 Historical background Alexis Carrel 1905 Reported
More informationINTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION a Society that includes Basic Science, the Failing Heart, and Advanced Lung Disease
International Society of Heart and Lung Transplantation Advisory Statement on the Implications of Pandemic Influenza for Thoracic Organ Transplantation This advisory statement has been produced by the
More informationTopic: Lung and Lobar Lung Transplant Date of Origin: March Section: Transplant Last Reviewed Date: March 2013
Medical Policy Manual Topic: Lung and Lobar Lung Transplant Date of Origin: March 2013 Section: Transplant Last Reviewed Date: March 2013 Policy No: 08 Effective Date: September 1, 2013 IMPORTANT REMINDER
More informationExtracorporeal Life Support Organization (ELSO) Guidelines for Pediatric Respiratory Failure
Extracorporeal Life Support Organization (ELSO) Guidelines for Pediatric Respiratory Failure Introduction This pediatric respiratory failure guideline is a supplement to ELSO s General Guidelines for all
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: heart_lung_transplantation 5/1985 6/2018 6/2019 6/2018 Description of Procedure or Service Combined heart/lung
More informationclinical investigations in critical care The Role of Open-Lung Biopsy in ARDS*
clinical investigations in critical care The Role of Open-Lung Biopsy in ARDS* Sanjay R. Patel, MD; Dimitri Karmpaliotis, MD; Najib T. Ayas, MD; Eugene J. Mark, MD; John Wain, MD, FCCP; B. Taylor Thompson,
More informationThe Pulmonary Pathology of Iatrogenic Immunosuppression. Kevin O. Leslie, M.D. Mayo Clinic Scottsdale
The Pulmonary Pathology of Iatrogenic Immunosuppression Kevin O. Leslie, M.D. Mayo Clinic Scottsdale The indications for iatrogenic immunosuppression Autoimmune/inflammatory disease Chemotherapy for malignant
More informationOntario s Referral and Listing Criteria for Adult Heart Transplantation
Ontario s Referral and Listing Criteria for Adult Heart Transplantation Version 3.0 Trillium Gift of Life Network Adult Heart Transplantation Referral & Listing Criteria PATIENT REFERRAL CRITERIA: The
More informationOverall Goals and Objectives for Transplant Hepatology EPAs:
Overall Goals and Objectives for Transplant Hepatology EPAs: 1. DIAGNOSTIC LIST During the one-year Advanced Pediatric Transplant Hepatology Program, fellows are expected to develop comprehensive skills
More informationLung Allograft Dysfunction
Lung Allograft Dysfunction Carlos S. Restrepo M.D. Ameya Baxi M.D. Department of Radiology University of Texas Health San Antonio Disclaimer: We do not have any conflict of interest or financial gain to
More informationPreoperative Workup for Pulmonary Resection. Kristen Bridges, M.D. Richmond University Medical Center January 21, 2016
Preoperative Workup for Pulmonary Resection Kristen Bridges, M.D. Richmond University Medical Center January 21, 2016 Patient Presentation 50 yo male with 70 pack year smoking history Large R hilar lung
More informationPREOPERATIVE CARDIOPULMONARY ASSESSMENT FOR LIVER TRANSPLANTATION James Y. Findlay Mayo Clinic College of Medicine, Rochester, MN, USA.
PREOPERATIVE CARDIOPULMONARY ASSESSMENT FOR LIVER TRANSPLANTATION James Y. Findlay Mayo Clinic College of Medicine, Rochester, MN, USA Introduction Liver transplantation (LT) has gone from being a high-risk
More informationRISK FACTORS FOR THE DEVELOPMENT OF BRONCHIOLITIS OBLITERANS SYNDROME AFTER LUNG TRANSPLANTATION
Illllll RISK FACTORS FOR THE DEVELOPMENT OF BRONCHIOLITIS OBLITERANS SYNDROME AFTER LUNG TRANSPLANTATION Timothy J. Kroshus, MD Vibhu R. Kshettry, MD Kay Savik, MS Ranjit John, MD Marshall I. Hertz, MD
More informationAcute Respiratory Distress Syndrome (ARDS) An Update
Acute Respiratory Distress Syndrome (ARDS) An Update Prof. A.S.M. Areef Ahsan FCPS(Medicine) MD(Critical Care Medicine) MD ( Chest) Head, Dept. of Critical Care Medicine BIRDEM General Hospital INTRODUCTION
More informationSteroid-Free Maintenance Immunosuppression After Heart Transplantation
Steroid-Free Maintenance Immunosuppression After Heart Transplantation Timothy E. Oaks, MD, Thomas Wannenberg, MD, Sherry A. Close, BSN, Laura E. Tuttle, BSN, and Neal D. Kon, MD Departments of Cardiothoracic
More informationProgression pattern of restrictive allograft syndrome after lung transplantation
http://www.jhltonline.org FEATURED ARTICLES Progression pattern of restrictive allograft syndrome after lung transplantation Masaaki Sato, MD, PhD, a,b David M. Hwang, MD, PhD, a Thomas K. Waddell, MD,
More informationLung Transplantation in the United States,
American Journal of Transplantation 2009; 9 (Part 2): 942 958 Wiley Periodicals Inc. No claim to original US government works Journal compilation C 2009 The American Society of Transplantation and the
More informationLONG-TERM RESULTS OF CARDIAC TRANSPLANTATION IN PATIENTS OLDER THAN SIXTY YEARS
LONG-TERM RESULTS OF CARDIAC TRANSPLANTATION IN PATIENTS OLDER THAN SIXTY YEARS Advanced age has traditionally been a contraindication to cardiac transplantation. We have, however, offered cardiac transplantation
More informationHeart Transplant: State of the Art. Dr Nick Banner
Heart Transplant: State of the Art Dr Nick Banner Heart Transplantation What is achieved Current challenges Donor scarcity More complex recipients Long-term limitations Non-specific Pharmacological Immunosuppression
More informationSurgical indications: Non-malignant pulmonary diseases. Punnarerk Thongcharoen
Surgical indications: Non-malignant pulmonary diseases Punnarerk Thongcharoen Non-malignant Malignant as a pathological term: Cancer Non-malignant = not cancer Malignant as an adjective: Disposed to cause
More informationStudy of systemic fungal infections in renal transplant recipients
Original Research Article Study of systemic fungal infections in renal transplant recipients N.D. Srinivasaprasad 1*, G. Chandramohan 1, M. Edwin Fernando 2 1 DM (Nephrology), Assistant Professor, 2 DM
More informationBilateral Versus Single Lung Transplant for Idiopathic Pulmonary Fibrosis
ArtIcle Bilateral Versus Single Lung Transplant for Idiopathic Pulmonary Fibrosis Sven Lehmann, 1* Madlen Uhlemann, 2* Sergey Leontyev, 1 Joerg Seeburger, 1 Jens Garbade, 1 Denis R. Merk, 1 Hartmuth B.
More informationLIVING-DONOR LOBAR LUNG TRANSPLANTATION EXPERIENCE: INTERMEDIATE RESULTS
LIVING-DONOR LOBAR LUNG TRANSPLANTATION EXPERIENCE: INTERMEDIATE RESULTS Vaughn A. Starnes Mark L. Barr Robbin G. Cohen Jeffrey A. Hagen Winfield J. Wells Monica V. Horn Felicia A. Schenkel Objective:
More informationPediatric lung transplantation
Cardiac and Pulmonary Transplantation Pediatric lung transplantation The years 1985 to 1992 and the clinical trial of FK 506 The application of lung transplantation to the pediatric population was a natural
More informationLiver Transplantation: The End of the Road in Chronic Hepatitis C Infection
University of Massachusetts Medical School escholarship@umms UMass Center for Clinical and Translational Science Research Retreat 2012 UMass Center for Clinical and Translational Science Research Retreat
More informationKathryn L. O Keefe, 1 Ahmet Kilic, 1 Amy Pope-Harman, 2 Don Hayes, Jr., 2,3 Stephen Kirkby, 2,3 Robert S. D. Higgins, 1 Bryan A. Whitson 1.
ArtIcle Changes in Pulmonary Artery Pressure Affect Survival Differently in Lung Transplant Recipients Who Have Pulmonary Hypertension or Chronic Obstructive Pulmonary Disease Kathryn L. O Keefe, 1 Ahmet
More informationMaximizing Donor Lungs: Push and Mend. Amy Pope-Harman, MD. Klassen Research Day. January 22, 2015
Maximizing Donor Lungs: Push and Mend Amy Pope-Harman, MD Klassen Research Day January 22, 2015 Goals Why do we care about donors? Bad things happens to donor lungs Donor criteria history Where we can
More informationSCLERODERMA LUNG DISEASE: WHAT THE PATIENT SHOULD KNOW
SCLERODERMA LUNG DISEASE: WHAT THE PATIENT SHOULD KNOW Lung disease can be a serious complication of scleroderma. The two most common types of lung disease in patients with scleroderma are interstitial
More informationHeart-lung transplantation: adult indications and outcomes
Brief Report Heart-lung transplantation: adult indications and outcomes Yoshiya Toyoda, Yasuhiro Toyoda 2 Temple University, USA; 2 University of Pittsburgh, USA Correspondence to: Yoshiya Toyoda, MD,
More informationCytomegalovirus (CMV) Viral Load in Bronchoalveolar Lavage Fluid (BALF) and Plasma to Diagnose Lung Transplant Associated CMV Pneumonia
Cytomegalovirus (CMV) Viral Load in Bronchoalveolar Lavage Fluid (BALF) and Plasma to Diagnose Lung Transplant Associated CMV Pneumonia I.P. Lodding 1,2, H.H. Schultz 3, J.U. Jensen 1,5, C. Andersen 4,
More informationInformation for patients (and their families) waiting for liver transplantation
Information for patients (and their families) waiting for liver transplantation Waiting list? What is liver transplant? Postoperative conditions? Ver.: 5/2017 1 What is a liver transplant? Liver transplantation
More informationLung and Lobar Lung Transplant
Lung and Lobar Lung Transplant Policy Number: Original Effective Date: MM.07.024 05/21/1999 Line(s) of Business: Current Effective Date: HMO; PPO 08/01/2014 Section: Transplants Place(s) of Service: Inpatient
More informationDoes Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?
Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles
More informationParenchymal air leak is a frequent complication after. Pleural Tent After Upper Lobectomy: A Randomized Study of Efficacy and Duration of Effect
Pleural After Upper Lobectomy: A Randomized Study of Efficacy and Duration of Effect Alessandro Brunelli, MD, Majed Al Refai, MD, Marco Monteverde, MD, Alessandro Borri, MD, Michele Salati, MD, Armando
More informationOutline. Congenital Heart Disease. Special Considerations for Special Populations: Congenital Heart Disease
Special Considerations for Special Populations: Congenital Heart Disease Valerie Bosco, FNP, EdD Alison Knauth Meadows, MD, PhD University of California San Francisco Adult Congenital Heart Program Outline
More informationINTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018
INTERSTITIAL LUNG DISEASE Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 Interstitial Lung Disease Interstitial Lung Disease Prevalence by Diagnosis: Idiopathic Interstitial
More informationLiving-donor lobar lung transplantation (LDLLT) was developed by. Living-donor lobar lung transplantation for various lung diseases.
Cardiothoracic Transplantation Date et al Living-donor lobar lung transplantation for various lung diseases Hiroshi Date, MD, a Motoi Aoe, MD, a Itaru Nagahiro, MD, a Yoshifumi Sano, MD, a Akio Andou,
More informationPostlung Transplant Survival is Equivalent Regardless of Cytomegalovirus Match Status
Postlung Transplant Survival is Equivalent Regardless of Cytomegalovirus Match Status Mark J. Russo, MD, MS, David I. Sternberg, MD, Kimberly N. Hong, MHSA, Robert A. Sorabella, BA, Alan J. Moskowitz,
More informationUCLA General Surgery Residency Program Rotation Educational Policy Goals and Objectives ROTATION: SURGICAL CRITICAL CARE AND TRANSPLANTATION SURGERY
UPDATED: August 2009 UCLA General Surgery Residency Program ROTATION: SURGICAL CRITICAL CARE AND TRANSPLANTATION SURGERY ROTATION DIRECTOR: Gerald Lipshutz, M.D. SITE: UCLA Medical Center LEVEL OF TRAINEE:
More informationHigh-Acuity Nursing. Global edition. Global edition. Kathleen Dorman Wagner Melanie G. Hardin-Pierce
High-Acuity Nursing For these Global Editions, the editorial team at Pearson has collaborated with educators across the world to address a wide range of subjects and requirements, equipping students with
More informationInduction Immunosuppression With Rabbit Antithymocyte Globulin in Pediatric Liver Transplantation
LIVER TRANSPLANTATION 12:1210-1214, 2006 ORIGINAL ARTICLE Induction Immunosuppression With Rabbit Antithymocyte Globulin in Pediatric Liver Transplantation Ashesh Shah, 1 Avinash Agarwal, 1 Richard Mangus,
More informationClinical lung transplantation in Japan: Current status and future trends
Allergology International (2002) 51: 1 8 Review Article Clinical lung transplantation in Japan: Current status and future trends Yuji Matsumura, Yoshinori Okada, Kazuyoshi Shimada, Tetsu Sado and Takashi
More informationOverview of paediatric heart-lung transplantation: a global perspective
Editorial Overview of paediatric heart-lung transplantation: a global perspective Yishay Orr The Heart Centre for Children, The Children s Hospital at Westmead, Westmead, NSW 2145, Australia Correspondence
More informationPSYCHOSOCIAL FACTORS AND MOBILE HEALTH INTERVENTION: IMPACT ON LONG-TERM OUTCOMES AFTER LUNG TRANSPLANTATION. Emily Muskin Rosenberger
PSYCHOSOCIAL FACTORS AND MOBILE HEALTH INTERVENTION: IMPACT ON LONG-TERM OUTCOMES AFTER LUNG TRANSPLANTATION by Emily Muskin Rosenberger BA, Wesleyan University, 2007 Submitted to the Graduate Faculty
More information5/15/2018. Background. Disclosure Statement
5/15/218 Efficacy of Bronchoscopically-Administered in the Setting of Primary Graft Dysfunction after Lung Transplantation Primary Investigator: Sana Ahmed, PharmD Research Associates: Matthew Soto-Arenall,
More informationPULMONARY MEDICINE BOARD REVIEW. Financial Conflicts of Interest. Question #1: Question #1 (Cont.): None. Christopher H. Fanta, M.D.
PULMONARY MEDICINE BOARD REVIEW Christopher H. Fanta, M.D. Pulmonary and Critical Care Division Brigham and Women s Hospital Partners Asthma Center Harvard Medical School Financial Conflicts of Interest
More informationCardiovascular Institute
Allegheny Health Network Cardiovascular Institute Extracorporeal Membrane Oxygenation (ECMO) Program Our patient survival rate is higher than the national average. ECMO experts. Multidisciplinary team.
More informationEndobronchial valve insertion to reduce lung volume in emphysema
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Endobronchial valve insertion to reduce lung volume in emphysema Emphysema is a chronic lung disease that
More informationLung Injury after HCT
Lung Injury after HCT J. Douglas Rizzo, MD, MS Financial Disclosure None SCS06_1.ppt Background HCT an important therapeutic modality for malignant and non-malignant diseases Pulmonary Toxicity common
More informationNHS. Living-donor lung transplantation for end-stage lung disease. National Institute for Health and Clinical Excellence. Issue date: May 2006
NHS National Institute for Health and Clinical Excellence Issue date: May 2006 Living-donor lung transplantation for end-stage Understanding NICE guidance information for people considering the procedure,
More informationMEDICAL PROGRESS. Review Articles. alpha 1
Review Articles Medical Progress LUNG TRANSPLANTATION SELIM M. ARCASOY, M.D., AND ROBERT M. KOTLOFF, M.D. SINCE the performance of the first successful lung transplantation nearly two decades ago, the
More informationPreoperative Pulmonary Evaluation. Michelle Zetoony, DO, FCCP, FACOI Board Certified Pulmonary, Critical Care, Sleep and Internal Medicine
Preoperative Pulmonary Evaluation Michelle Zetoony, DO, FCCP, FACOI Board Certified Pulmonary, Critical Care, Sleep and Internal Medicine No disclosures related to this lecture. Objectives Identify pulmonary
More informationCardiac disease is well known to be the leading cause
Coronary Artery Bypass Grafting in Who Require Long-Term Dialysis Leena Khaitan, MD, Francis P. Sutter, DO, and Scott M. Goldman, MD Main Line Cardiothoracic Surgeons, Lankenau Hospital, Jefferson Health
More informationDefinitions. You & Your New Transplant ` 38
Definitions Acute Short, relatively severe Analgesic Pain medicine Anemia A low number of red blood cells Anesthetic Medication that dulls sensation in order to reduce pain Acute Tubular Necrosis (ATN)
More informationClinical- Pathologic Conference
Clinical- Pathologic Conference Clinical-pathologic conference in general thoracic surgery: Bilateral lung transplantation for sarcoidosis with aspergilloma G. Alexander Patterson, MD From the Washington
More information