European Respiratory Journal最新文献

{"title":"From donor to durable graft: modern paradigms in lung transplantation.","authors":"Yasufumi Goda, Ramiro Fernandez, Gloria W Li, Cyrus A Vahdatpour, Prangthip Charoenpong, Muhammad K Hayat-Syed, Mudassir M Banday, Justin M Segraves, Hao-Min Pan, Gabriel Loor, Nirmal S Sharma","doi":"10.1183/13993003.00165-2026","DOIUrl":"https://doi.org/10.1183/13993003.00165-2026","url":null,"abstract":"<p><p>Lung transplantation is the only definitive therapy for selected patients with end-stage respiratory disease. Although survival after lung transplantation has improved over recent decades, long-term outcomes remain inferior to those of other solid organ transplants, largely because of chronic lung allograft dysfunction and infection-related complications. In this review, we synthesize contemporary practice across the lung transplant continuum, from donor identification and optimization to long-term survivorship. We first examine donor selection, management, and expansion strategies, including extended-criteria and donation-after-circulatory-death donors, ex vivo lung perfusion, uncontrolled DCD, and living-donor lobar transplantation. We then review current allocation frameworks, with emphasis on the U.S. composite allocation score, and highlight key candidate-level factors such as frailty, nutritional status, comorbidities, and the unique considerations for pediatric candidates and those bridged with extracorporeal support. Advances in operative techniques, intraoperative mechanical support, enhanced recovery pathways, and early extubation are discussed in the context of primary graft dysfunction and perioperative morbidity. We outline contemporary maintenance immunosuppressive regimens, infection prophylaxis strategies, and the spectrum of early and late alloimmune events, as well as post-transplant malignancies and their impact on long-term outcomes. Finally, we address functional recovery, health-related quality of life, reproductive health, and preventive care, and explore emerging frontiers including precision immunomonitoring with donor-derived cell-free DNA, cell-based immunotherapies, and lung xenotransplantation. Together, these developments underscore the substantial progress achieved and the opportunities that remain to extend allograft survival, reduce treatment-related toxicity, and improve the lived experience of lung transplant recipients.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implication of malignant pleural metastases in stage M1a non-small cell lung cancer in a real-world Dutch cohort receiving chemotherapy and/or immunotherapy.","authors":"Anneloes L Noordhof, Ronald A M Damhuis, Kevin G Blyth, Paul E van Schil, Najib M Rahman, Lizza E L Hendriks, Wouter H van Geffen","doi":"10.1183/13993003.00555-2026","DOIUrl":"https://doi.org/10.1183/13993003.00555-2026","url":null,"abstract":"<p><strong>Introduction: </strong>In the updated 9th TNM non-small cell lung cancer (NSCLC) staging edition, pleural and pulmonary metastases remain grouped within the M1a category, inferring similar prognostic implications. The aim was to evaluate the prognostic implication on overall survival (OS) of pleural <i>versus</i> contralateral pulmonary metastases in a stage M1a cohort, when treated with immune checkpoint inhibitors (ICI), chemotherapy, or chemo-ICI.</p><p><strong>Methods: </strong>Retrospective real-world data from the Netherlands Cancer Registry was used, including patients with M1a NSCLC that received systemic treatment between 2010-2022. The primary outcome was 2-year OS.</p><p><strong>Results: </strong>5632 patients were included: 2701 with contralateral lung metastases, 2590 with pleural metastases and 341 with both. Pleural metastases were more common in men (p=<0.001), in patients with worse performance score (p=<0.001) and in patients receiving mono-ICI (p=<0.001).Patients with contralateral lung metastases had a better 2-year OS (for chemo, ICI and chemo-ICI, this was 26.9% (95% CI 24.9-28.9), 49.5% (95% CI 43.4-55.2) and 40.4% (95% CI 36.5-44.2), respectively) than patients with pleural metastases (18.5% (95% CI 16.6-20.4), 41.6% (95% CI 36.6-46.5) and 28.6% (95% CI 24.9-32.4), respectively). Patients with both contralateral lung and pleural metastases had the worst OS (12.1% (95% CI 8.2-16.7), 31.1% (95% CI 18.4-44.7) and 25.0% (95% CI 15.7-35.4), respectively). The difference in OS was irrespective of the type of systemic treatment.</p><p><strong>Conclusion: </strong>Patients with pleural metastases have inferior OS compared to those with contralateral lung metastases. These findings indicate prognostic heterogeneity between M1a descriptors.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards global equity in access to medical devices.","authors":"Ramon Farré, Sy Duong-Quy, Laura Gochicoa-Rangel, Anh Tuan Dinh-Xuan","doi":"10.1183/13993003.01431-2026","DOIUrl":"https://doi.org/10.1183/13993003.01431-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Positive airway pressure adherence with mortality and cardiovascular events in high vs low risk sleep apnoea patients.","authors":"Sébastien Bailly, Margaux Blanchard, Adam Benjafield, Wojciech Trzepizur, Sandrine Kerbrat, François Goupil, Audrey Thomas, Raphael Heinzer, Abdelkebir Sabil, Frédéric Gagnadoux","doi":"10.1183/13993003.00531-2026","DOIUrl":"10.1183/13993003.00531-2026","url":null,"abstract":"<p><strong>Background: </strong>Positive airway pressure (PAP) has shown inconsistent effects on cardiovascular (CV) outcomes in obstructive sleep apnoea (OSA). Physiological biomarkers derived from sleep studies such as sleep apnoea-specific hypoxic burden (SASHB) and event-related heart rate response (ΔHR) may help identify OSA patients with modifiable CV risk.</p><p><strong>Methods: </strong>3370 PAP-treated moderate-to-severe OSA patients, from the <i>Pays de la Loire</i> sleep-clinic cohort linked to the French health database (SNDS), were stratified by a high-risk status defined by SASHB >40.6%·min·h⁻¹ or ΔHR >21.7 bpm, using percentile-based approach for threshold estimation. The primary composite outcome was defined using the first occurrence in SNDS of major adverse CV event (MACE). Cox models assessed the association between PAP adherence (mean PAP use ≥4 h/night) and MACE occurrence.</p><p><strong>Results: </strong>Over a median follow-up of 9 years, 740 patients experienced a MACE. PAP adherence <i>versus</i> non-adherence was associated with a reduced risk of MACE (adjusted hazard ratio [HR] 0.53, 95% CI [0.46-0.62], p<0.001), but the association was greater in patients with (71.7%) <i>versus</i> without (28.3%) high risk status (interaction HR 0.61 [0.43-0.87]; interaction p value =0.006). Similar findings were obtained using a simplified version of SASHB and ΔHR automatically derived from the single oximetry signal. The interaction of high-risk status between PAP adherence and MACE appeared stronger in non-sleepy patients.</p><p><strong>Conclusions: </strong>In sleep-clinic, the association of PAP adherence with reduced MACE risk was stronger in high risk OSA. These findings support the integration of hypoxic and autonomic biomarkers into clinical decision pathways for CV risk reduction in OSA.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle aspiration <i>versus</i> intercostal chest drain for secondary spontaneous pneumothorax (the PRINCE-SSP trial): a pragmatic, open-label, multi-centre, non-inferiority, randomised controlled trial.","authors":"Steven Walker, Siobhan Creanor, Edward Carlton, Eleanor Taylor, Heather Cook, Ella Chaudhuri, James Connors, Ramon Luengo-Fernandez, Adam Palmer-Welsh, Svetlana Ratushnyak, Augustine Smithies, Stefan J Marciniak, John P Corcoran, Adeel Ashraf, James Walters, Eslam Abdelrehem, Ben Bloom, Cyrus Daneshvar, Louise Anning, Peter Russell, Duneesha de Fonseka, Jayne Holme, Asad Anwar, Taj Hassan, Christopher Corbett, Samer Elkhodair, Girish Boggaram, Rakesh K Panchal, Kyaw Zeya, Bhaskar Sarvesh, Kimberly Ponsworno, Eleanor C Barton, Rahul Bhatnagar, Abiramy Jeyabalan, Robert F Miller, Nick Maskell","doi":"10.1183/13993003.00344-2026","DOIUrl":"https://doi.org/10.1183/13993003.00344-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"United for better breathing: reflections on progress and future priorities for partnership between patients, clinicians and researchers within respiratory research, education and care.","authors":"Liam Galvin, Courtney Coleman","doi":"10.1183/13993003.01191-2026","DOIUrl":"https://doi.org/10.1183/13993003.01191-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"68 2","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-driven CT quantification of mucus plugs to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis: a randomised controlled trial.","authors":"Yuxin Chen, Rudolfs Latisenko, Stephanie D Davis, Margaret Rosenfeld, Felix Ratjen, Karen D Hinckley Stukovsky, Stephen Stick, Harm A W M Tiddens","doi":"10.1183/13993003.01917-2025","DOIUrl":"10.1183/13993003.01917-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical support tool using artificial intelligence to diagnose pulmonary hypertension.","authors":"Seyed M Shams, Mary E Maldarelli, Yijun Yin, Steven Cassady, Gautam Ramani, Colleen M Ennett, Bradley A Maron, Katarina Zeder","doi":"10.1183/13993003.00125-2026","DOIUrl":"10.1183/13993003.00125-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>ERJ</i> Podcast August 2026: Fentanyl or morphine for persistent dyspnoea in COPD.","authors":"","doi":"10.1183/13993003.E6802-2026","DOIUrl":"https://doi.org/10.1183/13993003.E6802-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"68 2","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing mucus plugs in COPD: a potential role for erdosteine.","authors":"Peter M A Calverley","doi":"10.1183/13993003.01274-2026","DOIUrl":"10.1183/13993003.01274-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"68 2","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}