Journal of Heart and Lung Transplantation最新文献_第9页

Restoring discarded porcine lungs by ex vivo removal of neutrophil extracellular traps. 通过体外清除中性粒细胞胞外捕获物恢复废弃猪肺。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-20 DOI: 10.1016/j.healun.2024.07.007

Margareta Mittendorfer, Leif Pierre, Tibor Huzevka, Jeremy Schofield, Simon T Abrams, Guozheng Wang, Cheng-Hock Toh, Nicholas B Bèchet, Ilma Caprnja, Gunilla Kjellberg, Andrew Aswani, Franziska Olm, Sandra Lindstedt

{"title":"Restoring discarded porcine lungs by ex vivo removal of neutrophil extracellular traps.","authors":"Margareta Mittendorfer, Leif Pierre, Tibor Huzevka, Jeremy Schofield, Simon T Abrams, Guozheng Wang, Cheng-Hock Toh, Nicholas B Bèchet, Ilma Caprnja, Gunilla Kjellberg, Andrew Aswani, Franziska Olm, Sandra Lindstedt","doi":"10.1016/j.healun.2024.07.007","DOIUrl":"10.1016/j.healun.2024.07.007","url":null,"abstract":"<p><strong>Background: </strong>By causing inflammation and tissue damage, neutrophil extracellular traps (NETs) constitute an underlying mechanism of aspiration-induced lung injury, a major factor of the low utilization of donor lungs in lung transplantation (LTx).</p><p><strong>Methods: </strong>To determine whether NET removal during ex vivo lung perfusion (EVLP) can restore lung function and morphology in aspiration-damaged lungs, gastric aspiration lung injury was induced in 12 pigs. After confirmation of acute respiratory distress syndrome, the lungs were explanted and assigned to NET removal connected to EVLP (treated) (n = 6) or EVLP only (nontreated) (n = 6). Hemodynamic measurements were taken, and blood and tissue samples were collected to assess lung function, morphology, levels of cell-free DNA, extracellular histones, and nucleosomes as markers of NETs, as well as cytokine levels.</p><p><strong>Results: </strong>After EVLP and NET removal in porcine lungs, PaO<sub>2</sub>/FiO<sub>2</sub> ratios increased significantly compared to those undergoing EVLP alone (p = 0.0411). Treated lungs had lower cell-free DNA (p = 0.0260) and lower levels of extracellular histones in EVLP perfusate (p= 0.0260) than nontreated lungs. According to histopathology, treated lungs showed less immune cell infiltration and less edema compared with nontreated lungs, which was reflected in decreased levels of proinflammatory cytokines in EVLP perfusate and bronchoalveolar lavage fluid.</p><p><strong>Conclusions: </strong>To conclude, removing NETs during EVLP improved lung function and morphology in aspiration-damaged donor lungs. The ability to remove NETs during EVLP could represent a new therapeutic approach for LTx and potentially expand the donor pool for transplantation.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748395","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}

引用次数: 0

Alterations in circulating measures of Th2 immune responses pre-lung transplant associates with reduced primary graft dysfunction 肺移植前 Th2 免疫反应循环指标的改变与原发性移植物功能障碍的减少有关。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-17 DOI: 10.1016/j.healun.2024.07.011

Joanna M. Schaenman MD, PhD , Stephen Samuel Weigt MD , Mengtong Pan BS , Joshua J. Lee BS , Xinkai Zhou PhD , David Elashoff PhD , Michael Y. Shino MD , John M. Reynolds MD , Marie Budev DO , Pali Shah MD , Lianne G. Singer MD , Jamie L. Todd MD, MHS , Laurie D. Snyder MD, MHS , Scott Palmer MD, MHS , John Belperio MD

{"title":"Alterations in circulating measures of Th2 immune responses pre-lung transplant associates with reduced primary graft dysfunction","authors":"Joanna M. Schaenman MD, PhD , Stephen Samuel Weigt MD , Mengtong Pan BS , Joshua J. Lee BS , Xinkai Zhou PhD , David Elashoff PhD , Michael Y. Shino MD , John M. Reynolds MD , Marie Budev DO , Pali Shah MD , Lianne G. Singer MD , Jamie L. Todd MD, MHS , Laurie D. Snyder MD, MHS , Scott Palmer MD, MHS , John Belperio MD","doi":"10.1016/j.healun.2024.07.011","DOIUrl":"10.1016/j.healun.2024.07.011","url":null,"abstract":"<div><div>Primary graft dysfunction (PGD) is a complication of lung transplantation that continues to cause significant morbidity. The Th2 immune response has been shown to counteract tissue-damaging inflammation. We hypothesized that Th2 cytokines/chemokines in blood would be associated with protection from PGD. Utilizing pretransplant sera from the multicenter clinical trials in organ transplantation study, we evaluated Th2 cytokines/chemokines in 211 patients. Increased concentrations of Th2 cytokines were associated with freedom from PGD, namely IL-4 (odds ratio [OR] 0.66 [95% confidence interval {CI} 0.45-0.99], <em>p</em> = 0.043), IL-9 (OR 0.68 [95% CI 0.49-0.94], <em>p</em> = 0.019), IL-13 (OR 0.73 [95% CI 0.55-0.96], <em>p</em> = 0.023), and IL-6 (OR 0.74 [95% CI 0.56-0.98], <em>p</em> = 0.036). Multivariable regression performed for each cytokine, including clinically relevant covariables, confirmed these associations and additionally demonstrated association with IL-5 (OR 0.57 [95% CI 0.36-0.89], <em>p</em> = 0.014) and IL-10 (OR 0.55 [95% CI 0.32-0.96], <em>p</em> = 0.035). Higher levels of Th2 immune response before lung transplant appear to have a protective effect against PGD, which parallels the Th2 role in resolving inflammation and tissue injury. Pretransplant cytokine assessments could be utilized for recipient risk stratification.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727300","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}

引用次数: 0

The double barrel Impella exchange: A reliable method for uninterrupted mechanical circulatory support. 双管 Impella 交换器：不间断机械循环支持的可靠方法。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-17 DOI: 10.1016/j.healun.2024.07.009

Jessica S Clothier, Serge Kobsa, Jonathan Praeger, Markian Bojko, Mark Barr, Sanjeet Patel, Anahat Dhillon, Jonathan Cash, Raymond Lee

{"title":"The double barrel Impella exchange: A reliable method for uninterrupted mechanical circulatory support.","authors":"Jessica S Clothier, Serge Kobsa, Jonathan Praeger, Markian Bojko, Mark Barr, Sanjeet Patel, Anahat Dhillon, Jonathan Cash, Raymond Lee","doi":"10.1016/j.healun.2024.07.009","DOIUrl":"10.1016/j.healun.2024.07.009","url":null,"abstract":"<p><p>Classic Impella exchange interrupts flow when the old device is pulled into the aorta before advancing the new device across the aortic valve, threatening circulatory collapse and loss of left ventricular access. In \"double barrel,\" uninterrupted Impella exchange, the new device is placed into the ventricle alongside the old, where flow is first transitioned completely. Of 31 consecutive patients undergoing this procedure, none experienced intraoperative cardiac arrest, and 96.8% (30/31) had no new aortic insufficiency. One vascular complication ensued following known preoperative iliac injury. One patient suffered nonembolic stroke; another had subarachnoid hemorrhage. Fifty-five percent (17/31) of patients survived, with 22.6% (7/31) recovering, 25.8% (8/31) undergoing transplant, and 6.5% (2/31) transitioning to durable left ventricular assist device. Impella-only survival (83.3%, 10/12) was significantly higher than Impella-extracorporeal membrane oxygenation survival (36.8%, 7/19; (operating room) OR 14.46, 95% ((confidence interval) CI 1.74-119.93, p = 0.01). We conclude the \"double barrel\" technique is reliable in device-dependent cardiogenic shock patients, offering significant advantages and minimal risk.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727301","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}

引用次数: 0

Extrinsic outflow graft obstruction of the HeartMate 3 LVAD: A state-of-the-art review HeartMate 3 LVAD 的外源性外流移植物阻塞：最新研究综述。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-15 DOI: 10.1016/j.healun.2024.07.005

Daniel J. Goldstein MD , Manreet Kanwar MD , Jennifer Cowger MD , Snehal Patel MD , Dan M. Meyer MD , Ezequiel Molina MD , Christopher Salerno MD , Ashley Elmer BS , Sarah Schettle PA-C, MBA , Jeffrey Teuteberg MD , Francis Pagani MD, PhD , Josef Stehlik MD

{"title":"Extrinsic outflow graft obstruction of the HeartMate 3 LVAD: A state-of-the-art review","authors":"Daniel J. Goldstein MD , Manreet Kanwar MD , Jennifer Cowger MD , Snehal Patel MD , Dan M. Meyer MD , Ezequiel Molina MD , Christopher Salerno MD , Ashley Elmer BS , Sarah Schettle PA-C, MBA , Jeffrey Teuteberg MD , Francis Pagani MD, PhD , Josef Stehlik MD","doi":"10.1016/j.healun.2024.07.005","DOIUrl":"10.1016/j.healun.2024.07.005","url":null,"abstract":"<div><div>While notable improvements in survival, the incidence of hemocompatibility-related adverse events, hospitalizations, and cost have been demonstrated with the only commercially available durable left ventricular assist device, a category of pump malfunctions characterized by outflow graft obstruction has been noted with broader use and clinical follow-up of recipients of this technology. Of particular concern is the accumulation of acellular biodebris between the outflow graft and bend relief covering the outflow graft at its origin with the pump (which we term extrinsic outflow graft obstruction at the bend relief). This process tends to be insidious, occurs late in the postoperative course, can be challenging to diagnose, and can result in significant morbidity and mortality. Herein, we provide a review of this complication and outline diagnostic, treatment, and preventive strategies.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633727","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}

引用次数: 0

Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation. 肺移植术后长期暴露于空气污染与原发性移植物功能障碍的风险。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-15 DOI: 10.1016/j.healun.2024.07.003

Tatsuki Koyama, Zhiguo Zhao, John R Balmes, Carolyn S Calfee, Michael A Matthay, John P Reilly, Mary K Porteous, Joshua M Diamond, Jason D Christie, Edward Cantu, Lorraine B Ware

{"title":"Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation.","authors":"Tatsuki Koyama, Zhiguo Zhao, John R Balmes, Carolyn S Calfee, Michael A Matthay, John P Reilly, Mary K Porteous, Joshua M Diamond, Jason D Christie, Edward Cantu, Lorraine B Ware","doi":"10.1016/j.healun.2024.07.003","DOIUrl":"10.1016/j.healun.2024.07.003","url":null,"abstract":"<p><strong>Background: </strong>Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studied. We hypothesized that long-term exposure of the lung donor and recipient to high levels of ambient air pollutants would increase the risk of PGD in lung transplant recipients.</p><p><strong>Methods: </strong>Using data from 1428 lung transplant recipients and their donors enrolled in the Lung Transplant Outcomes Group observational cohort study, we evaluated the association between the development of PGD and zip-code-based estimates of long-term exposure to 6 major air pollutants (ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, particulate matter 2.5, and particulate matter 10) in both the lung donor and the lung recipient. Exposure estimates used daily EPA air pollutant monitoring data and were based on the geographic centroid of each subject's residential zip code. Associations were tested in both univariable and multivariable models controlling for known PGD risk factors.</p><p><strong>Results: </strong>We did not find strong associations between air pollutant exposures in either the donor or the recipient and PGD.</p><p><strong>Conclusions: </strong>Exposure to ambient air pollutants, at the levels observed in this study, may not be sufficiently harmful to prime the donor lung or the recipient to develop PGD, particularly when considering the robust associations with other established PGD risk factors.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633728","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}

引用次数: 0

Recurrent treatment of refractory acute cellular rejection with alemtuzumab after lung transplantation 用阿来珠单抗治疗肺移植术后复发的难治性急性细胞排斥反应

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-14 DOI: 10.1016/j.healun.2024.07.004

Eva van Haren PharmD , Lukas K. van Vugt MD , Nynke Wijbenga MSc , Heleen van der Sijs PharmD, PhD , Merel E. Hellemons MD, PhD

{"title":"Recurrent treatment of refractory acute cellular rejection with alemtuzumab after lung transplantation","authors":"Eva van Haren PharmD , Lukas K. van Vugt MD , Nynke Wijbenga MSc , Heleen van der Sijs PharmD, PhD , Merel E. Hellemons MD, PhD","doi":"10.1016/j.healun.2024.07.004","DOIUrl":"10.1016/j.healun.2024.07.004","url":null,"abstract":"<div><div>We present an exceptional case of a lung transplant recipient successfully treated by multiple courses of alemtuzumab for refractory acute cellular rejection (ACR). The patient experienced multiple episodes of ACR following the transplantation procedure. Alemtuzumab was initiated as a third-line rejection treatment and was repeated 6 times. Each treatment course resulted in complete recovery of the pulmonary function and depletion of T- and B-lymphocytes and natural killer cells (NK cells). The onset of rejection was consistently preceded by the recovery of NK cells, while T- and B-lymphocytes remained depleted. This suggests a rejection process mediated by NK cells. This case contributes to recent research findings suggesting that NK cells play a significant role in ACR in lung transplant recipients and stresses the importance to further investigate the role of NK cells in rejection. Furthermore, it demonstrates that ACR following lung transplantation can be repeatedly managed by treatment with alemtuzumab.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620158","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}

引用次数: 0

Information for Readers 读者信息

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-11 DOI: 10.1016/S1053-2498(24)01718-2

引用次数: 0

Of rivers, recipients and rejection: Revelations from deep immune phenotyping of lung allograft transbronchial biopsy tissue 河流、受体和排斥反应：肺异体移植经支气管活检组织的深度免疫表型揭示。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-08 DOI: 10.1016/j.healun.2024.07.001

引用次数: 0

Balloon pulmonary angioplasty: Not quite the fountain of youth in chronic thromboembolic pulmonary hypertension 球囊肺血管成形术：慢性血栓栓塞性肺动脉高压的青春之泉。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-05 DOI: 10.1016/j.healun.2024.06.016

引用次数: 0

Pediatric lung transplantation: A new landscape following the height of the COVID-19 pandemic 小儿肺移植：COVID-19大流行后的新局面。

IF 6.4 1区医学

Journal of Heart and Lung Transplantation Pub Date : 2024-07-01 DOI: 10.1016/j.healun.2024.06.017

引用次数: 0