Complications non chirurgicales de la transplantation pulmonaire

Knoop, Christiane; Rondelet, Benoît; Dumonceaux, M.; Estenne, Marc

doi:10.1016/j.pneumo.2010.08.002

Cited by 6 publications

(9 citation statements)

References 172 publications

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“…The definitive diagnosis of allograft dysfunction requires more specific investigations. Often a longer observation period is needed to confirm and classify the rejection and to differentiate between acute and chronic forms [2,20,21,22]. In general, patients are instructed to perform home spirometry on a daily basis and are advised to contact the transplant team or physician if the lung function deteriorates [23,24].…”

Section: Home Spirometry Lung Function Over Time and Signs Of Rejectionmentioning

confidence: 99%

“…Bronchoscopic biopsies may contribute to the tissue diagnosis of acute rejection [29,30]. Chronic rejection can be diagnosed based on functional criteria [2,3,21,22], and if tissue diagnosis is sought, then surgical biopsy is more likely to be diagnostic [13]. …”

Section: Home Spirometry Lung Function Over Time and Signs Of Rejectionmentioning

confidence: 99%

“…In this process, the cyclosporine dose is most closely monitored, with measurement of serum drug levels, often termed therapeutic drug monitoring (TDM) [31]. Dose adjustments are required especially when drug regimens are changed and drug interactions occur [2]. The adverse effects of cyclosporine need to be taken into account when the patient’s clinical condition deteriorates, for example if the renal function is progressively impaired [2,32].…”

Section: Immunosuppressionmentioning

confidence: 99%

“…Dose adjustments are required especially when drug regimens are changed and drug interactions occur [2]. The adverse effects of cyclosporine need to be taken into account when the patient’s clinical condition deteriorates, for example if the renal function is progressively impaired [2,32]. As is common practice elsewhere, we taper the steroid dose to a 0.1–0.15 mg/kg/day maintenance dose beyond 12 months after transplantation and additionally aim for a suppressed lymphocyte count as a marker for the therapeutic effect of MMF.…”

Section: Immunosuppressionmentioning

confidence: 99%

“…Complications after lung transplantation have been widely reported, generally including the analysis of aetiological factors [1,2,3,4,5,6,7]. Some of these reports mention strategies to prevent these complications.…”

Section: Introductionmentioning

confidence: 99%

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Practical Approach to Emergencies in Lung Transplant Recipients: How We Do It

et al. 2012

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Lung transplant recipients (LTRs) are prone to medical complications and emergencies due to the transplanted organ being in constant direct contact with the environment and the need for life-long profound immunosuppression (IS). As a result of these specific circumstances, the medical and surgical management of LTRs frequently differs from usual standard care. Therefore, we outline here some of the principles we take into account when dealing with the most frequent medical emergencies encountered in our lung transplant cohort in Zurich. The main topics dealt with are: diagnostics and treatment of infections, gastrointestinal emergencies, IS and other medication issues as well as work-up of unclear inflammatory signs and peri-operative precautions in LTRs. Early post-operative transplant complications, rare medical emergencies and surgical problems are not covered. Our report is intended to help internists and pulmonologists new to the field to obtain a better understanding of the peculiarities of LTRs and their management.

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Section: Home Spirometry Lung Function Over Time and Signs Of Rejectionmentioning

confidence: 99%

Section: Home Spirometry Lung Function Over Time and Signs Of Rejectionmentioning

confidence: 99%

Section: Immunosuppressionmentioning

confidence: 99%

Section: Immunosuppressionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practical Approach to Emergencies in Lung Transplant Recipients: How We Do It

et al. 2012

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Patient- and physician-related risk factors for hyperkalaemia in potassium-increasing drug–drug interactions

Eschmann

Beeler

Kaplan

et al. 2013

Eur J Clin Pharmacol

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PURPOSE: Hyperkalaemia due to potassium-increasing drug-drug interactions (DDIs) is a clinically important adverse drug event. The purpose of this study was to identify patient-and physicianrelated risk factors for the development of hyperkalaemia. METHODS: The risk for adult patients hospitalised in the University Hospital Zurich between 1 December 2009 and 31 December 2011 of developing hyperkalaemia was correlated with patient characteristics, number, type and duration of potassiumincreasing DDIs and frequency of serum potassium monitoring. RESULTS: The 76,467 patients included in this study were prescribed 8,413 potentially severe potassium-increasing DDIs. Patient-related characteristics associated with the development of hyperkalaemia were pulmonary allograft [relative risk (RR) 5.1; p < 0.0001), impaired renal function (RR 2.7; p < 0.0001), diabetes mellitus (RR 1.6; p = 0.002) and female gender (RR 1.5; p = 0.007). Risk factors associated with medication were number of concurrently administered potassium-increasing drugs (RR 3.3 per additional drug; p < 0.0001) and longer duration of the DDI (RR 4.9 for duration 6 days; p < 0.0001). Physician-related factors associated with the development of hyperkalaemia were undetermined or elevated serum potassium level before treatment initiation (RR 2.2; p < 0.001) and infrequent monitoring of serum potassium during a DDI (interval >48 h: RR 1.6; p < 0.01). CONCLUSION: Strategies for reducing the risk of hyperkalaemia during potassium-increasing DDIs should consider both patient-and physician-related risk factors. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 2 AbstractPurpose Hyperkalaemia due to potassium-increasing drug-drug interactions (DDIs) is a clinically important adverse drug event. The purpose of this study was to identify patient-and physician-related risk factors for the development of hyperkalaemia. MethodsThe risk for adult patients hospitalised in the University Hospital Zurich of developing hyperkalaemia was correlated with (i) patient characteristics, (ii) number, type and duration of potassium-increasing DDIs, and (iii) the frequency of serum potassium monitoring. (iii) Physician-related factors associated with development of hyperkalaemia were: undetermined or elevated serum potassium level before starting treatment (RR 2.2; p < 0.001) and infrequent monitoring of serum potassium during DDI (intervals > 48 h; RR 1.6; p < 0.01). ConclusionStrategies for hyperkalaemia risk reduction during potassium-increasing DDIs should consider patient-as well as physician-related risk factors.

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Imaging of lung transplant complications

Hemmert

Ohana

Jeung

et al. 2014

Diagnostic and Interventional Imaging

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Since the late 1980s, lung transplantation has emerged as a valid treatment option for some patients with advanced non-neoplastic lung disease. Long-term survival of lung transplant recipients, however, is lower than that of patients with other types of transplantation, because of numerous specific postoperative complications. Thanks to X-ray and CT, radiologists can guide clinicians, helped in this diagnostic approach by the time between the date of injury and date of transplantation. We will detail in this pictorial review the immediate and late surgical complications, the immunological complications, the infectious complications and other late complications.

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Complications non chirurgicales de la transplantation pulmonaire

Cited by 6 publications

References 172 publications

Practical Approach to Emergencies in Lung Transplant Recipients: How We Do It

Practical Approach to Emergencies in Lung Transplant Recipients: How We Do It

Patient- and physician-related risk factors for hyperkalaemia in potassium-increasing drug–drug interactions

Imaging of lung transplant complications

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