Lung Transplantation in COPD

Cheronis, Nicholas; Rabold, Erica; Singh, Anil; Cheema, Tariq

doi:10.1097/cnq.0000000000000340

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…1 The implementation of the LAS system in May 2005 immediately shortened the time to transplantation and decreased waitlist mortality for the most commonly transplanted lung diseases: idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). 2,3 Patients with IPF benefited most from the LAS. 4 It is less clear how the LAS affected lung transplantation waitlist outcomes in patients with less commonly transplanted lung diseases such as advanced pulmonary sarcoidosis (APS).…”

Section: Introductionmentioning

confidence: 99%

“…Introduced in May 2005 in the United States, the Lung Allocation Score (LAS) system uses diagnosis, functional status, exercise capacity, lung function, haemodynamic data and supplemental oxygen needs to prioritise patients with the highest urgency of lung transplantation while considering the chances of survival post-transplant [ 1 ]. The implementation of the LAS system in May 2005 immediately shortened the time to transplantation and decreased waitlist mortality for the most commonly transplanted lung diseases: idiopathic pulmonary fibrosis (IPF), COPD and cystic fibrosis [ 2 , 3 ]. Patients with IPF benefited most from the LAS [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Sarcoidosis lung transplantation waitlist mortality, a national registry database study

et al. 2023

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The Lung Allocation Score prioritizes lung transplantation candidates balancing waitlist-mortality and post-transplant survival. The score groups sarcoidosis candidates based on mean pulmonary artery pressure: ≤30 mmHg (Sarcoidosis A) are grouped with COPD and >30 mmHg (Sarcoidosis D) with idiopathic pulmonary fibrosis. We hypothesize that sarcoidosis candidates have a higher waitlist-mortality than other candidates within their LAS grouping. This is a retrospective cohort study of consecutive lung transplantation candidates from the Scientific Registry of Transplant Recipients database from May 2005 to May 2019. We included candidates ≥18 y/o diagnosed with sarcoidosis, COPD or IPF. Univariate, multivariate and survival estimate analysis were performed. We identified 385 sarcoidosis A, 642 sarcoidosis D, 7081 COPD, 10 639 IPF lung transplantation candidates. 17.3% of sarcoidosis D, 14.8% of IPF, 14.3% of sarcoidosis A, and 9.8% of COPD candidates died awaiting transplant. Sarcoidosis A was an independent risk factor for waitlist-mortality. Sarcoidosis A had a lower waitlist survival probability compared to COPD. Sarcoidosis D had the highest waitlist-mortality. IPF candidates had lower waitlist survival probability than sarcoidosis D in the first 60 days after listing. Based on our results the grouping of candidates with sarcoidosis in the allocation systems should be revised to mitigate the waitlist-mortality disparity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcoidosis lung transplantation waitlist mortality, a national registry database study

et al. 2023

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“…Lung transplantation (LTx) is an effective treatment modality for the end‐stage lung diseases 1 . The primary graft dysfunction (PGD) that lung transplant patients experience following surgery is the main complication that develops within 72 h of surgery and results in perioperative death in patients, according to information from the International Society for Heart and Lung Transplantation (ISHLT) 2–4 . PGD is defined as lung injury occurring within 72 h after lung implantation, 5 as evidenced by an PaO 2 /FiO 2 ratio below 300 and diffuse allograft edema and infiltration on chest radiographs 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram model to predict primary graft dysfunction in patients after lung transplantation based on the clinical factors

Qin

Cao

et al. 2023

Clinical Transplantation

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BackgroundPrimary graft dysfunction (PGD), a significant complication that can affect patients' prognosis and quality of life, develops within 72 h post lung transplantation (LTx). Early detection and prevention of PGD should be given special consideration. The purpose of this study was to create a clinical prediction model to forecast the occurrence of PGD.MethodsWe collected information on 622 LTx patients from Wuxi People's Hospital from 2016 to 2020 and used the data to construct the prediction model. Information on 224 patients from 2021 to June 2022 was used for external validation. We used LASSO regression for variable screening. A nomogram was developed for model presentation. Distinctness, fit, and calibration were used to evaluate the performance of the model.ResultsSubjects with respiratory failure, who received fresh frozen plasma, donor age, donor gender, donor mechanism of death, donor smoking, donor ventilator use time, and donor PaO 2/FiO 2 ratio were independent predictor variables for the occurrence of PGD. The area under the curve of the nomogram was .779. The Hosmer‐Lemeshow test showed a good model fit (P = .158). The calibration curve of the nomogram is fairly close to the ideal diagonal. Moreover, the decision curve analysis revealed a positive net benefit of the model. External validation also confirmed the reliability of the model.ConclusionsThe nomogram of PGD based on clinical risk factors in postoperative LTx patients was established with high reliability. It provides clinicians and nurses with a new and effective tool for early prediction of PGD and early intervention.

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Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review

Polastri,

Pehlivan,

Reed

et al. 2024

JYMS

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Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

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Lung Transplantation in COPD

Cited by 3 publications

References 31 publications

Sarcoidosis lung transplantation waitlist mortality, a national registry database study

Sarcoidosis lung transplantation waitlist mortality, a national registry database study

Development and validation of a nomogram model to predict primary graft dysfunction in patients after lung transplantation based on the clinical factors

Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review

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