Pulmonary Vascular Permeability after Lung Transplantation: A Positron Emission Tomographic Study

Kaplan, James D.; Trulock, Elbert P.; Cooper, Joel D.; Schuster, Daniel P.

doi:10.1164/ajrccm/145.4_pt_1.954

Cited by 33 publications

(38 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Controversial results have been observed in clinical transplantation. A negative influence of graft ischemic time on early graft function was found by several groups including ours (6,19,20), but others have not reported similar results (4,5,21,22). The discrepancy between previous results and our data may be explained by the high statistical power of our study.…”

Section: Discussioncontrasting

confidence: 84%

Influence of Preservation Solution on Early Graft Failure in Clinical Lung Transplantation

Thabut

Vinatier

Brugière

et al. 2001

Am J Respir Crit Care Med

View full text Add to dashboard Cite

The aim of this study was to assess the influence of preservation solution type and extra- or intracellular composition on the occurrence of early graft dysfunction after clinical lung transplantation. For 170 patients who underwent a single (n = 124) or bilateral (n = 46) lung transplantation in two centers in Paris between 1988 and 1999, the preservation technique applied to the donor lung was single-flush perfusion of the pulmonary artery with one of several solutions of intracellular (Euro-Collins, n = 61; University of Wisconsin, n = 24) or extracellular composition (Cambridge, n = 64; Celsior, n = 21). The early postoperative outcome of these patients was reviewed. Reimplantation edema occurred in 48% of all patients, and the overall 1-mo survival rate was 84%. No significant difference in the incidence of edema, duration of mechanical ventilation, and 1-mo survival rate was observed between the four groups or between intra- and extracellular groups. After adjustment for graft ischemic time by means of multivariate analysis, the use of extracellular preservation fluid was associated with a lower incidence of reimplantation edema without effect on 1-mo mortality. Graft ischemic time was associated with both edema occurrence and 1-mo survival rate (p = 0.02 and p = 0.01, respectively). We conclude that extracellular-type solutions are associated with better lung preservation than intracellular-type solutions in clinical transplantation.

show abstract

Section: Discussioncontrasting

confidence: 84%

Influence of Preservation Solution on Early Graft Failure in Clinical Lung Transplantation

Thabut

Vinatier

Brugière

et al. 2001

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…This response has been widely studied in animal models [2][3][4][5], but few data are available in clinical lung transplantation [8][9][10]14].…”

Section: Discussionmentioning

confidence: 99%

“…This correlation was also found in animal models [3], in which prolongation of graft ischaemia increases the incidence of obvious oedema formation. KAPLAN et al [10] evaluated the pulmonary vascular permeability in 15 patients after lung transplantation by measuring a quantitative index of vascular permeability, and they found that the longer preservation time was associated with higher index values. Curiously, BAVOUX et al [9] did not find any correlation between PRR and the graft ischaemic time in 35 heart-lung recipients [9].…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon, called pulmonary reimplantation response (PRR), was an early experience in human heart-lung transplantation [1], and is generally considered to be related to ischaemia-reperfusion lung injury. PRR has been widely studied in animal models [2][3][4][5][6][7], but few data are available in clinical lung transplantation [8][9][10]. The aim of this report is to describe the characteristics of PRR in single-lung transplantation (SLT), and to detail the occurrence, evolution, prognosis and risk factors of this complication.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary reimplantation response in single-lung transplantation

Sleiman

Mal²,

Fournier³

et al. 1995

Eur Respir J

View full text Add to dashboard Cite

P Pu ul lm mo on na ar ry y r re ei im mp pl la an nt ta at ti io on n r re es sp po on ns se e i in n s si in ng gl le e--l lu un ng g t tr ra an ns sp pl la an nt ta at ti io on n In 40% of the cases hypoxaemia was severe, precluding weaning and requiring prolonged mechanical ventilation with high fractional inspiratory oxygen (FIO 2 ). The mean duration of ventilation was 7 days (range 1-19 days). Clearing of the chest radiographs was progressive, with complete resolution between 6 and 21 days. In all cases, the pulmonary arterial wedge pressure was normal (6±2 mmHg) suggesting low pressure oedema. Sampling of the pulmonary oedema fluid revealed that the ratio of protein concentration in oedema fluid to that in serum exceeded 0.5. In patients with severe PRR (40% of cases) clinical, radiographic and haemodynamic abnormalities were identical to adult respiratory distress syndrome (ARDS), but the prognosis was more favourable with no death directly related to PRR in our patients. The mean duration of graft ischaemia of the oedematous grafts (241 ±103 min) was significantly longer than that of nonoedematous grafts (155±71 min).These date suggest that prolongation of graft ischaemia increased the incidence of PRR.

show abstract

“…Such a pathophysiological mechanism accounts for the high sensitivity of 201 Tl scintigraphy (92%) observed in the present study. This is further supported by positron-emission tomographic (PET) measurements of pulmonary-transcapillary escape rate, which were reported to be elevated in patients with biopsyproven lung rejection, and decreased after immunosuppressive treatment, suggesting that pulmonary vascular permeability is, indeed, altered by the rejection/lung injury state [21].…”

Section: Discussionmentioning

confidence: 77%

Thallium-201 scintigraphy in the evaluation of graft dysfunction in lung transplantation. Newark Beth Israel Medical Center Lung Transplant Group

Rr²,

Ma³

1996

Eur Respir J

View full text Add to dashboard Cite

T Th ha al ll li iu um m--2 20 01 1 s sc ci in nt ti ig gr ra ap ph hy y i in n t th he e e ev va al lu ua at ti io on n o of f g gr ra af ft t d dy ys sf fu un nc ct ti io on n i in n l lu un ng g t tr ra an ns sp pl la an nt ta at ti io on n ABSTRACT: The object of this study was to evaluate graft dysfunction utilizing thallium-201 scintigraphy in patients who had undergone lung transplantation.We studied 11 patients who had undergone single-lung transplantation and had 44 evaluations for suspected graft dysfunction. All evaluations included a lung thallium-201 scan and chest radiography. In addition, 42 transbronchial biopsies, 19 gallium-67 scans and 28 pulmonary function tests were obtained. Rejection was defined by histopathology and/or the response to an empirical pulse of methylprednisolone, while cultures of protected specimen brushes and blood with a positive chest radiograph were used to define infection.The sensitivity of thallium scintigraphy for diagnosing rejection and/or infection (94%) was higher than that for transbronchial biopsy (86%), gallium scintigraphy (47%), chest radiography (67%), or spirometry testing (30%). Specificity was 100% for thallium scintigraphy and transbronchial biopsy, as compared to chest radiography and spirometry, which were 75 and 80% respectively. This study indicated that thallium-201 scintigraphy is useful for screening lung transplant recipients for episodes of acute rejection and/or infection. A positive scan is confirmation of graft parenchymal dysfunction and may then be followed by empirical treatment or bronchoscopy with transbronchial biopsy and culture to differentiate rejection and infection.

show abstract

Pulmonary Vascular Permeability after Lung Transplantation: A Positron Emission Tomographic Study

Cited by 33 publications

References 5 publications

Influence of Preservation Solution on Early Graft Failure in Clinical Lung Transplantation

Influence of Preservation Solution on Early Graft Failure in Clinical Lung Transplantation

Pulmonary reimplantation response in single-lung transplantation

Thallium-201 scintigraphy in the evaluation of graft dysfunction in lung transplantation. Newark Beth Israel Medical Center Lung Transplant Group

Contact Info

Product

Resources

About