The Present Status of Lung Transplantation

Veith, Frank J.; Koerner, Spencer K.

doi:10.1001/archsurg.1974.01360060004002

Cited by 31 publications

(13 citation statements)

References 33 publications

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“…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 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%

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Pulmonary reimplantation response in single-lung transplantation

Sleiman

Mal²,

Fournier³

et al. 1995

Eur Respir J

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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.

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“…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%

mentioning

confidence: 99%

Pulmonary reimplantation response in single-lung transplantation

Sleiman

Mal²,

Fournier³

et al. 1995

Eur Respir J

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“…The use of low temperature in the preservation of kidneys (3), as well as other tissues (4)(5)(6), for transplantation has been extensively studied and found to maintain tissue function for a longer time than storage at warmer temperatures. Low temperature offers the further advantage of inhibiting fibroblast growth, which can be a problem when pancreatic islets are cultured at 370C (7).…”

Section: Introductionmentioning

confidence: 99%

Maintenance of insulin release from pancreatic islets stored in the cold for up to 5 weeks.

Frankel¹,

Gylfe²,

Hellman³

et al. 1976

J. Clin. Invest.

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A B S T R A C T Insulin content and release were measured from hand-dissected pancreatic islets from noninbred ob/ob mice after 1-5 wk storage in tissue culture medium 199 at various temperatures and glucose concentrations.After storage of islets for 1 wk at 37°, 22°, or 80C in 18 mM glucose medium and preincubation with 1 mM glucose, glucose-stimulated insulin release during the subsequent incubation was only 20-35% of that of fresh islets. The addition of a 4-h period at 370C with 18 mM glucose between the cold storage and perincubation restored glucose-stimulated insulin release from 80C-stored islets to fresh-islet levels. Release throughout the 1-18 mM glucose range was strikingly parallel to that of fresh islets. Exposure of fresh islets to the same 4-h period increased basal release but did not affect maximal release.When islets were stored at 80C with 18 mM glucose for more than 1 wk, a short period at 370C every week was necessary for maintenance of release. After 5 wk of this procedure, glucose-stimulated insulin release was one-third that of fresh islets, or similar to that of islets stored for only 1 wk at 370C. Storage at 80C for 1 wk with 3 mM glucose, or continuously for 3 or 5 wk with 18 mM glucose, maintained islet insulin content, whereas release was lost.Thus, glucose-stimulated insulin release is best maintained by storage of pancreatic islets in tissue culture medium with a high concentration of glucose at 80C with short weekly periods at 370C.

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“…From the earliest attempts at treating ESLD with lung transplant, there has been conceptual appeal to apply extracorporeal gas exchange and circulatory support in the perioperative period surrounding transplant. 23 Initial extracorporeal gas exchange devices relied on a direct blood-air interface, which limited support duration due to severe coagulation derangements, hemolysis, and thrombocytopenia. 24 Although the first human lung transplant was reported in 1963, early efforts were characterized by complications and poor outcomes.…”

Section: History Of Ecmo As a Bridge To Lung Transplantmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplant

Stokes

Gannon

Bacchetta

2021

Semin Respir Crit Care Med

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Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary technology capable of supporting cardiac and respiratory function in the presence of end-stage lung disease. Initial experiences using ECMO as a bridge to lung transplant (ECMO-BTLT) were characterized by high rates of ECMO-associated complications and poor posttransplant outcomes. More recently, ECMO-BTLT has garnered success in preserving patients' physiologic condition and candidacy prior to lung transplant due to technological advances and improved management. Despite recent growth, clinical practice surrounding use of ECMO-BTLT remains variable, with little data to inform optimal patient selection and management. Although many questions remain, the use of ECMO-BTLT has shown promising outcomes suggesting that ECMO-BTLT can be an effective strategy to ensure that complex and rapidly decompensating patients with end-stage lung disease can be safely transplanted with good outcomes. Further studies are needed to refine and inform practice patterns, management, and lung allocation in this high-risk and fragile patient population.

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The Present Status of Lung Transplantation

Cited by 31 publications

References 33 publications

Pulmonary reimplantation response in single-lung transplantation

Pulmonary reimplantation response in single-lung transplantation

Maintenance of insulin release from pancreatic islets stored in the cold for up to 5 weeks.

Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplant

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