Lobar Lung Transplantation From Deceased Donor: Monocentric Experience

Mendogni, Paolo; Palleschi, Alessandro; Tosi, Davide; Righi, I.; Montoli, M.; Damarco, Francesco; Morlacchi, Letizia Corinna; Santambrogio, Luigi; Nosotti, Mario; Rosso, Lorenzo

doi:10.1016/j.transproceed.2017.02.020

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…One study by Park reported optimal outcomes when the donorrecipient ratio was 0.89 (45). In case of larger donors, graft downsizing, by means of peripheral or anatomic resections, must be considered; reported results are comparable to standard procedures (46,47).…”

Section: Surgical and Anesthesiological Considerationsmentioning

confidence: 97%

Transplant options for end stage chronic obstructive pulmonary disease in the context of multidisciplinary treatments

et al. 2018

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Lung transplantation (LTx) in advanced stage chronic obstructive pulmonary disease (COPD) patients is associated with significant improvement in lung function and exercise capacity. However, demonstration that the procedure also provides a survival benefit has been more elusive compared to other respiratory conditions. Identification of patients with increased risk of mortality is crucial: a low forced expiratory volume in 1 second (FEV 1) is perhaps the most common reason for referral to a lung transplant center, but in itself is insufficient to identify which COPD patients will benefit from LTx. Many variables have to be considered in the selection of candidates, time for listing, and choice of procedure: age, patient comorbidities, secondary pulmonary hypertension, the balance between individual and community benefit. This review will discuss patient selection, transplant listing, potential benefits and critical issues of bilateral (BLTx) and single lung (SLTx) procedure, donor-to-recipient organ size-matching; furthermore, it will describe LTx outcomes and its effects on recipient survival and quality of life.

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Section: Surgical and Anesthesiological Considerationsmentioning

confidence: 97%

Transplant options for end stage chronic obstructive pulmonary disease in the context of multidisciplinary treatments

et al. 2018

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“…A single-center, propensity score-weighted cohort study of high-risk patients with stage I NSCLC who received CT-guided MWA (n = 32) or lung lobectomy (n = 35) 39 found no significant difference in median survival (MWA: 43.8 months, 95% CI: 26.1-55 months vs lobectomy: 55.8 months, 95% CI: 49.9-76.8 months; log-rank test, P = .041) but did find improved disease-free survival estimates in the lobectomy groups and greater recurrence rates (distant + local relapses) in the MWA group (MWA: 28 (90.6%) vs lobectomy: 14 (40.0%); P < .001).…”

Section: Image-guided Percutaneous Therapiesmentioning

confidence: 99%

Image-Guided Percutaneous and Transarterial Therapies for Primary and Metastatic Lung Cancer

Mansur

Garg

Camacho

et al. 2023

Technol Cancer Res Treat

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Lung cancer is the leading cause of cancer mortality in the world. A significant proportion of patients with lung cancer are not candidates for surgery and must resort to other treatment alternatives. Rapid technological advancements in fields like interventional radiology have paved the way for valid treatment modalities like image-guided percutaneous and transarterial therapies for treatment of both primary and metastatic lung cancer. The rationale of ablative therapies relies on the fact that focused delivery of energy induces tumor destruction and pathological necrosis. Image-guided percutaneous thermal ablation therapies are established techniques in the local treatment of hepatic, renal, bone, thyroid, or uterine lesions. In the lung, the 3 main indications for lung ablation include local curative intent, a strategy to achieve a chemoholiday in oligometastatic disease, and recently, oligoprogressive disease. Transarterial therapies include a set of catheter-based treatments that involve delivering embolic and/or chemotherapeutic agents directed into the target tumor via the supplying arteries. This article provides a comprehensive review of the various techniques available and discusses their applications and associated complications in primary and metastatic lung cancer.

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“…In case of size mismatch between donor and recipient or lung injury (i.e. lung contusions, vascular injuries), graft downsizing is usually entails atypical lung resection or, if necessary, graft segmentectomy or lobectomy, as previously described [7][8][9] . After LuTx, all patients were treated with the same immune suppression therapy.…”

Section: Lung Transplantationmentioning

confidence: 99%

Usefulness of autofluorescence bronchoscopy in early diagnosis of airway complications after lung transplantation

Mendogni

Gherzi

Tosi

et al. 2020

Sci Rep

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Despite the promising results achieved so far in long-term survival after lung transplantation (LuTx), airway complications (ACs) still arise in the post-operative period. Early diagnosis and prompt treatment of ACs play a critical role in preventing their onset. Specifically, large bronchi ischemia has been recognized as a triggering factor for ACs. Autofluorescence bronchoscopy, which was first introduced for early cancer diagnosis, displays ischemic mucosae as red spots, while normal vascularized mucosae appear in green. The aim of this study is to investigate whether a significant correlation exists between ACs and the red/green (RG) ratio detected on scheduled autofluorescence bronchoscopy up to 1 year after LuTx. This prospective, observational, single-center cohort study initially considered patients who underwent LuTx between July 2014 and February 2016. All patients underwent concomitant white-light and autofluorescence bronchoscopy at baseline (immediately after LuTx), on POD7, POD14, POD21, POD28, POD45, 3 months, 6 months, and 1 year after LuTx. An autofluorescence image of the first bronchial carina distal to the anastomosis was captured and analyzed using histograms for red and green pixels; the R/G ratio was then recorded. Potential ACs were classified according according to the presence of a white-light following the MDS (macroscopic aspect, diameter and suture) criteria. The authors assessed the association between the R/G ratio and the ACs occurrence using a generalized estimating equations model. Thirty-one patients met the inclusion criteria and were therefore selected. Out of a total of 53 bronchial anastomoses, 8 developed complications (late bronchial stenosis), with an average onset time of 201 days after LuTx. ACs showed a similar baseline covariate value when compared to anastomoses that involved no complication. Generalized estimating equations regression indicated a clear association over time between the R/G ratio and the rise of complications (p = 0.023). The authors observed a significant correlation between post-anastomotic stenosis and the delayed decrease of the R/G ratio. Preliminary outcomes suggest that autofluorescence bronchoscopy may be an effective and manageable diagnostic tool, proving complementary to other instruments for early diagnosis of ACs after LuTx. Further research is needed to confirm and detail preliminary findings.

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Lobar Lung Transplantation From Deceased Donor: Monocentric Experience

Cited by 12 publications

References 11 publications

Transplant options for end stage chronic obstructive pulmonary disease in the context of multidisciplinary treatments

Transplant options for end stage chronic obstructive pulmonary disease in the context of multidisciplinary treatments

Image-Guided Percutaneous and Transarterial Therapies for Primary and Metastatic Lung Cancer

Usefulness of autofluorescence bronchoscopy in early diagnosis of airway complications after lung transplantation

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