Current Status and Future of Lung Transplantation.

Date, Hiroshi

doi:10.2169/internalmedicine.40.87

Cited by 8 publications

(2 citation statements)

References 53 publications

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“…However, several newclinical therapies including continuous infusion of epoprostenol (Epo) (4-7) and lung transplantation (8) are recently being used in Japan. It has been reported that Epo therapy improves the prognosis compared with conventional therapy.…”

Section: Introductionmentioning

confidence: 99%

Effects and Problems of Continuous Infusion of Epoprostenol for Patients with Primary Pulmonary Hypertension.

et al. 2002

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Objective Weexamined the usefulness and the problems of epoprostenol (Epo) therapy in adult Japanese with primary pulmonary hypertension (PPH).Subjects and Methods In eleven cases with PPH, both acute and chronic effects, and clinical effects of Epo were assessed. ResultsIn the acute challenge test (n=6), Epo reduced both systemic and pulmonary vascular resistance and increased the cardiac output, but did not change the ratio of pulmonaryto systemic vascular resistance, while the systemic and pulmonary blood pressure also did not change. In the chronic study (n=9), Epo decreased the pulmonary blood pressure without changes in systemic blood pressure, and increased the cardiac output. Both systemic and pulmonaryvascular resistance decreased with a decrease in the ratio of the pulmonaryto systemic vascular resistance. The level of brain natriuretic peptide and atrial natriuretic peptide, NYHAfunctional class and 6-minute walking distance were improved by Epo therapy. In spite of Epo therapy, two patients did not improve and died. Another patient improved in terms of symptoms but then died suddenly from massive lung bleeding. Two patients who improved physically could not be discharged because of psychiatric problems. One patient underwent lung transplantation. Five out-patients have been continuing Epo therapy. Conclusion Wedemonstrated that the chronic effect of Epo treatment is sufficient even at the dose used in our hospital. However, it was shown that there was resistance to this therapy in some of the cases and that we should pay attention to the severe adverse effects of Epo. (Internal Medicine 41: 784-788, 2002)

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Section: Introductionmentioning

confidence: 99%

Effects and Problems of Continuous Infusion of Epoprostenol for Patients with Primary Pulmonary Hypertension.

et al. 2002

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“…2 Over the next 15 years, nearly 40 patients underwent lung transplantation, but only two survived more than 2 months and none survived to hospital discharge. 3 Infection and bronchial anastomotic complications were the leading causes of death among patients transplanted in this early era.…”

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confidence: 99%

Immunosuppression: What's Standard and What's New?

Witt

Hachem

2013

Semin Respir Crit Care Med

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Lung transplantation is the ultimate treatment option for patients with end-stage lung disease. Chronic rejection, in the form of bronchiolitis obliterans syndrome, and noncytomegalovirus infections are the major causes of morbidity and mortality beyond the first year after transplantation. Most lung transplant recipients are treated lifelong with a three-drug immunosuppression regimen consisting of a calcineurin inhibitor, an antimetabolite, and low-dose corticosteroids. However, induction and maintenance immunosuppression strategies vary widely between centers, and a consensus on the ideal management of this patient population remains elusive. Over the past 20 years, several studies comparing the calcineurin inhibitors cyclosporine and tacrolimus and other studies comparing the antimetabolites azathioprine and mycophenolate mofetil have been performed. Additionally, the role of mammalian target of rapamycin (mTOR) inhibitors in the treatment of lung transplant recipients and the utility of azithromycin to treat and prevent bronchiolitis obliterans syndrome are areas of active investigation. This review discusses induction and traditional maintenance immunosuppressive agents and regimens and the evidence that exists to help guide therapy. Newer research involving the use of mTOR inhibitors in place of calcineurin inhibitors or antimetabolites and azithromycin for the treatment and prevention of bronchiolitis obliterans syndrome is also explored.

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Lung Perfusion in Clinical Heart-Lung Transplantation

Gohrbandt

Haverich²

2010

Principles of Pulmonary Protection in Heart Surgery

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Current Status and Future of Lung Transplantation.

Cited by 8 publications

References 53 publications

Effects and Problems of Continuous Infusion of Epoprostenol for Patients with Primary Pulmonary Hypertension.

Effects and Problems of Continuous Infusion of Epoprostenol for Patients with Primary Pulmonary Hypertension.

Immunosuppression: What's Standard and What's New?

Lung Perfusion in Clinical Heart-Lung Transplantation

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