Modified reperfusion and ischemia-reperfusion injury in human lung transplantation

Ardehali, A.; Laks, Hillel; Russell, Hyde M.; Levine, Michael S.; Shpiner, Robert; Lackey, Stephanie; Ross, David J.

doi:10.1016/s0022-5223(03)00976-0

Cited by 27 publications

(19 citation statements)

References 28 publications

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“…In one small study, a group of 23 patients who underwent lung transplantation with modified reperfusion was compared to 23 matched controls. 113 No patients developed post-transplant ischemic reperfusion injury, compared with 5 patients in the unmodified control group. In addition, a trend toward improved survival was noted as well (96% vs 81%, respectively).…”

Section: Reperfusion Technique and Pgdmentioning

confidence: 92%

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-Related Risk Factors and Markers

Barr

Kawut

Whelan

et al. 2005

The Journal of Heart and Lung Transplantation

123

104

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Section: Reperfusion Technique and Pgdmentioning

confidence: 92%

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-Related Risk Factors and Markers

Barr

Kawut

Whelan

et al. 2005

The Journal of Heart and Lung Transplantation

123

104

View full text Add to dashboard Cite

“…Selective filtration mediated by the monolayer is abrogated, leading to mass transport of fluid and solutes into the alveolar space. The cells undergo many phenotypic and functional changes that facilitate injury (reviewed in References 41,42). For example, glycoprotein adhesion receptors are strongly expressed on endothelium, and Weibel-Palade bodies undergo exocytosis (43).…”

Section: Early Graft Dysfunctionmentioning

confidence: 99%

Lung Transplantation: Opportunities for Research and Clinical Advancement

Wilkes¹

2006

Am J Respir Crit Care Med

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Lung transplantation is the only definitive therapy for many forms of end-stage lung diseases. However, the success of lung transplantation is limited by many factors: (1 ) Too few lungs available for transplantation due to limited donors or injury to the donor lung; (2 ) current methods of preservation of excised lungs do not allow extended periods of time between procurement and implantation; (3 ) acute graft failure is more common with lungs than other solid organs, thus contributing to poorer short-term survival after lung transplant compared with that for recipients of other organs; (4 ) lung transplant recipients are particularly vulnerable to pulmonary infections; and (5 ) chronic allograft dysfunction, manifest by bronchiolitis obliterans syndrome, is frequent and limits long-term survival. Scientific advances may provide significant improvements in the outcome of lung transplantation. The National Heart, Lung, and Blood Institute convened a working group of investigators on June 14-15, 2004, in Bethesda, Maryland, to identify opportunities for scientific advancement in lung transplantation, including basic and clinical research. This workshop provides a framework to identify critical issues related to clinical lung transplantation, and to delineate important areas for productive scientific investigation. Keywords: allograft dysfunction; infection; ischemia-reperfusion injury; lung transplantation; obliterative bronchiolitis; rejectionThe transplantation of organs offers the promise of life-saving and life-enhancing therapy for a variety of ailments. Lung transplantation (LTx) has become an acceptable therapy to palliate patients with a variety of end-stage lung diseases. However, lung transplantation has not turned out to be a panacea for chronic lung disease because of significant limitations in the entire transplant process (Figure 1). First, there are not nearly enough suitable donor lungs to meet the needs of all patients with end-stage lung disease. As a result, more patients die waiting for transplants than from mortality associated with a lung transplant. Second, early graft survival after LTx is worse than for other types of organs transplanted (1). Finally, late survival after successful LTx is hampered by the development of chronic allograft dysfunction and by the life-limiting complications associated with conventional immunosuppressive medications. Two factors impede progress to address these problems: (1 ) lung transplant centers lack the infrastructure to facilitate prospective, multicenter clinical studies of sufficient power to address clinical questions and (2 ) there are too few investigators studying the biology of lung transplantation.The NHLBI convened a workshop on June 14-15, 2004, to better understand these complex problems and to identify strategies to address these and prioritize them. The topics addressed by participants were wide-ranging. They included the following: lung use rates from conventional brain-dead organ donors; safe limits for donor lung function; consideration o...

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“…5 Modified reperfusion techniques, including leukocyte depletion and modified reperfusate solution as well as alterations in the duration and pressure of reperfusion may also decrease risk of PGD. 67,68 Treatment of PGD Traditional Strategies. There is no consensus on treatment of PGD.…”

Section: Risk Factors For Pgdmentioning

confidence: 99%

Evaluation of Hypoxemia and Respiratory Failure in the Early Period After Lung Transplantation

Antin‐Ozerkis¹,

Christie²

2007

Clinical Pulmonary Medicine

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Hypoxemic respiratory failure is relatively common in the period immediately following lung transplantation. In addition to the usual etiologies of postoperative hypoxemia, several pulmonary complications are specific to the lung transplant population. Technical and immunologic complications are uncommon but must be ruled out. Additionally, the lung transplant recipient is at particular risk for nosocomial and opportunistic infection. A significant minority of patients develop primary graft dysfunction (PGD), a form of ischemia-reperfusion injury that is clinically equivalent to the acute respiratory distress syndrome (ARDS). This article reviews the causes of early and late postoperative hypoxemia with a focus on PGD. We describe the new grading and classification system for PGD and summarize risk factors and treatment strategies for this syndrome.

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Modified reperfusion and ischemia-reperfusion injury in human lung transplantation

Cited by 27 publications

References 28 publications

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-Related Risk Factors and Markers

Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-Related Risk Factors and Markers

Lung Transplantation: Opportunities for Research and Clinical Advancement

Evaluation of Hypoxemia and Respiratory Failure in the Early Period After Lung Transplantation

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