Update on lung transplantation: programmes, patients and prospects

Kotsimbos, Tom; Williams, Trevor; Anderson, Gary P.

doi:10.1183/09059180.00006312

Cited by 37 publications

(31 citation statements)

References 423 publications

(522 reference statements)

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“…1,2 More than 2000 lung transplants are performed annually in the United States. 3 Whereas lung transplantation is recognized as an established therapy that improves survival and provides an improved quality of life for transplant recipients, 4 there are several hurdles that make the transplantation of donor lungs a challenging endeavor.…”

Section: Introductionmentioning

confidence: 99%

Future prospects for tissue engineered lung transplantation

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Future prospects for tissue engineered lung transplantation

et al. 2014

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“…Um dos efeitos adversos da doença pulmonar avançada é a inflamação sistêmica que inibe o crescimento de miócitos e promove a reabsorção de proteína muscular (18) . Além desses fatores há, simultaneamente, a troca do tipo de fibra muscular de oxidativa para predominantemente glicolítica, e a somatória desses fatores pode influenciar na perda da capacidade de exercício em candidatos a transplante de pulmão (18) . As alterações funcionais decorrentes da doença pulmonar crônica possivelmente afetarão a atividade cotidiana desses indivíduos, o que gera um ciclo vicioso de disfunções (14) .…”

Section: Discussionunclassified

Reabilitação Pulmonar Em Paciente Com Fibrose Pulmonar Idiopática: Relato De Caso

Mateus

Troncoso²,

Mendonça³

2016

ACS

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Conflito de interesses: NãoContribuição dos autores: APM delineamento do estudo, etapas de execução, tabulação, análise e interpretação dos dados, discussão dos achados, redação do manuscrito. EAMT concepção e elaboração, orientação do projeto, delineamento do estudo, análise e interpretação dos dados e elaboração do manuscrito.LGM concepção e elaboração do projeto, coleta de dados, análise e interpretação dos dados e delineamento do estudo. Contato para correspondência: Adriano Petrolini Mateus E-mail: adriano_petro@hotmail. Abstract Introduction:Idiopathic pulmonary fibrosis is a non-infectious chronic disease of unknown cause. One of the therapeutic strategies for patients with chronic respiratory disease with no possibility of cure is the pulmonary rehabilitation program. Objectives: Evaluate through the six-minute walk test questionnaire and Saint George Respiratory Questionnaire the effects of 36 pulmonary rehabilitation sessions in preoperative lung transplantation in patients with idiopathic pulmonary fibrosis. Patients and Method:The selected patient was a candidate for lung transplantation. He had a clinical diagnosis of Idiopathic Pulmonary Fibrosis and underwent 36 sessions of pulmonary rehabilitation. Data analysis was performed to collect and compare information from the six--minute walk test and quality of life. Data were collected before and after 36 weeks of pulmonary rehabilitation. Results: Before the pulmonary rehabilitation, the six-minute walk test showed a respiratory rate of 20 and 30 incursions per minute, respectively. After the intervention, the test showed 15 and 25 incursions per minute, respectively. Before and after the pulmonary rehabilitation, the teste showed a peak heart rate of 148 and 131 beats per minute. The recovery time of peripheral oxygen saturation was of five minutes and thirty seconds before and two minutes after reevaluation; the walking distance was 270 meters before and 513 meters after 36 sessions of pulmonary rehabilitation. Through the application of the Saint George Respiratory Questionnaire, it was noted an improvement in the following domains after pulmonary rehabilitation: symptoms, activity, impact, and total. The observation of these data characterizes functional and quality of life improvement for this patient. Conclusion: For this patient, 36 pulmonary rehabilitation sessions provided a positive impact on functional capacity and quality of life.

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“…Later in 1988 cystic fibrosis patients were recruited and transplanted again at the same center. In the meantime, in Europe, active lung transplant programs were being developed at Papworth, Newcastle, Harefield in the United Kingdom, in Paris, Hannover and Vienna in central Europe [2,7,8].…”

Section: History Of Lung Transplantation Is Written By Endeavors and mentioning

confidence: 99%

History of Lung Transplantation

Dabak¹,

Şenbaklavacı²

2016

Turk Toraks Dergisi

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History of lung transplantation in the world can be traced back to the early years of the 20 th century when experimental vascular anastomotic techniques were developed by Carrel and Guthrie, followed by transplantation of thoracic organs on animal models by Demikhov and finally it was James Hardy who did the first lung transplantation attempt on human. But it was not until the discovery of cyclosporine and development of better surgical techniques that success could be achieved in that field by the Toronto Lung Transplant Group led by Joel Cooper. Up to the present day, over 51.000 lung transplants were performed in the world at different centers. Dr. James Hardy from Jackson Mississippi, USA was the first surgeon in the world to perform lung transplantation in man in 1963. The patient was a 58-year old man who had lung cancer involving the left main airway and obstructing distal airways resulting in lung collapse and recurrent pneumonia. While the patient was serving a life sentence in prison, Hardy outlined the potential complications and risks with him in detail and he agreed to proceed [1][2][3]. This was the time the countdown for a donor and prospect transplant started. Both medically and legally, such a patient would not be an appropriate candidate for lung transplantation at any transplant center at this time and day. No matter what opponents claim, this was a challenging and risky task both for Hardy and his patient with their own selfexplanatory reasons and motivation.The donor was taken to the operating room for retrieval while the recipient was prepared for transplantation in the adjacent operating room almost simultaneously. Both operations were remarkably uncomplicated and the recipient began breathing spontaneously. Indeed, the arterial oxygen saturation improved from 87% before to 98% immediately after the transplant. Chest X-rays and an angiogram confirmed that the transplanted lung was very well ventilated and perfused [2]. Surgeons had done their jobs perfectly well. The cornerstones of a successful lung transplantation today are good donor, good recipient and good surgery followed by meticulous early postoperative management. The donor and recipient selection in the very first lung transplantation of the world was maybe arbitrary due to aformentioned reasons and not so ideal, but the surgery had gone smooth owing to surgeons' interest and experience. The immunosuppressive regimen consisted of azathioprine, prednisone, and cobalt radiation to the mediastinum and thymus. Notably, cyclosporine and tacrolimus, which are the mainstays of immunosuppression in modern transplantation, had not yet been discovered [2,3]. Those were the times 'less was more' and against all odds, this was the first, but not the only or the final success in lung transplant history.Every single step, every attempt that we find worthy of mentioning today, be it from Hardy, Carrel, Guthrie, Demikhov are bricks in the gigantic wall of lung transplantation.

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Update on lung transplantation: programmes, patients and prospects

Cited by 37 publications

References 423 publications

Future prospects for tissue engineered lung transplantation

Future prospects for tissue engineered lung transplantation

Reabilitação Pulmonar Em Paciente Com Fibrose Pulmonar Idiopática: Relato De Caso

History of Lung Transplantation

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