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Lung transplantation for chronic obstructive pulmonary disease: past, present, and future directions.

Tue, 12/12/2017 - 16:48

Lung transplantation for chronic obstructive pulmonary disease: past, present, and future directions.

Curr Opin Pulm Med. 2017 Dec 07;:

Authors: Siddiqui FM, Diamond JM

Abstract
PURPOSE OF REVIEW: Lung transplantation offers an effective treatment modality for patients with end-stage chronic obstructive pulmonary disease (COPD). The exact determination of when to refer, list, and offer transplant as well as the preferred transplant procedure type remains unclear. Additionally, there are special considerations specific to patients with COPD being considered for lung transplantation, including the implications of single lung transplantation on lung cancer risk, native lung hyperinflation, and overall survival.
RECENT FINDINGS: The International Society for Heart and Lung Transplantation's most recent recommendations rely on an assessment of COPD severity based on BODE index. Despite the lack of evidence supporting a mortality benefit of bilateral over single lung transplantation for COPD patients, the majority of transplants performed in this population remain bilateral. Some of the concerns specific to single lung transplantation remain the possibility of de novo native lung cancer and the hemodynamic and physiologic implications of acute native lung hyperinflation.
SUMMARY: COPD remains the most common worldwide indication for lung transplantation. Ongoing study is still required to assess the overall survival benefit of lung transplantation and assess the overall quality of life impact on the COPD patient population.

PMID: 29227305 [PubMed - as supplied by publisher]

Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey.

Tue, 12/12/2017 - 16:48

Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey.

JACC Heart Fail. 2017 Nov 27;:

Authors: Girerd N, Seronde MF, Coiro S, Chouihed T, Bilbault P, Braun F, Kenizou D, Maillier B, Nazeyrollas P, Roul G, Fillieux L, Abraham WT, Januzzi J, Sebbag L, Zannad F, Mebazaa A, Rossignol P, INI-CRCT, Great Network, and the EF-HF Group

Abstract
Congestion is one of the main predictors of poor patient outcome in patients with heart failure. However, congestion is difficult to assess, especially when symptoms are mild. Although numerous clinical scores, imaging tools, and biological tests are available to assist physicians in ascertaining and quantifying congestion, not all are appropriate for use in all stages of patient management. In recent years, multidisciplinary management in the community has become increasingly important to prevent heart failure hospitalizations. Electronic alert systems and communication platforms are emerging that could be used to facilitate patient home monitoring that identifies congestion from heart failure decompensation at an earlier stage. This paper describes the role of congestion detection methods at key stages of patient care: pre-admission, admission to the emergency department, in-hospital management, and lastly, discharge and continued monitoring in the community. The multidisciplinary working group, which consisted of cardiologists, emergency physicians, and a nephrologist with both clinical and research backgrounds, reviewed the current literature regarding the various scores, tools, and tests to detect and quantify congestion. This paper describes the role of each tool at key stages of patient care and discusses the advantages of telemedicine as a means of providing true integrated patient care.

PMID: 29226815 [PubMed - as supplied by publisher]

Experience with leflunomide as treatment and as secondary prophylaxis for cytomegalovirus infection in lung transplant recipients: a case series and review of the literature.

Tue, 12/12/2017 - 16:48
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Experience with leflunomide as treatment and as secondary prophylaxis for cytomegalovirus infection in lung transplant recipients: a case series and review of the literature.

Clin Transplant. 2017 Dec 11;:

Authors: Silva JT, Pérez-González V, López-Medrano F, Alonso-Moralejo R, Fernández-Ruiz M, San-Juan R, Brañas P, Folgueira MD, Aguado JM, de Pablo-Gafas A

Abstract
Data concerning the use of leflunomide -a drug approved for rheumatoid arthritis with in vitro anti-cytomegalovirus (CMV) activity- in lung transplant (LT) recipients are scarce. We performed a single center retrospective study including LT recipients who received leflunomide for CMV infection or as secondary prophylaxis after viremia clearance. We also conducted a full systematic PubMed search until June 30, 2017. We identified 5 LT recipients in our center, plus 7 patients reported in the literature. All patients had previously received ganciclovir (GCV) and foscarnet, with drug-induced adverse effects described in 6 recipients (50%). Antiviral resistance mutations were observed in 8 patients (66.7%). Leflunomide was prescribed for CMV infection in 9 of 12 patients (75%) and as secondary prophylaxis in 3 patients (25%). Initial decrease of CMV viremia after starting leflunomide was observed in 7 of 9 recipients (77.7%), although this response was only transient in two patients. Long-term suppression of CMV viremia was reported in 7 of 12 patients (58.3%). In 3 recipients (25%), leflunomide was discontinued due to adverse effects. Leflunomide, alone or in combination, could be an effective treatment in selected LT recipients with GCV-resistant CMV infection and as secondary prophylaxis. Further studies are necessary. This article is protected by copyright. All rights reserved.

PMID: 29226391 [PubMed - as supplied by publisher]

Recent advances in managing idiopathic pulmonary fibrosis.

Tue, 12/12/2017 - 16:48
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Recent advances in managing idiopathic pulmonary fibrosis.

F1000Res. 2017;6:2052

Authors: Scelfo C, Caminati A, Harari S

Abstract
Idiopathic pulmonary fibrosis (IPF) is a rare pulmonary disease with a poor prognosis and severe impact on quality of life. Early diagnosis is still challenging and important delays are registered before final diagnosis can be reached. Available tools fail to predict the variable course of the disease and to evaluate response to antifibrotic drugs. Despite the recent approval of pirfenidone and nintedanib, significant challenges remain to improve prognosis and quality of life. It is hoped that the new insights gained in pathobiology in the last few years will lead to further advances in the diagnosis and management of IPF. Currently, early diagnosis and prompt initiation of treatments reducing lung function loss offer the best hope for improved outcomes. This article aims at providing an overview of recent advances in managing patients with IPF and has a particular focus on how to reach a diagnosis, manage comorbidities and lung transplantation, care for the non-pharmacological needs of patients, and address palliative care.

PMID: 29225786 [PubMed]

[Clinical analysis of lung transplantation in eight patients with obstructive bronchiolitis syndrome after hematopoietic stem cell transplantation].

Tue, 12/12/2017 - 16:48
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[Clinical analysis of lung transplantation in eight patients with obstructive bronchiolitis syndrome after hematopoietic stem cell transplantation].

Zhonghua Xue Ye Xue Za Zhi. 2017 Nov 14;38(11):977-980

Authors: Wang LL, Wang HY, Shen YF, Lu MZ, Chen JY, Wu B

Abstract
Objective: To investigate the efficacy and prognosis of lung transplantation (LT) for end-stage bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of eight cases with end-stage BOS after allo-HSCT who were treated by LT in our hospital were retrospectively analyzed. Results: Eight patients with hematological malignancy underwent allo-HSCT, and the median age was 23 (12-40) years. The donors are parents or siblings. Severe BOS occurred in 8 patients after allo-HSCT, the median age for LT was 27.5 (13-47) years. The median interval between allo-HSCT and LT was 69 (21-132) months. The median follow-up time for 8 patients after LT was 15 (6-63) months, 7 patients survived, 1 patient died of pulmonary hemorrhage 15 months after LT treatment. Of the survivors, three had BOS again, and one of them received reduplicated lung transplantation. Conclusion: LT is an effective treatment for patients with severe BOS after HSCT.

PMID: 29224324 [PubMed - in process]

[Clinical value of PCR for viral detection of bronchoalveolar lavage fluid in the diagnosis and treatment of pneumonia after allogeneic hematopoietic stem cell transplantation].

Tue, 12/12/2017 - 16:48
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[Clinical value of PCR for viral detection of bronchoalveolar lavage fluid in the diagnosis and treatment of pneumonia after allogeneic hematopoietic stem cell transplantation].

Zhonghua Xue Ye Xue Za Zhi. 2017 Nov 14;38(11):934-939

Authors: Chen YY, Luo XY, Zhao XS, Jiang ZH, Chen Y, Chen H, Mo XD, Han W, Wang FR, Wang JZ, Yan CH, Sun YQ, Zhang YY, Han TT, Tang FF, Fu HX, Zhang S, Wang Y, Xu LP, Zhang XH, Liu KY, Huang XJ

Abstract
Objective: To analyze the clinical value of real-time PCR for virus detection in the diagnosis and treatment of patients after allo-HSCT who had no infection evidence of pneumonia using routine pathogen detection panel. Methods: The clinical data of 71 episodes with acute lung injury from May 2015 to March 2017 after allo-HSCT in hematology department of Peking University People's Hospital (PKUPH) were retrospectively analyzed. PCR for virus detection and other routine pathogen detection tests were performed on bronchoalveolar lavage fluid (BALF) samples. Results: Among 71 episodes with acute lung injury, a total of 15 patients were diagnosed as lower respiratory tract disease merely associated with virus (detection rate of 21.13%) , 19 episodes were absent of lower respiratory tract infection. The median time from allo-HSCT to the occurrence of lung injury were 176 (49-1 376) d and 196 (57-457) d respectively (z=-0.191, P=0.864) . There were no statistical differences for baseline characteristics and clinical features between two groups. The 100-day attributable mortalities were 13.3% (2/15) and 26.3% (5/19) (χ(2)=0.864, P=0.426) . Patients with low-dose steroids treatment had favorable outcome than those with high-dose steroids treatment (the dose of methylprednisolone ≥250 mg/d as standard) [4.2% (1/24) vs 60.0% (6/10) ]. In patients with detectable virus in BALF, 2 patients died with early high-dose steroids treatment, while 11 patients survived with no steroids treatment or late application. Conclusions: Virus infection should be considered in post-HSCT pneumonia patient with negative result using routine pathogen detection panel. Expanding virus detection panel by PCR in BALF could increase diagnostic precision and might be instructive to treatment.

PMID: 29224314 [PubMed - in process]

Concise Review: Mesenchymal Stem (Stromal) Cells: Biology and Preclinical Evidence for Therapeutic Potential for Organ Dysfunction Following Trauma or Sepsis.

Tue, 12/12/2017 - 16:48
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Concise Review: Mesenchymal Stem (Stromal) Cells: Biology and Preclinical Evidence for Therapeutic Potential for Organ Dysfunction Following Trauma or Sepsis.

Stem Cells. 2017 Feb;35(2):316-324

Authors: Matthay MA, Pati S, Lee JW

Abstract
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have antimicrobial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients. Progress has been made in understanding the mechanisms of benefit, including MSC release of paracrine factors, transfer of mitochondria, and elaboration of exosomes and microvesicles. Regardless of how well they are designed, preclinical studies have limitations in modeling the complexity of clinical syndromes, especially in patients who are critically ill. In order to facilitate translation of the preclinical studies of MSC to critically ill patients, there will need to be more standardization regarding MSC production with a focus on culture methods and cell characterization. Finally, well designed clinical trials will be needed in critically ill patient to assess safety and efficacy. Stem Cells 2017;35:316-324.

PMID: 27888550 [PubMed - indexed for MEDLINE]

Changes in Urinary Microbiome Populations Correlate in Kidney Transplants With Interstitial Fibrosis and Tubular Atrophy Documented in Early Surveillance Biopsies.

Tue, 12/12/2017 - 16:48
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Changes in Urinary Microbiome Populations Correlate in Kidney Transplants With Interstitial Fibrosis and Tubular Atrophy Documented in Early Surveillance Biopsies.

Am J Transplant. 2017 Mar;17(3):712-723

Authors: Modena BD, Milam R, Harrison F, Cheeseman JA, Abecassis MM, Friedewald JJ, Kirk AD, Salomon DR

Abstract
An unbalanced microbiome may lead to disease by creating aberrant immune responses. A recent association of cellular rejection with the development of interstitial fibrosis and tubular atrophy (IFTA) suggests the role of immune-mediated tissue injury. We hypothesized that developing IFTA correlates with altered urinary tract microbiomes (UMBs). UMBs at two serial time points, 1 and 6-8 months posttransplant, were assessed by 16S microbial ribosomal gene sequencing in 25 patients developing biopsy-proven IFTA compared to 23 transplant patients with normal biopsies and excellent function (TX) and 20 healthy nontransplant controls (HC). Streptococcus, the dominant genera in HC males, was lower in IFTA and TX males at 1 month compared to HCs. At 6-8 months, Streptococcus was further decreased in IFTA males, but normalized in TX. IFTA males and females had increases in number of genera per sample at 6-8 months. UMB composition varied substantially between individuals in all groups. Despite the wide variation in UMBs between individuals, IFTA was associated with a loss in dominant resident urinary microbes in males, and a parallel increase in nonresident, pathogenic bacteria in males and females. UMB changes may contribute to IFTA development by alteration of the host immune response.

PMID: 27597148 [PubMed - indexed for MEDLINE]

Novel signaling collaboration between TGF-β and adaptor protein Crk facilitates EMT in human lung cancer.

Tue, 12/12/2017 - 16:48
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Novel signaling collaboration between TGF-β and adaptor protein Crk facilitates EMT in human lung cancer.

Oncotarget. 2016 May 10;7(19):27094-107

Authors: Elmansuri AZ, Tanino MA, Mahabir R, Wang L, Kimura T, Nishihara H, Kinoshita I, Dosaka-Akita H, Tsuda M, Tanaka S

Abstract
The signaling adaptor protein Crk has been shown to play an important role in various human cancers. However, its regulatory machinery is not clear. Here, we demonstrated that Crk induced EMT in A549 human lung adenocarcinoma cells through differential regulation of Rac1/Snail and RhoA/Slug, leading to decreased expression of E-cadherin and increased N-cadherin, fibronectin, and MMP2 expression. Cancer cells with mesenchymal features produced TGF-β and also increased the levels of TGF-β receptor. TGF-β increased the endogenous levels of Crk and also augmented Crk-dependent expression of Snail and Slug, and conversely TGF-β receptor inhibitor suppressed the levels of Snail and Slug. Overexpression of Crk was observed at the invasive front of human lung cancer tissues and was significantly associated with poor prognosis. Thus, TGF-β and Crk collaborate to form a positive feedback loop to facilitate EMT, which may lead to the malignancy of human cancers possibly being affected by their microenvironment.

PMID: 27027347 [PubMed - indexed for MEDLINE]

REVEAL risk scores applied to riociguat-treated patients in PATENT-2: Impact of changes in risk score on survival.

Mon, 12/11/2017 - 11:05

REVEAL risk scores applied to riociguat-treated patients in PATENT-2: Impact of changes in risk score on survival.

J Heart Lung Transplant. 2017 Nov 11;:

Authors: Benza RL, Farber HW, Frost A, Ghofrani HA, Gómez-Sánchez MA, Langleben D, Rosenkranz S, Busse D, Meier C, Nikkho S, Hoeper MM

Abstract
BACKGROUND: The Registry to Evaluate Early and Long-term PAH Disease Management (REVEAL) risk score (RRS) calculator was developed using data derived from the REVEAL registry, and predicts survival in patients with pulmonary arterial hypertension (PAH) based on multiple patient characteristics. Herein we applied the RRS to a pivotal PAH trial database, the 12-week PATENT-1 and open-label PATENT-2 extension studies of riociguat. We examined the effect of riociguat vs placebo on RRS in PATENT-1, and investigated the prognostic implications of change in RRS during PATENT-1 on long-term outcomes in PATENT-2.
METHODS: RRS was calculated post hoc for baseline and Week 12 of PATENT-1, and Week 12 of PATENT-2. Patients were grouped into risk strata by RRS. Kaplan-Meier estimates were made for survival and clinical worsening-free survival in PATENT-2 to evaluate the relationship between RRS in PATENT-1 and long-term outcomes in PATENT-2.
RESULTS: A total of 396 patients completed PATENT-1 and participated in PATENT-2. In PATENT-1, riociguat significantly improved RRS (p = 0.031) and risk stratum (p = 0.018) between baseline and Week 12 compared with placebo. RRS at baseline, and at PATENT-1 Week 12, and change in RRS during PATENT-1 were significantly associated with survival (hazard ratios for a 1-point reduction in RRS: 0.675, 0.705 and 0.804, respectively) and clinical worsening-free survival (hazard ratios of 0.736, 0.716 and 0.753, respectively) over 2 years in PATENT-2.
CONCLUSIONS: RRS at baseline and Week 12, and change in RRS, were significant predictors of both survival and clinical worsening-free survival. These data support the long-term predictive value of the RRS in a controlled study population.

PMID: 29223470 [PubMed - as supplied by publisher]

Posttransplant Lymphoproliferative Disorders in Epstein-Barr Virus Donor Positive/Recipient Negative Lung Transplant Recipients.

Mon, 12/11/2017 - 11:05

Posttransplant Lymphoproliferative Disorders in Epstein-Barr Virus Donor Positive/Recipient Negative Lung Transplant Recipients.

Ann Thorac Surg. 2017 Dec 06;:

Authors: Courtwright AM, Burkett P, Divo M, Keller S, Rosas IO, Trindade A, Mody GN, Singh SK, El-Chemaly S, Camp PC, Goldberg HJ, Mallidi HR

Abstract
BACKGROUND: Epstein-Barr virus (EBV) donor positive/recipient negative (D+/R-) status is a significant risk factor for posttransplant lymphoproliferative disorder (PTLD) in lung transplant. There are, however, no studies that identify the risk factors for PTLD in the EBV D+/R- lung transplant population to guide the decision to proceed with an EBV-positive donor.
METHODS: This was a retrospective cohort study of adults listed in the Scientific Registry of Transplant Recipients between May 5, 2005, and August 31, 2016. Cox proportional hazards models were used to assess the impact of EBV D+/R- status on the development of PTLD, the impact of PTLD on survival, and survival differences between EBV D+/R- and EBV D-/R- recipients.
RESULTS: The incidence of PTLD was 6.2% (79 of 1,281) versus 1.4% (145 of 10,352) in EBV D+/R- versus all other recipients (adjusted odds ratio 4.0; 95% confidence interval: 2.8 to 5.9, p < 0.001). Among EBV D+/R- recipients, age less than 40 years and white race were associated with PTLD. The EBV D+/R- patients who had PTLD had increased adjusted risk of death (hazard ratio 1.91; 95% confidence interval: 1.35 to 2.71; p < 0.001). Compared with EBV D+/R- recipients, EBV D-/R- recipients did not have improved adjusted survival (hazard ratio 0.82; 95% confidence interval: 0.57 to 1.18; p = 0.30).
CONCLUSIONS: Despite increased rates of PTLD and associated mortality in the EBV D+/R- population, EBV seronegative patients did not have worse mortality when transplanted with lungs from EBV seropositive donors compared with lungs from EBV seronegative donors. Consideration should be given for close monitoring for PTLD among EBV D+/R- recipients, particularly those who are white and less than 40 years of age.

PMID: 29223419 [PubMed - as supplied by publisher]

The distal airway microbiome after lung transplantation: A driver of immune regulation?

Sun, 12/10/2017 - 13:45
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The distal airway microbiome after lung transplantation: A driver of immune regulation?

J Heart Lung Transplant. 2017 Nov 22;:

Authors: Mitchell AB, Glanville AR

PMID: 29221917 [PubMed - as supplied by publisher]

Lung transplantation in the most critically-III: forging ahead.

Sun, 12/10/2017 - 13:45
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Lung transplantation in the most critically-III: forging ahead.

J Thorac Dis. 2017 Sep;9(9):3430-3432

Authors: Mulvihill MS, Hartwig MG, Daneshmand MA

Abstract
Lung transplantation is the gold standard therapy for patients with end-stage lung disease. The use of the lung allocation score (LAS) has permitted improved allocation of scarce pulmonary allografts. Recently, Crawford et al. examined the experience in the United States in lung transplantation in candidates with the highest LAS, demonstrating that outcomes for candidates with the highest LAS scores have improved significantly. This editorial places these data in the broader context of thoracic transplantation, and highlights the critical need for ongoing examination of this critically-ill patient population.

PMID: 29221330 [PubMed]

Recipient selection process and listing for lung transplantation.

Sun, 12/10/2017 - 13:45
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Recipient selection process and listing for lung transplantation.

J Thorac Dis. 2017 Sep;9(9):3372-3384

Authors: Verleden GM, Dupont L, Yserbyt J, Schaevers V, Van Raemdonck D, Neyrinck A, Vos R

Abstract
Lung transplantation remains the ultimate treatment option for selected patients with end-stage (cardio) pulmonary disease. Given the current organ shortage, it is without any doubt that careful selection of potential transplant candidates is essential as this may greatly influence survival after the procedure. In this paper, we will review the current guidelines for referral and listing of lung transplant candidates in general, and in more depth for the specific underlying diseases. Needless to state that these are not absolute guidelines, and that decisions depend upon center's activity, waiting list, etc. Therefore, every patient should be discussed with the transplant center before any definite decision is made to accept or decline a patient for lung transplantation.

PMID: 29221322 [PubMed]

Living-related lung transplantation.

Sun, 12/10/2017 - 13:45
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Living-related lung transplantation.

J Thorac Dis. 2017 Sep;9(9):3362-3371

Authors: Date H

Abstract
Living-donor lobar lung transplantation (LDLLT) was developed to deal with the severe shortage of brain dead door for patients who would not survive the long waiting period. In standard LDLLT, right and left lower lobes removed from two healthy donors are implanted into a recipient after right and left pneumonectomies using cardiopulmonary bypass (CPB). The number of LDLLT has decreased in the USA due to the recent change in allocation system for cadaveric donor lungs. For the past several years, most of the reports on LDLLT have been from Japan, where the average waiting time for a cadaveric lung is exceeding 800 days. LDLLT has been performed both for adult and pediatric patients suffering from various end-stage lung diseases including restrictive, obstructive, vascular and infectious lung diseases. Since only two lobes are implanted, size matching is a very important issue. Functional size matching by measuring donor pulmonary function and anatomical size matching by three-dimensional computed tomography (3D-CT) volumetry are very useful. For oversize graft, we have employed several techniques, including single lobe transplantation, delayed chest closure, downsizing the graft, and middle lobe transplantation. In cases of undersize mismatch, native upper lobe sparing transplant or right-left inverted transplant was performed. The 5-, 10- and 15-year survivals were 80.8%, 72.6% and 61.7%, respectively. There was no difference in survival between standard LDLLT and non-standard LDLLT such as single, sparing and inverted transplant. All donors have been discharged without any restrictions. LDLLT is a viable option for very ill patients who would not survive a long waiting time for cadaveric lungs. We have successfully developed various surgical techniques to overcome size mismatching with favorable outcome.

PMID: 29221321 [PubMed]

Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

Sun, 12/10/2017 - 13:45
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Bridging to lung transplantation with extracorporeal circulatory support: when or when not?

J Thorac Dis. 2017 Sep;9(9):3352-3361

Authors: Loor G, Simpson L, Parulekar A

Abstract
Patients with end-stage lung disease who are candidates for lung transplantation may acutely decompensate before a donor organ becomes available. In this scenario, extracorporeal life support (ECLS) may be considered as a bridge to transplant or as a bridge to decision. In the current chapter, we review the indications, techniques, and outcomes for bridging to lung transplantation with ECLS.

PMID: 29221320 [PubMed]

Lung transplantation in elderly patients.

Sun, 12/10/2017 - 13:45
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Lung transplantation in elderly patients.

J Thorac Dis. 2017 Sep;9(9):3346-3351

Authors: Courtwright A, Cantu E

Abstract
Consensus statements on the selection of lung transplant candidates have consistently identified older age as a relative contraindication to transplantation. A combination of population-level demographic changes, revision of the lung allocation score (LAS), and clearer data on outcomes in elderly transplant recipients has, however, driven a steady increase in the threshold at which age is taken into consideration. This article reviews the current state of lung transplantation in elderly patients with an emphasis on the factors that have increased lung transplantation in older age groups, their expected outcomes including survival and health-related quality of life, and the factors that go in to appropriate candidate and procedure selection in this population.

PMID: 29221319 [PubMed]

TERT rs2736098 (Ex2-659G>A) polymorphism and cancer susceptibility: evidence from a comprehensive meta-analysis.

Sun, 12/10/2017 - 13:45
Related Articles

TERT rs2736098 (Ex2-659G>A) polymorphism and cancer susceptibility: evidence from a comprehensive meta-analysis.

Oncotarget. 2017 Nov 10;8(56):96433-96441

Authors: Pang T, Zhou M, Liu R, Luo J, Xia R

Abstract
Increasing researches have been performed regarding the relationship between TERT rs2736098 and cancer risk, but no consensus has been reached about the relationship. Here, we conducted this updated meta-analysis, aiming to comprehensively evaluate the role of TERT rs2736098 in cancer risk. We systematically searched potential relevant articles through PubMed, EMBASE, CNKI, and WanFang database before August 2017. A total of 33 studies with 18685 cases and 23820 controls were finally included in the current meta-analysis. We then adopted odds ratios (ORs) and 95% confidence intervals (CIs) to analyze the contributions of TERT rs2736098 to cancer risk. We found that the TERT rs2736098 polymorphism was associated with risk of cancer in overall analysis (AA vs. GG: OR = 1.26, 95% CI = 1.09-1.47; AA vs.
AG/GG: OR = 1.22, 95% CI = 1.09-1.36; AA/AG vs. GG: OR = 1.13, 95% CI = 1.02-1.24; A vs. G: OR = 1.11, 95% CI = 1.04-1.20). Furthermore, in analysis stratified by cancer type, ethnicity, control source, quality score, and Hardy-Weinberg equilibrium (HWE) in controls, we found increased risk of cancer among lung cancer, bladder cancer, breast cancer, colorectal cancer, other cancers, Asians, hospital-based subgroup, score > 9 group, as well as controls agreement with HWE group. Despite some limitations, the current meta-analysis represented the largest and the most comprehensive investigations, with the strongest conclusion than ever before. To further explicit the association between TERT rs2736098 and cancer risk, more well-design case-control studies with larger sample size are warranted in the future.

PMID: 29221218 [PubMed]

NKG2C Deletion is a Risk Factor for Human Cytomegalovirus-Viremia and Disease after Lung Transplantation.

Sat, 12/09/2017 - 13:45

NKG2C Deletion is a Risk Factor for Human Cytomegalovirus-Viremia and Disease after Lung Transplantation.

J Infect Dis. 2017 Dec 06;:

Authors: Vietzen H, Pollak K, Honsig C, Jaksch P, Puchhammer-Stöckl E

Abstract
Human cytomegalovirus (HCMV) replication is limited by HCMV-specific natural-killer (NK) cell response. Distinct genetic polymorphisms, which are potentially involved in antiviral NK-cell response, have been described. Here, the association between polymorphisms at IgG1 GM3/17, FcγRIIIα/CD16a-158V/F, NKG2Cwt/del, CD226/rs727088 and rs763361, respectively, and HCMV-viremia and disease was investigated in 98 lung transplant recipients (LTRs), within 9 months after stop of post-transplant HCMV-prophylaxis. From all variants, only the NKG2Cwt/wt genotype was significantly associated with freedom from HCMV-viremia (P= 0.0002) and disease (P= 0.02), compared to the NKG2Cwt/del genotype. Thus, LTRs expressing the homozygous NKG2C wildtype seem to have a selective advantage in HCMV-defence.

PMID: 29220498 [PubMed - as supplied by publisher]

End-stage renal disease after pediatric heart transplantation: A 25-year national cohort study.

Sat, 12/09/2017 - 13:45
Related Articles

End-stage renal disease after pediatric heart transplantation: A 25-year national cohort study.

J Heart Lung Transplant. 2017 Nov 15;:

Authors: Azeka E

PMID: 29217110 [PubMed - as supplied by publisher]

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