The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Nov 2015
The impact of pre-transplant allosensitization on outcomes after lung transplantation.
Allosensitization can be a significant barrier to transplantation for some patients, and previous studies suggested that pre-transplant allosensitization was associated with worse outcomes after lung transplantation. However, human leukocyte antigen (HLA) antibody testing has evolved significantly over the past 10 years, and current assays are highly sensitive and specific. ⋯ Pre-transplant allosensitization does not adversely affect outcomes after lung transplantation when the potentially reactive HLAs are avoided in the donor by a virtual crossmatch with the recipient.
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J. Heart Lung Transplant. · Nov 2015
Multicenter StudyLow body mass index is associated with increased waitlist mortality among children listed for heart transplant.
In adults, low body mass index (BMI) and high BMI have been associated with increased mortality after heart transplantation. Studies of BMI in children with heart failure have had inconsistent results. ⋯ Children listed for heart transplant are commonly either underweight or obese. Underweight patients have high risk-adjusted mortality before transplantation, whereas obese patients have borderline higher adjusted post-transplant mortality.
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J. Heart Lung Transplant. · Nov 2015
Randomized Controlled TrialEffects of complementary whole-body vibration training in patients after lung transplantation: A randomized, controlled trial.
In recent years, some studies have shown that whole-body vibration training (WBVT) may be a beneficial training mode in patients with chronic obstructive pulmonary disease (COPD). However, the effects of WBVT in patients after lung transplantation (LTx) have not yet been investigated. ⋯ A complementary WBVT on top of conventional endurance and strength training seems to be a feasible and safe exercise modality in patients after LTx. Furthermore, it may even enhance the benefits of a comprehensive PR on exercise capacity.
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J. Heart Lung Transplant. · Nov 2015
Erratic tacrolimus exposure, assessed using the standard deviation of trough blood levels, predicts chronic lung allograft dysfunction and survival.
Erratic tacrolimus blood levels are associated with liver and kidney graft failure. We hypothesized that erratic tacrolimus exposure would similarly compromise lung transplant outcomes. This study assessed the effect of tacrolimus mean and standard deviation (SD) levels on the risk of chronic lung allograft dysfunction (CLAD) and death after lung transplantation. ⋯ Erratic tacrolimus levels are a risk factor for poor lung transplant outcomes. Identifying and modifying factors that contribute to this variability may significantly improve outcomes.
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J. Heart Lung Transplant. · Nov 2015
Influence of right ventricular function on the development of primary graft dysfunction after lung transplantation.
Primary graft dysfunction (PGD) remains a significant cause of lung transplant postoperative morbidity and mortality. The underlying mechanisms of PGD development are not completely understood. This study analyzed the effect of right ventricular function (RVF) on PGD development. ⋯ A better RVF, as measured by BLS, is a risk factor for severe PGD. Careful preoperative RVF assessment using speckle-tracking echocardiography may identify LTrs with the highest risk of developing PGD.