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. · Apr 1996
Comparative StudyThromboxane receptor blockade does not attenuate pulmonary pressor response in porcine single lung transplantation.
The ischemia-reperfusion lung injury is characterized by increased pulmonary vascular resistance, edema, and subsequent deterioration of oxygenation. Other models of acute lung injury suggest that thromboxane A2 may contribute to the pulmonary hypertension after transplantation. ⋯ Thromboxane does not seem to be among the principal mediators in the pulmonary hypertension after transplantation.
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J. Heart Lung Transplant. · Apr 1996
Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation.
Acute lung rejection after transplantation may lead to significant graft dysfunction. Hence surveillance protocols which include transbronchial biopsies have been established to monitor for early findings suggestive of acute rejection. However, the frequency of acute rejection diminishes as time from the transplant procedure increases. We therefore sought to examine the incidence of acute rejection seen on surveillance transbronchial biopsy performed at least 2 years after transplantation. ⋯ We conclude that transbronchial biopsy-proven acute rejection may occur in patients with asymptomatic, stable conditions who have survived at least 2 years, but the yield of transbronchial biopsy performed beyond 4 years is exceedingly low.
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J. Heart Lung Transplant. · Mar 1996
Comparative StudyControlled pressure reperfusion of rat pulmonary grafts yields improved function after twenty-four-hours' cold storage in University of Wisconsin solution.
Pulmonary graft recipients commonly have a degree of pulmonary hypertension. Immediate reperfusion of stored pulmonary grafts at supraphysiologic or even physiologic pressures may be detrimental to subsequent function. We wished to test the hypothesis that initial reperfusion of pulmonary grafts at low pressures may be beneficial. ⋯ The pressure at which pulmonary grafts are initially reperfused appears to be critical to their subsequent integrity. A protocol of controlled reperfusion may reduce reperfusion injury and improve graft function in clinical practice.
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J. Heart Lung Transplant. · Feb 1996
Comparative StudyDiagnostic yield and therapeutic impact of flexible bronchoscopy in lung transplant recipients.
Bronchoalveolar lavage and transbronchial biopsy are often used for definitive diagnosis of lung rejection and infection in lung transplant recipients. Although protected specimen brushing is of value in nosocomial bacterial pneumonia, its role in lung transplant recipients had not been widely reported. The aim of the study is to review the diagnostic yield and therapeutic impact of flexible bronchoscopy with the use of a combination of bronchoalveolar lavage, protected specimen brushing, and transbronchial biopsy in lung transplant recipients. ⋯ We conclude that bronchoscopy, with the use of a combination of bronchoalveolar lavage, protected specimen brushing, and transbronchial biopsy, is safe with a high diagnostic yield and therapeutic impact for treating lung transplant recipients.
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J. Heart Lung Transplant. · Feb 1996
Prognostic determinants of six-month morbidity and mortality in heart transplant recipients. The Italian Study Group on Infection in Heart Transplantation.
Knowledge of time course and risk factors for morbidity and mortality may allow better cardiac graft allocation, surveillance timing, and planning of immunosuppressive strategies. ⋯ Morbidity and mortality have the highest incidence during the early posttransplantation phase. Preoperative variables are of limited value with respect to immunosuppressive treatment in predicting outcome. Infection is far less frequent than rejection but, in view of the higher lethality rate, deserves a vigorous effort for prevention, which is best addressed by appropriate modulation of immunosuppressive strategies.