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. · Sep 2012
A panel of lung injury biomarkers enhances the definition of primary graft dysfunction (PGD) after lung transplantation.
We aimed to identify combinations of biomarkers to enhance the definition of primary graft dysfunction (PGD) for translational research. ⋯ Measurement of the combination of a marker of impaired fibrinolysis with an epithelial injury or cell adhesion marker had the best discrimination for PGD and prediction for early death and may provide an alternative outcome useful in future research.
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J. Heart Lung Transplant. · Sep 2012
Case ReportsRapidly progressive pulmonary venoocclusive disease in young women taking oral contraceptives.
Pulmonary venoocclusive disease (PVOD) is a rare cause of pulmonary hypertension characterized by a progressive clinical course and poor outcomes if not treated by early lung transplantation. The pathogenesis of PVOD remains poorly understood. We report PVOD that developed in 2 young women soon after the initiation of oral contraceptives (OCs). ⋯ Only 1 prior patient with PVOD and a handful of unclassified patients with pulmonary hypertension in association with OCs have been documented. The importance of PVOD as the basis of pulmonary hypertension in patients with connective tissue disease has been recently proposed, as well as the role of thrombogenesis, in the development of PVOD. The temporal sequence in these 2 patients suggests the thrombogenic action of OCs may contribute to the development of PVOD, with or without underlying connective tissue disease.
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J. Heart Lung Transplant. · Sep 2012
Diagnostic role of whole-body [18F]-FDG positron emission tomography in patients with symptoms suspicious for malignancy after heart transplantation.
Increased rates of malignancies and infections occur in transplant patients under immunosuppression, but the resultant clinical symptoms, and results of physical examination, chest X-ray, abdominal ultrasonography and laboratory findings are frequently difficult to interpret or inconclusive. The aim of the present study was to investigate the usefulness of whole-body [(18)F]-FDG PET for investigation of heart transplant patients suffering from suspicious symptoms, with a previously ambiguous diagnosis. ⋯ A non-invasive strategy of using whole-body [(18)F]-FDG PET or PET/CT in heart transplant recipients with non-specific unexplained symptoms may offer diagnostic stratification for malignancy and infections with a high sensitivity and modest diagnostic accuracy. These findings require prospective confirmation.
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J. Heart Lung Transplant. · Aug 2012
Recovery of right heart function with temporary right ventricular assist using a centrifugal pump in patients with severe biventricular failure.
Long-term outcomes of a biventricular assist device (BiVAD) support are worse than those of an isolated left ventricular assist device (LVAD) support. This study evaluated our strategy for right heart failure using a temporary right VAD (RVAD) with an extracorporeal centrifugal pump. ⋯ Our strategy with temporary RVAD for severe acute right heart failure was effective in selecting the patients who could be weaned from RVAD support. Patient survival was improved by avoiding the long-term support with a paracorporeal pulsatile BiVAD.
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J. Heart Lung Transplant. · Aug 2012
Randomized Controlled Trial Multicenter StudyTacrolimus and cyclosporine have differential effects on the risk of development of bronchiolitis obliterans syndrome: results of a prospective, randomized international trial in lung transplantation.
Chronic lung allograft dysfunction, which manifests as bronchiolitis obliterans syndrome (BOS), is recognized as the primary cause of morbidity and mortality after lung transplantation. In this study we assessed the efficacy and safety of two de novo immunosuppression protocols to prevent BOS. ⋯ Compared with cyclosporine, de novo tacrolimus use was found to be associated with a significantly reduced risk for BOS Grade ≥1 at 3 years despite a similar rate of acute rejection. However, no survival advantage was detected.