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 2009
Case ReportsTreprostinil to reverse pulmonary hypertension associated with idiopathic pulmonary fibrosis as a bridge to single-lung transplantation.
The available therapies and prognosis of idiopathic pulmonary fibrosis remain relatively poor, and concurrent pulmonary hypertension further increases the risk of death and complications after lung transplantation. Limited data exist for the treatment of pulmonary hypertension associated with idiopathic pulmonary fibrosis. We describe a case where intravenous treprostinil was used to bridge an elderly patient with idiopathic pulmonary fibrosis with severe pulmonary hypertension to successful single-lung transplantation.
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J. Heart Lung Transplant. · Sep 2009
Mechanical circulatory support devices improve tissue perfusion in patients with end-stage heart failure or cardiogenic shock.
This study evaluated the effects of mechanical circulatory support (MCS) on sub-lingual microcirculation as a surrogate for splanchnic microvascular perfusion. ⋯ Mechanical circulatory support for severe heart failure is associated with a consistent, significant, and sustained improvement in tissue perfusion, as measured at the bedside by a 2-dimensional microcirculation imaging technique.
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J. Heart Lung Transplant. · Aug 2009
Impact of U.S. Lung Allocation Score on survival after lung transplantation.
The Lung Allocation Score (LAS) dramatically changed organ allocation in lung transplantation. The impact of this change on patient outcomes is unknown. The purpose of the study was to examine early mortality after lung transplantation under the LAS system. ⋯ Overall 1-year survival under the new LAS system appears to be similar to that in historic reports. However, risk of death was significantly increased among patients with LAS >46.
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J. Heart Lung Transplant. · Aug 2009
Initial experience with lung donation after cardiocirculatory death in Canada.
Organ donation after cardiac death (DCD) has the potential to alleviate some of the shortage of suitable lungs for transplantation. Only limited data describe outcomes after DCD lung transplantation. This study describes the early and intermediate outcomes after DCD lung transplantation in Canada. ⋯ DCD has steadily increased in Canada since 2006. The use of controlled DCD lungs for transplantation is associated with very acceptable early and intermediate clinical outcomes.
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J. Heart Lung Transplant. · Aug 2009
High incidence of thromboembolic events in left ventricular assist device patients treated with recombinant activated factor VII.
Dosing of recombinant activated factor VII (rFVIIa) is controversial and unstandardized, and there is growing concern about thromboembolic complications, especially in left ventricular assist device (LVAD)-supported patients. We reviewed our experience with rFVIIa administration in patients with LVADs and examined its effectiveness and adverse effects, including the incidence of thromboembolic events and its correlation with increasing doses. ⋯ Although rFVIIa administration seemed helpful in controlling life-threatening hemorrhage, patients requiring higher doses (30 to 70 microg/kg) had a dramatically higher incidence of serious thromboembolic events.