The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Soluble Mesothelin-Related Peptide as a Prognosticator in Pleural Mesothelioma Patients Receiving Checkpoint Immunotherapy.
Immune checkpoint therapy (ICT) has significantly impacted the treatment of malignant pleural mesothelioma (MPM). Despite some promising results from combination therapies, nearly half of MPM patients do not benefit, underscoring the urgent need for reliable predictive biomarkers. This study assesses the prognostic value of serum soluble mesothelin-related peptide (SMRP) and PD-L1 levels in MPM patients receiving ICT. ⋯ SMRP is a promising serum biomarker for predicting survival in MPM patients treated with ICT and warrants prospective investigation.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Initial Patient Characteristics of TSOG 102: A Multicenter Prospective Registry of Active Surveillance in Patients with Multiple Ground Glass Opacities.
Presentation with multiple ground-glass opacities (GGOs) is an increasingly common occurrence, and the optimal management of these lesions is unclear. Active surveillance has been increasingly adopted as a management strategy for other low-grade malignancies. We hypothesized that active surveillance could be a feasible and safe option for patients with multiple GGOs. ⋯ Active surveillance, rather than immediate intervention, was an acceptable option to patients, and accrual to this registry trial was feasible. Safety end points and long-term outcomes will be assessed in the planned 5-year follow-up in accordance with the protocol.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Adoption of a Semi-elective Lung Transplantation Practice by Safely Extending Cold Ischemic Times.
Lung transplantation is a complex surgical procedure performed by specialized teams. Practice changes to eliminate overnight lung transplants were implemented at our center and patient outcomes were evaluated. ⋯ Donor lungs preserved in an iceless cooler were successfully transplanted after extended cold ischemic times. Adoption of a semielective transplant strategy can be successfully implemented without compromising patient outcomes. Additional advantages may be gleaned through daytime transplantation with standard transplant surgical teams rather than overnight, on-call, teams.
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J. Thorac. Cardiovasc. Surg. · Oct 2024
Bloodless Lung Transplantation: Comparison Between Two Central Venoarterial ECMO Anticoagulation Strategies and Their Impact on Lung Transplant Outcomes.
To report differences between 2 anticoagulation protocols during venoarterial extracorporeal membrane oxygenation (VA-ECMO) intraoperative support and their effects on outcomes after lung transplantation. ⋯ Our low-dose heparin VA-ECMO protocol for intraoperative support during lung transplantation led to a significant reduction of blood product use. Although this did not translate to a reduced rates of grade 3 primary graft dysfunction, the low-dose heparin protocol was associated with similar postoperative outcomes.