Lung Transplantation

New England Journal of Medicine, Год журнала: 2024, Номер 391(19), С. 1822 - 1836

Опубликована: Ноя. 13, 2024

Lung transplantation has evolved from an experimental to a standard treatment. The authors review recent developments and future opportunities in the delivery of this potentially life-transforming therapy.

Язык: Английский

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Increasing Risk of Post-Lung Transplant Hospitalizations for Infection: An Analysis of Recent Trends

JHLT Open, Год журнала: 2025, Номер 8, С. 100231 - 100231

Опубликована: Фев. 27, 2025

Язык: Английский

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The search for peripheral tolerance in lung transplantation

Current Opinion in Pulmonary Medicine, Год журнала: 2025, Номер unknown

Опубликована: Май 21, 2025

Purpose of review Median survival after lung transplantation is 5.7 years, which lags behind other solid organ transplants, such as heart, liver, and kidney. The major barrier to long-term in transplant recipients chronic allograft dysfunction (CLAD). This discusses the challenge CLAD a tolerance identifies key areas field that require further development. Recent findings heterogenous disease its kinetics onset severity remains clinical diagnosis exclusion, based on decline function. While acute cellular rejection antibody-mediated are risk-factors for CLAD, barriers acceptance aspiration primary graft dysfunction. However infections, particularly respiratory viral infections Cytomegalovirus (CMV) remain most significant risks CLAD. Additionally, limited by lack molecular diagnostic assays Further, new targets needed precision immunosuppression, more studies develop novel interventions extend acceptance. Summary lines study address important unmet needs necessary Other studies, tandem bone marrow select patients with immunodeficiency may provide additional lessons how potentially establish tolerance. However, extremely rare, pursue this ultimate goal.

Язык: Английский

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Outcomes of SARS‐CoV‐2 infection among lung transplant recipients: A single center retrospective study

Transplant Infectious Disease, Год журнала: 2023, Номер 25(1)

Опубликована: Янв. 5, 2023

Lung transplant recipients (LTRs) are at increased risk for coronavirus disease 2019 (COVID-19)-associated complications.We aimed to describe the outcomes of polymerase chain reaction-documented severe acute respiratory syndrome 2 (SARS-CoV-2) infection in LTRs followed our institution from March 2020 July 2022. The primary outcome investigated was hospitalization or death COVID-19-related symptoms within 28 days diagnosis.Overall, 60 cases were included, which 18 (30%) reached outcome. Only one patient (2%) died. Anti-spike monoclonal antibodies (mAbs) administered as early treatment 36 patients (casirivimab/imdevimab = 2, sotrovimab 31, and tixagevimab/cilgavimab 3). Multivariate analysis revealed that age >60 years (p .003; odds ratio [OR] 9.41; confidence interval [CI] 2.52-41.05) associated with a higher outcome, while administration mAbs .030; OR 0.23; CI 0.06-0.87) lower risk. No effect vaccination SARS-CoV-2 variant observed. Forced expiratory volume 1 s forced vital capacity values did not decrease among 37 who had spirometry performed month after COVID-19.We observed relatively low morbidity mortality COVID-19 LTR. mAb better

Язык: Английский

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Chronic Lung Allograft Dysfunction Is Associated with Significant Disability after Lung Transplantation—A Burden of Disease Analysis in 1025 Cases

Advances in respiratory medicine, Год журнала: 2023, Номер 91(5), С. 432 - 444

Опубликована: Окт. 12, 2023

Chronic lung allograft dysfunction (CLAD) is the leading cause of death after first postoperative years transplantation (LTx).To assess number disability-adjusted life (DALYs) per patient with severe CLAD.The clinical and demographic data patients who received their between 2010 2020 in Hanover Medical School (Germany) were evaluated.A total 1025 transplant followed for a median 51 months (4.25 years); age at was 52.8 (interquartile range (IQR) 19) years. More than quarter (271/1025 or 26.4%) developed CLAD, mostly (60%) bronchiolitis obliterans syndrome (BOS) phenotype. Of CLAD patients, 99, 36.5%, suffered from significant disability, which on average occurred 2 (IQR 2.55). The survival disability significantly lower compared to that without (median 4.04 versus 5.41 years). Adjusted DALY estimation approach, lost 1.29 (YLL) lived 0.8 (YLD), adding up 2.09 DALYs (range 1.99-2.72) patient.CLAD major public health problem associated substantial costs. Further work needed develop therapeutic interventions reduce its development.

Язык: Английский

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COVID-19 infection is mild and has minimal impact on lung function in well vaccinated and widely treated lung transplant recipients

The Journal of Heart and Lung Transplantation, Год журнала: 2024, Номер 43(6), С. 944 - 953

Опубликована: Фев. 24, 2024

Язык: Английский

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Early outcomes of lung transplantation with lung allografts from coronavirus disease 2019 (COVID-19)–positive donors

Journal of Thoracic and Cardiovascular Surgery, Год журнала: 2023, Номер 167(6), С. 1955 - 1964.e3

Опубликована: Авг. 23, 2023

Язык: Английский

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Evolving impact of the COVID-19 pandemic on lung transplant recipients: A single-center experience

The Journal of Heart and Lung Transplantation, Год журнала: 2023, Номер 43(3), С. 442 - 452

Опубликована: Окт. 17, 2023

Язык: Английский

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Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in LungTransplant Patients

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(12), С. 4125 - 4125

Опубликована: Июнь 18, 2023

COVID-19 causes high mortality in Lung Transplant (LTx) patients, therefore vaccination this population is potentially life-saving. However, the antibody response impaired after three vaccinations LTx patients. We questioned whether might be increased, and studied serological IgG across up to five doses of SARS-CoV-2 vaccine. In addition, risk factors for non-response were investigated.In large retrospective cohort study, responses assessed 1-5 mRNA-based vaccines all patients between February 2021 September 2022. A positive vaccine was defined as an level ≥ 300 BAU/mL. Positive due infection excluded from analysis. Outcome clinical parameters compared responders non-responders, multivariable logistic regression analysis performed determine vaccine-response failure.The 292 analyzed. occurred 0%, 15%, 36%, 46%, 51%, respectively. During study period, 146/292 (50%) vaccinated individuals tested infection. The COVID-19-related 2.7% (4/146), four non-responders. Risk associated with univariable analyses age (p = 0.004), chronic kidney disease (CKD) 0.006), shorter time since transplantation 0.047). analysis, they CKD 0.043), 0.028).A two- five-dose regime increases probability results a cumulative 51% population. patient impaired, especially shortly LTx, CKD, elderly.

Язык: Английский

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Impact of COVID‐19 on long‐term lung function in lung transplant recipients: A single‐center retrospective cohort study

Transplant Infectious Disease, Год журнала: 2023, Номер 25(5)

Опубликована: Сен. 25, 2023

Available data are limited concerning long-term lung function (LF) evolution after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in transplant (LT) recipients. The aim of this study is to determine the effect first SARS-CoV-2 on LF LT We analyzed spirometry results recipients followed at our institution (March 2020 July 2022) 3, 6, and 12 months infection. Overall, 42 patients cohort (70%) with COVID-19 were included for analysis. Forced expiratory volume 1 s (FEV1 ) declined significantly 3 (-4.5%, -97 mL, 95% CI [-163; -31], p < .01), but not 6 (-3.9%, -65 [-168; +39], = .21). Results quite similar forced vital capacity. Spirometry values recipients, presented a mixed decline months, no significant months.

Язык: Английский

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