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Jabiry-Zieniewicz Z, Ochman M, Galle D, Królikowska M, Kowal A, Ludwin A, Mucha K, Jaworska I, Urlik M, Stącel T, Hrapkowicz T. First Successful Pregnancy After Lung Transplantation in Poland-Case Report. Transplant Proc 2024:S0041-1345(24)00190-8. [PMID: 38705735 DOI: 10.1016/j.transproceed.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/29/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Lung transplantation is well-established treatment for patients with advanced lung dysfunction in cystic fibrosis (CF). Pregnancy in CF lung transplant recipients is feasible, although it still remains challenging for even professionals and demands a multidisciplinary approach. CASE REPORT We report the case of pregnancy in a 22-year-old woman after lung transplantation (LTx) due to end-stage respiratory failure in the course of CF. The interval from transplant to conception was 2.5 years. In 2019, orthotopic LTx was performed and a 3-drug immunosuppressive scheme was used-tacrolimus, mycophenolate mofetil, and prednisolone. There were no complications in the postoperative course. In April 2022, the patient was confirmed pregnant. All fetotoxic or teratogenic drugs were discontinued. Throughout the whole pregnancy, the patient was regularly monitored in the transplant and obstetrics centers. Due to the vaginal bleeding and irregular contractions at the 33 weeks of pregnancy, the course of steroids was administered. At 38 weeks and 5 days of gestation, she presented premature rupture of membranes. The caesarean section was performed because of breech presentation of the fetus. A live, term daughter was born and according to the screening test she does not have CF. Currently, 12 months after the delivery, the mother's lung function is good. CONCLUSIONS Getting pregnant and having a safe pregnancy after LTx is possible, but it requires a specialized and individual approach. The patient should be well informed about possible complications and risks including graft failure. The patient's attitude and her cooperation with doctors play a major role.
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Affiliation(s)
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | - Dagmara Galle
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Magdalena Królikowska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Anna Kowal
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Artur Ludwin
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Mucha
- Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Hrapkowicz
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Stącel T, Sybila P, Mędrala A, Ochman M, Nęcki M, Pasek P, Kegler K, Przybyłowski P, Hrapkowicz T, Borowik D, Urlik M. Lung Transplantation in Patients With Systemic Scleroderma-Description of the First Consecutive Cases in Poland: Case Series Report and a Short Literature Review. Transplant Proc 2024:S0041-1345(24)00243-4. [PMID: 38702265 DOI: 10.1016/j.transproceed.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024]
Abstract
Pulmonary complications of systemic scleroderma (SSc), such as interstitial lung disease and pulmonary hypertension (PH), are responsible for up to 60% of deaths among patients. For many years, most centers considered SSc a contraindication to lung transplantation (LTx); however, recent publications show that appropriately selected SSc candidates for LTx give results comparable to patients with idiopathic PH or idiopathic pulmonary fibrosis. This paper presents the cases of a 60-year-old male patient (patient 1) and a 42-year-old female patient (patient 2) diagnosed with SSc in 2019 and 2013, respectively. In both patients, interstitial-fibrotic changes in the lungs leading to respiratory failure were confirmed by high-resolution computed tomography as well as pulmonary hypertension (WHO group 3), which was also diagnosed during right heart catheterization. In both cases, despite pharmacotherapy, pulmonary fibrosis progressed, leading to severe respiratory failure. The patients were referred for LTx qualification. LTx was possible to consider in patients due to the lack of significant changes in other internal organs. Double LTx was successfully performed in both patients (patient 1-July 19, 2022; patient 2-September 14, 2022). They were discharged from the hospital in good condition on the 22nd and 20th postoperative day, respectively. LTx is a last-chance therapy that saves lives among patients with extreme respiratory failure in the course of SSc. It prolongs and improves the quality of life. The selection of appropriate patients is key to the success of the procedure.
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Affiliation(s)
- Tomasz Stącel
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Paweł Sybila
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.
| | - Agata Mędrala
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Mirosław Nęcki
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Pasek
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Kamil Kegler
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Hrapkowicz
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Dawid Borowik
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, Katowice, Poland
| | - Maciej Urlik
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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Ochman M, Galle D, Goryczka A, Gałeczka-Turkiewicz A, Zawadzki F, Chorąży K, Stącel T, Urlik M, Hrapkowicz T. Pediatric Lung Transplantations: New Possibilities and Challenges in Treatment of Children With End-Stage Respiratory Failure. Transplant Proc 2024:S0041-1345(24)00189-1. [PMID: 38688728 DOI: 10.1016/j.transproceed.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/29/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Lung transplantation (LTx) is the last treatment option for children with end-stage respiratory failure. According to the literature, cystic fibrosis remains the most common cause of pediatric LTx. The study aimed to assess the characteristics of pediatric LTx recipients as well as the outcomes of the transplantation. METHODS Our study is a single-center retrospective review of clinical data of all 11 patients who underwent a LTx before the age of 18 years between the years 2016 and 2020. Medical records were examined for patients' characteristics, general treatment, and complications. RESULTS There were a total of 11 patients (8 males) with a median age 14.5 years (range: 11-17). The primary diseases that led to LTx were: cystic fibrosis in 8 patients (72.73%), hereditary hemorrhagic telangiectasia in 2 patients (18.18%), and idiopathic pulmonary arterial hypertension in 1 patient (9.09%). Median period from qualification to LTx was 235.55 days (range: 11-748). Two patients (18.18%) underwent lung retransplantation after 3 and 5 years. One patient passed away 10 months after surgery due to noncompliance. CONCLUSIONS Pediatric lung transplantation is less common than lung transplantation in adults. It also differs in fields of donors accessibility, stronger immune system response and noncompliance that may lead to graft failure.
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Affiliation(s)
- Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Dagmara Galle
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | - Agnieszka Goryczka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Alicja Gałeczka-Turkiewicz
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland; Department of Lung Diseases and Tuberculosis, Medical University of Silesia in Katowice, Stanisław Szyszko Independent Public Clinical Hospital No. 1, Zabrze, Poland
| | - Karol Chorąży
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Hrapkowicz
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Stącel T, Kegler K, Mędrala A, Sybila P, Ochman M, Nęcki M, Pasek P, Gummenyi I, Pióro A, Przybyłowski P, Hrapkowicz T, Urlik M. Lung Transplantation in Patients With Pulmonary Hypertension With Extracorporeal Membrane Oxygenation (ECMO) Support: 5-Year Experience. Transplant Proc 2024:S0041-1345(24)00170-2. [PMID: 38580513 DOI: 10.1016/j.transproceed.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 04/07/2024]
Abstract
Lung transplantation (LTx) is the only treatment option of patients (pts) with pulmo-nary hypertension (PH) when pharmacologic treatment is unsatisfactory. ECMO is essential during LTx in every patient with pulmonary arterial hypertension and in most patients with sec-ondary PH. This is a retrospective, single-center study comparing LTx outcomes in patients with and without PH covering a 5-year experience. In the years 2018-2023, 219 LTx were performed, of which 56 (25.6%) with ECMO support, among which PH was diagnosed in 34pts (60.7%) in WHO groups 1,3,4: 19pts, 14pts. and 1pt respectively. The veno-arterial type of ECMO was used in patients with PH as intraoperative support (n = 34; 100%). The early (30-day) and long-term survival (1 year) of patients with and without PH did not differ statistically: 91.2% (95% CI: 82.1%-100%) vs. 77.3% (95% CI: 82.1%-100%)(P = .48) and 53.0% (95% CI: 36.6%-76.7 %) vs. 41.3% (95%CI: 23.1-74.0) (P = .48) respectively and the median hospitalization time from ECMO weaning to dis-charge was also comparable: 31 days (Q1-Q3: 21-40; IQR 20) vs. 28 days (Q1-Q3: 24-42; IQR :18) (P = .99). Patients with or without PH undergoing LTx with ECMO have comparable survival and hospital stay outcomes despite being the most challenging of all lung diseases treated with lung transplantation.
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Affiliation(s)
- Tomasz Stącel
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Kamil Kegler
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.
| | - Agata Mędrala
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Pawel Sybila
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Mirosłąw Nęcki
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Pasek
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Igor Gummenyi
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Anna Pióro
- Department of Cardiac Anaesthesia and Intensive Care, Silesian Centre for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Hrapkowicz
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Maciej Urlik
- Department of Cardiac, Silesian Centre for Heart Diseases in Zabrze, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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Stącel T, Sybila P, Mędrala A, Ochman M, Latos M, Zawadzki F, Pióro A, Pasek P, Przybyłowski P, Hrapkowicz T, Mroczek E, Kuczaj A, Kopeć G, Fiszer R, Pawlak S, Stanjek-Cichoracka A, Urlik M. Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA). J Cardiovasc Dev Dis 2022; 9:jcdd9120457. [PMID: 36547454 PMCID: PMC9783473 DOI: 10.3390/jcdd9120457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect-patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice.
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Affiliation(s)
- Tomasz Stącel
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence: (T.S.); (A.M.); Tel.: +48-691-045-785 (T.S.); +48-731-832-083 (A.M.)
| | - Paweł Sybila
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Agata Mędrala
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence: (T.S.); (A.M.); Tel.: +48-691-045-785 (T.S.); +48-731-832-083 (A.M.)
| | - Marek Ochman
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Magdalena Latos
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Fryderyk Zawadzki
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anna Pióro
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Pasek
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Przybyłowski
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
- First Department of General Surgery, Collegium Medicum of Jagiellonian University, 30-688 Krakow, Poland
| | - Tomasz Hrapkowicz
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Ewa Mroczek
- Institute of Heart Diseases, University Clinical Hospital Mikulicz Radecki in Wroclaw, ul. Borowska 213, 50-558 Wroclaw, Poland
| | - Agnieszka Kuczaj
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Grzegorz Kopeć
- Pulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland
| | - Roland Fiszer
- Silesian Centre for Heart Diseases in Zabrze, Department of Congenital Heart Defects and Pediatric Cardiology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Szymon Pawlak
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anita Stanjek-Cichoracka
- Department of Biophysics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jedności 8, 41-200 Sosnowiec, Poland
| | - Maciej Urlik
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland
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Mularek-Kubzdela T, Wojnarski J, Kamiński K, Ochman M, Kasprzak JD, Stącel T, Kurzyna M, Karolak W, Mroczek E, Kopeć G, Przybylski R, Skorzylas I, Żegleń S, Lewicka E, Urlik M, Grabka M, Furdal M, Florczyk M, Torbicki A. Lung transplantation in patients with pulmonary arterial hypertension: The opinion of the Polish Cardiac Society Working Group on Pulmonary Circulation. Kardiol Pol 2022; 80:1167-1179. [DOI: 10.33963/kp.a2022.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 12/07/2022]
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Błachut M, Szczegielniak A, Zawadzki F, Wajda-Pokrontka M, Tatoj Z, Stącel T, Urlik M, Latos M, Pelar K, Nowak K, Przybyłowski P, Ochman M. The Quality of Sex Life Among Patients Before and After Lung Transplantation: A Single-Center Study. Transplant Proc 2022; 54:1109-1114. [PMID: 35654636 DOI: 10.1016/j.transproceed.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Lung transplantation (LTx) is the only effective method of treatment for patients with end-stage lung diseases; LTx prolongs and increases the quality of life (QoL). An important aspect of QoL that changes in the course of severe diseases is the quality of sex life. This aspect is yet to be discussed in relationship to LTx. We aim to compare patients' quality of sex life at the qualification process with patients' who underwent LTx. METHODS The studied group consisted of 100 patients (24 women before and 16 after LTx, 39 men before and 21 after LTX) who were admitted to the lung transplantology department for qualification or to control the function after LTx. To assess the patients' quality of sex life, we used The Changes in Sexual Functioning Questionnaire (CSFQ) and World Health Organization (WHO) QoL-BREF. To assess lung function, patients underwent a 6-Minute-Walk-Test (6MWT). RESULTS Patients after LTx obtained higher results-compared to patients qualified for LTx-in the WHO QoL-BREF in every domain (somatic, psychological, social, and environment). Men after LTx got more points in every domain and better total score (53 ± 5.62 vs 44.23 ± 10.28 point; P < .05) in CSFQ. Women before and after LTx obtained comparable results in CSFQ. Results of 6-Minute-Walk-Test were better among patients after LTx than in qualified patients (523.62 ± 95.71 vs 333.14 ± 145.38 and 524.12 ± 56.17 vs 317.20 ± 141.6, respectively for men and women). CONCLUSIONS Patients after LTx show better pulmonary function and quality of sex life than qualified. Preliminary results encourage us to conduct research on a larger group.
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Affiliation(s)
- Michał Błachut
- Departments of Psychiatry in Tarnowskie Góry, Medical University of Silesia, Katowice, Poland
| | - Anna Szczegielniak
- Department of Psychoprophylaxis, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland.
| | - Marta Wajda-Pokrontka
- Clinical Department of Cardiac Anesthesia and Intensive Therapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
| | - Zofia Tatoj
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Kaja Pelar
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Klaudia Nowak
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Przybyłowski
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
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Urlik M, Latos M, Stącel T, Wystrychowski W, Joanna M, Nęcki M, Antończyk R, Badura J, Horynecka Z, Sekta S, Król B, Gawęda M, Pandel A, Zembala M, Ochman M, Król R. First in Poland Simultaneous Liver-Lung Transplantation With Liver-First Approach for Recipient Due to Cystic Fibrosis: A Case Report. Transplant Proc 2022; 54:1171-1176. [PMID: 35597673 DOI: 10.1016/j.transproceed.2022.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
Cystic fibrosis is an autosomal progressive disease affecting the lung, pancreas, and liver. Some patients develop end-stage respiratory and liver failure. For such patients, combined lung-liver transplantation remains the only therapeutic option. In this article we present the first simultaneous lung-liver transplantation in Poland, as well as in Central and Eastern Europe, with detailed clinical history, surgical aspects, and postoperative course.
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Affiliation(s)
- Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Wojciech Wystrychowski
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Musialik Joanna
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Remigiusz Antończyk
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Joanna Badura
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Zuzanna Horynecka
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Sylwia Sekta
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Bogumiła Król
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Martyna Gawęda
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Anastazja Pandel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Robert Król
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
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Latos M, Urlik M, Nęcki M, Pawlak D, Niepokój K, Stącel T, Zawadzki F, Przybyłowski P, Ochman M. Influence of Bronchoscopic Interventions on Graft Function of Double Lung Transplant Recipients due to Cystic Fibrosis. Transplant Proc 2022; 54:1092-1096. [PMID: 35459464 DOI: 10.1016/j.transproceed.2022.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Healing of bronchial anastomoses may sometimes be complicated and require bronchoscopic intervention (BI). The main aim of the study was to assess whether patients who require BI present comparable lung function after reaching 1-year posttransplant survival to those who did not require any BI by means of spirometry and 6-minute walk test (6MWT). METHODS This retrospective study included an analysis of 44 primary double lung transplant recipients who underwent transplant for end-stage respiratory failure in the course of cystic fibrosis transplanted in a single center between 2018 and 2021. Bronchoscopic intervention is defined as performing endoscopic bronchoplasty through balloon dilatation, cryoprobe, argon plasma, and/or laser treatment. Group 1 (25 patients who required at least 1 BI) presented similar spirometry parameters at qualification as group 2 (no BI). RESULTS Statistically significant differences between the groups for the following parameters were reported: forced expiratory volume in 1 second (FEV1), FEV1 (%), Tiffeneau-Pinelli index (FEV1/forced vital capacity percentage of predicted value), oxygen saturation after conclusion of 6MWT (%) and oxygen saturation before 6MWT (%). In each case, the mean for the BI group in the first year was lower. All patients in this group received an average amount of 6.8 ± 4.9 bronchoscopic procedures during the first year (minimum = 1; maximum = 18). Strong negative correlations were observed between the number of balloons in the first year and the FEV1 (%) and FEV1/forced vital capacity percentage of predicted value indicators after the first year. CONCLUSIONS Lung transplant recipients who underwent transplant because of cystic fibrosis and required at least 1 BI during the first posttransplant year presented inferior spirometry and 6MWT results in comparison with those who did not require any.
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Affiliation(s)
- Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Daria Pawlak
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kornelia Niepokój
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
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Stanjek-Cichoracka A, Łaszewska A, Zawadzki F, Kobylska A, Urlik M, Stącel T, Ochman M. Diagnostics of the Epstein-Barr Virus Before and After Lung Transplantation in a Patient With Developing Posttransplant Lymphoproliferative Disease: A Case Report. Transplant Proc 2022; 54:1180-1182. [DOI: 10.1016/j.transproceed.2022.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 12/27/2022]
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Urlik M, Stącel T, Latos M, Pasek P, Pióro A, Zawadzki F, Gmerek M, Księżopolska P, Przybyłowski P, Ochman M. Lung transplantation as a treatment for patients with end-stage respiratory failure due to Coronavirus disease of 2019 (COVID-19). Transplant Proc 2022; 54:908-912. [PMID: 35725595 PMCID: PMC8995202 DOI: 10.1016/j.transproceed.2022.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
Abstract
Background COVID-19 may lead to development of irreversible acute respiratory distress syndrome. Some patients sustain severe respiratory failure after infection subsides. They may require lung transplant as a last resort treatment. The aim of the study is to assess the effect and feasibility of lung transplant as a treatment for patients with severe irreversible respiratory failure due to COVID-19. Methods This retrospective study pertains to analysis of 119 patients in critical condition who were referred to Lung Transplant Ward (Zabrze, Poland). between July 2020 and June 2021 after developing respiratory failure requiring extracorporeal membrane oxygenation, invasive ventilation, or both, as well as a few patients on high-flow oxygen therapy. Inclusion criteria for referral were confirmed lack of viral disease and exhaustion of other therapeutic options. Results Of the referred patients, 21.84% were disqualified from such treatment owing to existing contraindications. Among the suitable patients, 75.8% died without transplant. Among all patients who were qualified for lung transplant, only 9 patients became double lung transplant recipients. Intraoperative mortality for this procedure was 33%. Four patients were discharged after the procedure and are currently self-reliant with full respiratory capacity. Conclusions Patients with severe irreversible respiratory failure after COVID-19 present significantly high mortality without lung transplant. This procedure may present satisfactory results but must be performed in a timely fashion owing to critical condition and scarcity of lung donors, only aggravated around the time of peak infection waves.
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Pióro A, Latos M, Urlik M, Stącel T, Zawadzki F, Gawęda M, Pandel A, Przybyłowski P, Knapik P, Ochman M. Various Aspects of Bacterial Infections in the Early Postoperative Stage Among Lung Transplant Recipients on Broad-Spectrum Antibiotics: A Single Center Study. Transplant Proc 2022; 54:1097-1103. [DOI: 10.1016/j.transproceed.2022.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022]
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13
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Ochman M, Latos M, Galle D, Niepokój K, Stącel T, Urlik M, Zawadzki F, Przybyłowski P. Coronavirus disease of 2019 (COVID-19) among lung transplant recipients – a single center study. Transplant Proc 2022; 54:913-916. [PMID: 35595560 PMCID: PMC8995323 DOI: 10.1016/j.transproceed.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/20/2022]
Abstract
Background When COVID-19 became a pandemic, it was difficult to predict how it would affect lung transplant recipients. The aim of this study was to assess the mortality, influence on graft function as well as attitude toward SARS-CoV-2 vaccination among lung transplant recipients from a single center. Methods We analyzed medical data pertaining to 124 recipients who received lung transplants between 2008-2021 from a single center and original questionnaire on the COVID-19 severity classification system and the patients’ attitude toward SARS-CoV-2 vaccination. Graft function was assessed by spirometry and a 6-minute walk test (6MWT), at least at the first postCOVID-19 visit. Results Among 29 patients who were confirmed to have COVID-19, 6 people died during or directly after contracting this infectious disease. The significant decrease in spirometry and distance in a 6MWT has been rarely observed in COVID-19 survivors. After vaccination ( n=107 patients) , most patients reported mild symptoms with slight pain and discomfort at the injection site being the most common (51.4%). 67.7% of all studiedpatients did not have any fears regarding the vaccination. Others reported being significantly worried about its effects (19.4% agreed to receive a vaccination anyway and 12.9% refused to be vaccinated). Conclusions COVID-19 may present significant mortality among lung transplant recipients. The short-term safety and outcomes of vaccinations among these patients seemed encouraging. We are aware of the small study group limitations and hope to research this issue further.
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Pióro A, Latos M, Urlik M, Stącel T, Gawęda M, Pandel A, Przybyłowski P, Knapik P, Ochman M. Antifungal Prophylaxis and Treatment Among Lung Transplant Recipients in Early Postoperative Stage: A Single-Center Study. Transplant Proc 2022; 54:1104-1108. [DOI: 10.1016/j.transproceed.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
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Stącel T, Latos M, Urlik M, Nęcki M, Antończyk R, Hrapkowicz T, Kurzyna M, Ochman M. Interventional and Surgical Treatments for Pulmonary Arterial Hypertension. J Clin Med 2021; 10:jcm10153326. [PMID: 34362109 PMCID: PMC8348951 DOI: 10.3390/jcm10153326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/20/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022] Open
Abstract
Despite significant advancements in pharmacological treatment, interventional and surgical options are still viable treatments for patients with pulmonary arterial hypertension (PAH), particularly idiopathic PAH. Herein, we review the interventional and surgical treatments for PAH. Atrial septostomy and the Potts shunt can be useful bridging tools for lung transplantation (Ltx), which remains the final surgical treatment among patients who are refractory to any other kind of therapy. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) remains the ultimate bridging therapy for patients with severe PAH. More importantly, VA-ECMO plays a crucial role during Ltx and provides necessary left ventricular conditioning during the initial postoperative period. Pulmonary denervation may potentially be a new way to ensure better transplant-free survival among patients with the aforementioned disease. However, high-quality randomized controlled trials are needed. As established, obtaining the Eisenmenger physiology among patients with severe pulmonary hypertension by creating artificial defects is associated with improved survival. However, right-to-left shunting may be harmful after Ltx. Closure of the artificially created defects may carry some risk associated with cardiac surgery, especially among patients with Potts shunts. In conclusion, PAH requires an interdisciplinary approach using pharmacological, interventional, and surgical modalities.
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Affiliation(s)
- Tomasz Stącel
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
- Correspondence: (T.S.); (M.O.); Tel.: +48-691-045-785 (T.S.); +48-60-923-4437 (M.O.)
| | - Magdalena Latos
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
| | - Maciej Urlik
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
| | - Mirosław Nęcki
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
| | - Remigiusz Antończyk
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
| | - Tomasz Hrapkowicz
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
| | - Marcin Kurzyna
- European Health Centre Otwock, Centre of Postgraduate Medical Education, Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, 05-400 Otwock, Poland;
| | - Marek Ochman
- Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, 40-055 Katowice, Poland; (M.L.); (M.U.); (M.N.); (R.A.); (T.H.)
- Correspondence: (T.S.); (M.O.); Tel.: +48-691-045-785 (T.S.); +48-60-923-4437 (M.O.)
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Urlik M, Szułdrzyński K, Stącel T, Nęcki M, Bielański P, Jankowski M, Antończyk R, Latos M, Pióro A, Zembala M, Pyrć K, Ochman M. First lung transplantation as a treatment of a patient supported with extracorporeal membrane oxygenation (ECMO) after COVID-19 in Poland. Adv Respir Med 2021; 89:328-333. [PMID: 34196386 DOI: 10.5603/arm.a2021.0042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/12/2021] [Accepted: 02/27/2021] [Indexed: 11/25/2022]
Abstract
A 44-year-old male with no history of underlying diseases was referred to academic hospital due to ARDS with confirmed SARSCoV-2 infection after 7 days of mechanical ventilation. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was initiated as no improvement was noted in prone position. Mechanical ventilation was continued with TV of 3-4 mL/kg. A gradual decline of static lung compliance was observed from baseline 35 mL/cm H20 to 8 mL/cm H2O. The chest CT scan revealed extensive ground-glass areas with a significant amount of traction bronchiectasis after 3 weeks since admission. When the patient was negative for SARS-CoV-2 during the 4th week of ECMO, the decision to perform an emergency lung transplantation (LTx) was made based on the ongoing degradation of lung function and irreversible damage to lung structure. The patient was transferred to the transplant center where he was extubated, awaiting the transplant on passive oxygen therapy and ECMO. Double lung transplantation was performed on the day 30th of ECMO. Currently, the patient is self-reliant. He does not need oxygen therapy and continues physiotherapy. ECMO may be life-saving in severe cases of COVID-19 ARDS but some of these patients may require LTx, especially when weaning proves impossible. VV ECMO as a bridging method is more difficult but ultimately more beneficial due to insufficient number of donors, and consequently long waiting time in Poland.
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Affiliation(s)
- Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Konstanty Szułdrzyński
- Jagiellonian University Medical College, Faculty of Medicine, Krakow, Poland.,The Centre for Extracorporeal Therapies University Hospital Krakow, Krakow, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Bielański
- The Centre for Extracorporeal Therapies University Hospital Krakow, Krakow, Poland
| | - Miłosz Jankowski
- Jagiellonian University Medical College, Faculty of Medicine, Krakow, Poland.,The Centre for Extracorporeal Therapies University Hospital Krakow, Krakow, Poland
| | - Remigiusz Antończyk
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Anna Pióro
- Department of Cardiac Anaesthesia and Intensive Care SUM, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Pyrć
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
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Zawadzki F, Wajda-Pokrontka M, Stącel T, Urlik M, Nęcki M, Antończyk R, Latos M, Królikowska M, Maruszak D, Łazaj M, Kowacka M, Kliczka A, Zembala M, Ochman M. Emphysema as a possible complication of infant respiratory distress syndrome leading to lung transplantation. Adv Respir Med 2021; 89:211-215. [PMID: 33559118 DOI: 10.5603/arm.a2020.0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/25/2022]
Abstract
Infant respiratory distress syndrome (IRDS) develops among premature infants due to structural immaturity of the lungs and insufficient production of pulmonary surfactant. Nowadays, treatment takes place under conditions of intensive care and includes oxygen therapy, mechanical ventilation, exogenous supplementation of pulmonary surfactant and antenatal corticosteroid therapy. The treatment of IRDS, especially mechanical ventilation, may lead to complications which can contribute to developing a severe dysfunction of the respiratory system. Unavailability of pharmacological treatment of IRDS and development of pulmonary barotrauma due to mechanical ventilation in our patient led to the forming of severe pulmonary interstitial emphysema. In this case report, lung transplantation was performed as an only successful therapeutic option.
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Affiliation(s)
- Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | - Marta Wajda-Pokrontka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Remigiusz Antończyk
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Maria Królikowska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Damian Maruszak
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marcelina Łazaj
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Małgorzata Kowacka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Alina Kliczka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Nęcki M, Latos M, Urlik M, Antończyk R, Gawęda M, Pandel A, Stącel T, Przybyłowski P, Zembala M, Ochman M. Number of Bronchoscopic Interventions in Lung Transplant Recipients Correlates with Respiratory Function Assessed by Pulmonary Function Tests. Ann Transplant 2021; 26:e927025. [PMID: 33495435 PMCID: PMC7847086 DOI: 10.12659/aot.927025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Lung transplant recipients may suffer from airway stenosis (AS). The aim of this study was to assess whether pulmonary function (as measured by spirometry and a 6-minute walk test [6MWT]) in patients with AS treated consistently with bronchoscopic interventions (BIs) was comparable to that in their AS-free counterparts at the 1-year follow-up visit. Material/Methods Fifty patients who underwent primary double-lung transplantation between January 2015 and March 2019 at a single center (23 who received BIs and 27 who did not) were enrolled in this retrospective study. Graft function was assessed with spirometry, based on forced expiratory volume (FEV1) and forced vital capacity (FVC), both measured in liters (L) and percentages (%), and the Tiffeneau-Pinelli index (FEV1/FVC), and a 6MWT and parameters such as oxygen saturation measured before and after the test. Results Patients in need of BIs had significantly lower FEV1% compared with individuals who did not receive BIs during their first post-transplant year. Airway obstruction was present in 22% of patients who did not receive BIs and 65.23% of those who did receive the interventions. There were statistically significant, strong, negative correlations pertaining to the number of balloon BIs and 1-year FEV1% (rs=0.67) as well as the number of balloon BIs and 1-year FEV1/FVC (rs=0.72). A statistically significant, strong, negative correlation (rs=0.75) was found between the number of balloon bronchoplasty treatments and oxygen saturation after the 6WMT. Conclusions Despite receiving BIs, patients who experience bronchial stenosis may not obtain the expected ventilatory improvement at their 1-year follow-up visit. Their AS may recur or persist despite use of various procedures. Further study in that regard is required.
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Affiliation(s)
- Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Remigiusz Antończyk
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Martyna Gawęda
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Anastazja Pandel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Piotr Przybyłowski
- First Chair of General Surgery, Jagiellonian University , Crcaow, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.,Silesian Center for Heart Diseases, Zabrze, Poland
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19
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Nęcki M, Pandel A, Urlik M, Antończyk R, Latos M, Gawęda M, Stącel T, Wajda-Pokrontka M, Zawadzki F, Okienica M, Przybyłowski P, Zembala M, Ochman M. The Impact of Airway Complications on Survival Among Lung Transplant Recipients. Transplant Proc 2020; 52:2173-2177. [DOI: 10.1016/j.transproceed.2020.03.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
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20
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Stącel T, Urlik M, Nęcki M, Antończyk R, Latos M, Wajda-Pokrontka M, Tatoj Z, Zawadzki F, Przybyłowski P, Zembala M, Ochman M. Secondary Pulmonary Hypertension Among Patients Qualified for Lung Transplantation: Single-Center Study. Transplant Proc 2020; 52:2101-2109. [DOI: 10.1016/j.transproceed.2020.02.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022]
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21
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Stącel T, Jaworska I, Zawadzki F, Wajda-Pokrontka M, Tatoj Z, Urlik M, Nęcki M, Latos M, Szywacz W, Szczerba A, Antończyk R, Pióro A, Przybyłowskia P, Zembala M, Ochman M. Assessment of Quality of Life Among Patients After Lung Transplantation: A Single-Center Study. Transplant Proc 2020; 52:2165-2172. [PMID: 32682577 DOI: 10.1016/j.transproceed.2020.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lung transplantation (LTx) is the only effective method of treatment to improve the health and quality of life (QoL) of patients with end-stage lung diseases. After LTx, medical examination accompanied by quality of life assessment should be performed on routine follow-up visits. The aim of the study was to assess the QoL of patients after LTx. MATERIAL AND METHODS The study group consisted of 60 patients (29 women and 31 men); 20 patients received single lung transplantation (SLT), and 40 received double lung transplantation (DLT). To determine the patient's QoL, the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Test-BREF (WHOQOL-BREF), and the Saint George Respiratory Questionnaire (SGRQ) were used. Spirometry and the 6-minute walk test were analyzed to examine efficiency of transplanted organs. RESULTS In SGRQ there are differences between patients with cystic fibrosis and interstitial lung disease in symptom domain (20.28% vs 39.26%, P = .025) and total score (19.38% vs 32.47%, P = .028). As reported in the GHQ, men had worse overall results than women in sten scale (5.22 points vs 4.69 points). Patients after SLT achieved similar scores in every questionnaire. CONCLUSION Studies assessing QoL should be an important addition to lung function tests and an integral part of control during postoperative follow-up visits. This study is one of the important contributions to understanding of how essential QoL is after LTx. The authors of this study realize that their work does not cover the whole issue, and further studies in this area are warranted.
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Affiliation(s)
| | - Izabela Jaworska
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.
| | - Marta Wajda-Pokrontka
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Zofia Tatoj
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Maciej Urlik
- Silesian Center for Heart Diseases, Zabrze, Poland
| | | | - Magdalena Latos
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Wioletta Szywacz
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Alicja Szczerba
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Remigiusz Antończyk
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Anna Pióro
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowskia
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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22
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Stącel T, Nęcki M, Antończyk R, Latos M, Urlik M, Kościołek J, Kordylewska-Kubus A, Litewka J, Przybyłowski P, Zawadzki F, Wajda-Pokrontka M, Pyrć K, Zembala M, Ochman M. Effectiveness of Lung Transplantation in Patients With Interstitial Lung Diseases. Transplant Proc 2020; 52:2143-2148. [PMID: 32571712 DOI: 10.1016/j.transproceed.2020.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/10/2020] [Accepted: 03/30/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Interstitial lung diseases (ILDs) are a heterogeneous group of more than 200 diseases manifested by progressive exercise dyspnea, radiological lung changes, and ventilation restrictive disorders. ILDs are the second most common indication for lung transplantation (LTx). Our study group consisted of 139 patients who qualified for LTx at the Silesian Center for Heart Diseases between 2004 and 2018. Of the 139, 92 patients died while on the waiting list, and 47 patients underwent LTx. Medical records including laboratory test results, spirometry, and the 6-minute walk test (6MWT) were analyzed to determine eligibility for LTx. We also assessed quality of life post-LTx. RESULTS Patients who qualified for LTx showed decreased values of parameters measured by spirometry (43.69 ± 19.05% of forced expiratory volume in the first second [FEV1] and 43.07 ± 20.55% of forced vital capacity [FVC] and severe desaturation during the 6MWT (SpO2 = 88.78% before 6-minute walk test and 73.23% after the test). After LTx, longer distances were achieved in the 6MWT (235.47 ± 159.57 m during qualification vs 533.2 ± 34.15 m 12 months after LTx) and increased values of spirometry. On average, patients had stopped working 6 years prior to LTx. CONCLUSION There is no effective medical treatment for patients with end-stage ILDs. Therefore, lung transplantation is a lifesaving procedure for patients that also extends patients' lives and improves their quality of life.
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Affiliation(s)
- Tomasz Stącel
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mirosław Nęcki
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Remigiusz Antończyk
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Kościołek
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Angelika Kordylewska-Kubus
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Litewka
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland; Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marta Wajda-Pokrontka
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Pyrć
- Małopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
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23
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Urlik M, Stącel T, Latos M, Antończyk R, Ferens M, Zawadzki F, Król B, Pasek P, Przybyłowski P, Zembala M, Nęcki M, Ochman M. Donor-related Risk Factors Associated With Increased Mortality After Lung Transplant. Transplant Proc 2020; 52:2133-2137. [PMID: 32532556 DOI: 10.1016/j.transproceed.2020.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lung transplant is a surgical procedure for end-stage lung disease. Many factors related to lung donors influence the outcome of transplant. The main aim of this single-center study was to assess which donor-related and procedure-related factors would influence the 30-day or hospital mortality of the recipients. METHODS This retrospective study group consisted of 110 donor-recipient pairs undergoing lung transplant between 2012 and 2017 (group 1) and 2018 and 2019 (group 2) in Silesian Center for Heart Diseases. Both groups of donor- and procedure-related factors were included in the analysis: oxygenation index at reporting of the donor, time donor spent in the intensive care unit (ICU), presence of cardiac arrest while being in the ICU, donor age, type of transplant, cumulative ischemia time, duration of the operation, and time of mechanical ventilation. RESULTS The type of surgery was significantly associated with an increase in the chance of death within 30 days. Patients who underwent single lung transplant had a 20.217 times greater chance of dying within 30 days than patients after double lung transplant (interquartile range, 2.116-193.125). CONCLUSIONS Single lung transplant increases the risk of death during the first 30 days after lung transplant, and using lungs from older donors may increase the rate of hospital mortality. Oxygenation index, sudden cardiac arrest of the donors, and donor time spent in the ICU do not impact the short-term mortality of lung graft recipients.
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Affiliation(s)
- Maciej Urlik
- Silesian Center for Heart Diseases, Zabrze, Poland
| | | | - Magdalena Latos
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.
| | - Remigiusz Antończyk
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marta Ferens
- Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | | | - Piotr Pasek
- Silesian Center for Heart Diseases, Zabrze, Poland
| | - Piotr Przybyłowski
- Silesian Center for Heart Diseases, Zabrze, Poland; First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Marian Zembala
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | | | - Marek Ochman
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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24
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Antończyk R, Stącel T, Urlik M, Latos M, Kręt M, Borowik D, Wajda-Pokrontka M, Zawadzki F, Tatoj Z, Przybyłowski P, Zembala M, Ochman M, Nęcki M. Single Lung Transplant vs Double Lung Transplant: A Single-Center Experience With Particular Consideration for Idiopathic Pulmonary Arterial Hypertension. Transplant Proc 2020; 52:2138-2142. [PMID: 32474000 DOI: 10.1016/j.transproceed.2020.03.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/10/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Lung transplant remains the only viable treatment for certain patients with end-stage lung diseases. Such patients can become either single or double lung recipients. The 2 procedures are associated with specific risks and benefits. The aim of the study was to assess the survival of patients after lung transplant in a single center. METHODS The retrospective study consists of 128 lung transplant recipients. Patients underwent transplant between 2004 and 2017 because of following diseases: chronic obstructive pulmonary disease (28.2%), cystic fibrosis (26.5%), and primary pulmonary hypertension (12.3%), including idiopathic pulmonary arterial hypertension and interstitial lung diseases (33%). Patients with idiopathic pulmonary arterial hypertension were not treated with postoperative extracorporeal membrane oxygenation as left heart conditioning. RESULTS Regardless of underlying disease, 75% of DLT recipients and 51% of SLT recipients reached 5-year survival (P = .0066). A total of 87% of lung transplant recipients with cystic fibrosis reached 1-year survival. Among lung recipients with primary pulmonary hypertension who underwent DLT and SLT, 5-year survival was reached by 84% and 51%, respectively (P = .025). Among patients with chronic obstructive pulmonary disease, 82% of DLT recipients and 62% of SLT recipients reached 1-year survival (P = .22). Patients who received transplants because of primary pulmonary hypertension presented the worst short-term survival among all SLT recipients. CONCLUSIONS Patients with CF have the best overall survival among all lung transplant recipients. Double lung transplant provides statistically significantly better outcomes than single lung transplant. This observation is also present among recipients who underwent transplant because of primary pulmonary hypertension, as single lung transplant is not recommended among such patients in particular.
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Affiliation(s)
- Remigiusz Antończyk
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | | | - Maciej Urlik
- Silesian Center for Heart Diseases, Zabrze, Poland
| | - Magdalena Latos
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland.
| | - Michał Kręt
- Silesian Center for Heart Diseases, Zabrze, Poland
| | | | - Marta Wajda-Pokrontka
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Zofia Tatoj
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Silesian Center for Heart Diseases, Zabrze, Poland; First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Marian Zembala
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marek Ochman
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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25
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Urlik M, Latos M, Antończyk R, Nęcki M, Kaczur E, Miernik M, Zawadzki F, Król B, Pasek P, Przybyłowski P, Zembala M, Ochman M, Stącel T. Suboptimal Donors Do Not Mean Worse Results: A Single-Center Study of Extending Donor Criteria for Lung Transplant. Transplant Proc 2020; 52:2123-2127. [PMID: 32482452 DOI: 10.1016/j.transproceed.2020.03.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Lung transplant remains the only viable treatment for most of the end-stage lung diseases. It is believed that extending criteria for donor lungs would increase the number of lung transplants. The aim of the study was to compare the graft function by means of oxygenation index among recipients who received the lungs from donors of extended criteria with those whose received lungs from donors who met the standard criteria. METHODS This retrospective study analyzed 71 donors whose lungs where transplanted into 71 first-time double lung recipients of 2 groups: patients who received transplants before and after 2018. The objective was to assess whether there is a significant difference in quality of the donor pool after applying extended criteria. The second objective was to compare results of recipients with lungs from donors of oxygenation index > 400 mm Hg with those obtained among recipients with this parameter < 400 mm Hg. RESULTS In the case of transplants performed in 2018 to 2019, oxygenation indices were significantly lower in donors but significantly higher in recipients on the first day than those observed in 2015 to 2017. The number of transplants increased from 9 per year to 22 per year. Irrespective of whether the donor had PaO2/fraction of inspired oxygen above or below 400 mm Hg, recipients showed similar oxygenation index values after transplant (mean oxygenation index, 462 vs 412 mm Hg, respectively). Short-term mortality did not differ either. CONCLUSIONS Extended criteria of lungs suitability as a potential grafts not only increases the donor pool but also proves that suboptimal donors are not associated with producing inferior results of the recipients.
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Affiliation(s)
- Maciej Urlik
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Magdalena Latos
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Remigiusz Antończyk
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mirosław Nęcki
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Emilia Kaczur
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marcelina Miernik
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Fryderyk Zawadzki
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Bogumiła Król
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Piotr Pasek
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Piotr Przybyłowski
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marian Zembala
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marek Ochman
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland; Silesian Center for Heart Diseases, Zabrze, Poland
| | - Tomasz Stącel
- First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
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26
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Nęcki M, Gawęda M, Pandel A, Urlik M, Antończyk R, Latos M, Wajda-Pokrontka M, Zawadzki F, Przybyłowski P, Zembala M, Stącel T, Ochman M. Microbiological Status as a Factor of Airway Complications After Lung Transplantation. Transplant Proc 2020; 52:2149-2154. [PMID: 32446686 DOI: 10.1016/j.transproceed.2020.02.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Lung transplantation (LTx) is the only treatment for patients with end-stage lung disease. This procedure is associated with a risk of complications related to airway stenosis, which can be treated by means of bronchoscopic interventions (BI). Microbiological colonization may have an impact on airway complications. The aim of the study was to investigate the effect of presence of microbiological pathogens in graft among lung recipients and frequency of BI, considered as the indicator of severe complications. MATERIALS AND METHODS The study design was single-center retrospective cohort research; cases of 116 patients with complete microbiological data who underwent LTx from April 2013 to June 2019 were reviewed (70.3% of transplanted patients). All statistical analyses were performed with SPSS version 25.0 and R 3.5.3. For analyses involving the number of bronchoscopy interventions, univariate and multivariate Poisson regression were used. Interaction effect of variables in multivariate Poisson regression was assessed with partial response plot. RESULTS The mean number of pathogens colonizing each patient was approximately 4.66 (range, 0 to 19) with Candida albicans (n = 42, 36.2%), Aspergillus spp. (n = 33, 28.4%), Pseudomonas aeruginosa (n = 32, 27.59%), and methicillin-sensitive Staphylococcus aureus (MSSA) (n = 29, 25%) being the most prominent. Microbiological agents causing the greatest increase in the risk of intervention are as follows: Proteus mirabilis by 3.84 times, Aspergillus spp. by 3.53 times, and Stenotrophomonas maltophilia by 3.09 times. Burkholderia multivorans, Enterococcus spp., and Klebsiella spp. do not have a statistically significant impact on the number of BI. CONCLUSIONS Some pathogens increase the frequency of complications, which are associated with deterioration of the general condition. Therefore, patients should be monitored for the presence of pathogens in the airways.
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Affiliation(s)
| | - Martyna Gawęda
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Anastazja Pandel
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland.
| | - Maciej Urlik
- Silesian Center for Heart Diseases, Zabrze Poland
| | - Remigiusz Antończyk
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Magdalena Latos
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marta Wajda-Pokrontka
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Fryderyk Zawadzki
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Przybyłowski
- Silesian Center for Heart Diseases, Zabrze Poland; First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Marian Zembala
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
| | | | - Marek Ochman
- Silesian Center for Heart Diseases, Zabrze Poland; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Zabrze, Poland
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Nęcki M, Antończyk R, Pandel A, Gawęda M, Latos M, Urlik M, Stącel T, Wajda-Pokrontka M, Zawadzki F, Przybyłowski P, Zembala M, Ochman M. Impact of Cold Ischemia Time on Frequency of Airway Complications Among Lung Transplant Recipients. Transplant Proc 2020; 52:2160-2164. [PMID: 32430145 DOI: 10.1016/j.transproceed.2020.03.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/09/2020] [Accepted: 03/30/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The cold ischemia time (CIT) is a period of time between harvesting an organ for transplant and its reperfusion just after implantation. CIT may have an impact on frequency of complications after lung transplant that can be treated by means of bronchoscopic intervention. The aim of the study was to investigate the correlation between CIT and frequency of bronchoscopic intervention. METHODS The retrospective study consists of 91 patients: 22 single lung recipients (24%) and 69 double lung recipients (76%) who underwent lung transplant from March 2012 to June 2019. All statistical analyses were performed in SPSS 25.0 and R 3.5.3. The P levels less than .05 were deemed statistically significant. RESULTS The average CIT in single lung transplant was 5.91 hours, and in double lung transplant it was 8.61 hours. For the 4- to 8-hour CIT the percentages were 80.95% for single lung recipients and 46.38% for double lung recipients. For CIT longer than 8 hours, the following percentages were observed: 9.53% in single lung transplant and 53.62% in double lung transplant. Each subsequent hour of CIT exponentially increases the risk of intervention 1505 times (50.05%). CONCLUSIONS Prolonged CIT seems to be a risk factor for airway complication, especially in the double lung recipient group.
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Affiliation(s)
| | - Remigiusz Antończyk
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Anastazja Pandel
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | - Martyna Gawęda
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Magdalena Latos
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Maciej Urlik
- Silesian Center for Heart Diseases, Zabrze, Poland
| | | | - Marta Wajda-Pokrontka
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Fryderyk Zawadzki
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Piotr Przybyłowski
- Silesian Center for Heart Diseases, Zabrze, Poland; First Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland
| | - Marian Zembala
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marek Ochman
- Silesian Center for Heart Diseases, Zabrze, Poland; Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Stanjek-Cichoracka A, Woźniak-Grygiel E, Łaszewska A, Stącel T, Perć K, Zembala M, Ochman M. Interleukin 6 and Interleukin 10 in Patients Before and After Lung Transplantation. Transplant Proc 2020; 52:2098-2100. [PMID: 32307149 DOI: 10.1016/j.transproceed.2020.02.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 10/24/2022]
Abstract
The aim of the study was to investigate the serum concentration of cytokines (interleukin 6 [IL-6] and IL-10) in patients before and after lung transplantation (LTx). The studied groups consisted of 14 patients (9 men and 5 women aged 47.7 ± 11.4; body mass index [BMI] 21.9 ± 2.3) followed for up to 6 months after LTx and 29 patients (15 men and 14 women, age 49.2 ± 9.4; BMI 23.1 ± 3.7) who were considered for LTx. The study population consisted of patients with idiopathic lung disease (ILD; 8 vs 17) and patients with chronic obstructive pulmonary disease (COPD; 6 vs 12). Cytokine serum levels were assessed using commercially available enzyme-linked immunosorbent assay kits. Significantly lower levels of IL-10 were observed in the group of patients considered for LTx compared to those in recipients (1.8 ± 0.99 vs 5.1 ± 1.44; P = .000726). Significantly lower levels of IL-10 were observed in the group of patients with ILD considered for LTx compared to recipients (1.8 ± 0.95 vs 3.4 ± 1.16; P = .005984). There were no differences in levels of IL-10 in the group of patients with COPD. There were no differences in levels of IL-6 when the studied groups were compared. The present results introduce the cytokines IL-6 and IL-10 in patients before and after LTx. The procedure of LTx influenced increasing of plasma concentration of IL-10. Immunosuppressive drugs may affect IL-10 serum levels. Further studies are needed to evaluate whether analyzed cytokines could be used as biomarkers of clinical status in patients before and after LTx.
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Affiliation(s)
- Anita Stanjek-Cichoracka
- Department of Biophysics, School of Pharmacy, Division of Laboratory Medicine, Medical University of Silesia in Katowice, Sosnowiec, Poland; Laboratory of Transplant Immunology, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | | | - Anna Łaszewska
- Laboratory of Transplant Immunology, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Krzysztof Perć
- Virogenetics Laboratory of Virology, Malopolska Center of Biotechnology Jagiellonian University, Kraków, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Ochman M, Latos M, Orzeł G, Pałka P, Urlik M, Nęcki M, Stącel T, Zembala M. Employment after lung transplantation in Poland - a single center study. Int J Occup Med Environ Health 2019; 32:379-386. [PMID: 31144676 DOI: 10.13075/ijomeh.1896.01362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Lung transplantation not only saves a patient's life but also creates the opportunity for becoming more self-reliant and getting back to work. The aim of this single center study was to assess the prospects of employment, as well as its influence on the quality of life and physical activity, of the lung transplant recipients of the Silesian Center for Heart Diseases in Zabrze, Poland. MATERIAL AND METHODS A retrospective study covered 67 lung transplant recipients of the Silesian Center of Heart Diseases. Only patients with ≥ 6-month follow-up were included. All of the patients gave their written consent to be included in the study before filling out the questionnaire containing questions about employment, income, education and how work affected their quality of life before and after lung transplantation. A physical capability assessment was performed by climbing flights of stairs and by means of a 6-min walk test, and spirometry parameters were also measured. RESULTS Twenty of the patients included in the study (31.7%) were employed after lung transplantation, 63.2% of whom worked full-time. Profession was changed by 2 patients (14.3%). The patients diagnosed with cystic fibrosis were found to have the highest chance of finding employment after lung transplantation. The statistical analysis revealed that the employed patients were able to cover longer distances during the 6-min walk test (556 m, on average) than the unemployed ones (494 m, on average). CONCLUSIONS One in 3 patients finds employment after lung transplantation. Work improves the quality of life of the majority of lung transplant recipients. The patients who are employed are also in a better physical condition, and they are more self-reliant in comparison to those who remain unemployed. Lung transplant recipients with cystic fibrosis are most likely to find employment, and so are patients with higher education. Int J Occup Med Environ Health. 2019;32(3):379-86.
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Affiliation(s)
- Marek Ochman
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology).
| | - Magdalena Latos
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology).
| | - Gabriela Orzeł
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology).
| | - Paulina Pałka
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology)
| | - Maciej Urlik
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology).
| | - Mirosław Nęcki
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology).
| | - Tomasz Stącel
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology)
| | - Marian Zembala
- Medical University of Silesia in Katowice, Zabrze, Poland (Silesian Center for Heart Diseases, Department of Cardiac, Vascular and Endovascular Surgery and Transplantology)
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Ochman M, Latos M, Urlik M, Stącel T, Nęcki M, Tatoj Z, Zawadzki F, Wajda-Pokrontka M, Przybyłowski P, Zembala M. Cystic Fibrosis: From Qualification to Lung Transplantation, a Single Center Experience. Ann Transplant 2019; 24:185-190. [PMID: 30948702 PMCID: PMC6467174 DOI: 10.12659/aot.914328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Cystic fibrosis (CF) is congenital multisystem disorder, that leads to gradual deterioration of pulmonary function. Advancements in therapy of CF-related lung disease have delayed its progression. However, lung transplantation remains the only therapeutic option for majority of such patients. Aim of the study was to assess qualification process and outcome of lung transplantation as a treatment of CF patients qualified in a single center between 2011 and 2018. Material/Methods This retrospective study assessed 41 patients who were qualified to be treated by means of lung transplantation due to CF in Lung Transplant Program of Silesian Center for Heart Diseases between 2011 and 2018. Analysis of patients during qualification process and after lung transplantation was performed. Lung recipients were observed during 1-year follow-up by means of pulmonary function tests. Results 1-year survival was noted among 80% of the patients; 3-year survival and 5-year survival were noted among 70% of the recipients. Mean forced expiratory volume in 1 second (FEV1) increased after lung transplantation: 21.19% at qualification; and 76.67% at 12 months after lung transplantation. Mean forced vital capacity (FVC) results also improved: 34.18% at qualification and 78.34% at 12 months after lung transplantation. The 6-minute walk test (6MWT) before and after treatment noted an increase of 175.55 m. Conclusions Lung transplantation improves respiratory capacity of CF patients and prolongs their life.
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Affiliation(s)
- Marek Ochman
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Magdalena Latos
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Maciej Urlik
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Stącel
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Mirosław Nęcki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Zofia Tatoj
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Fryderyk Zawadzki
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Marta Wajda-Pokrontka
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
| | - Piotr Przybyłowski
- Institute of Cardiology, Jagiellonian University, Medical College, Cracow, Poland.,Department of Cardiosurgery, John Paul II Hospital, Cracow, Poland
| | - Marian Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
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Deja MA, Kargul T, Domaradzki W, Stącel T, Mazur W, Wojakowski W, Gocoł R, Gaszewska-Żurek E, Żurek P, Pytel A, Woś S. Effects of preoperative aspirin in coronary artery bypass grafting: A double-blind, placebo-controlled, randomized trial. J Thorac Cardiovasc Surg 2012; 144:204-9. [DOI: 10.1016/j.jtcvs.2012.04.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 03/13/2012] [Accepted: 04/03/2012] [Indexed: 11/15/2022]
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