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Life
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Current Trends in Lung Transplantation
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Current Trends in Lung Transplantation

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (20 October 2022) | Viewed by 16027

Special Issue Editors

Dr. Davorin Sef, PhD, FEBCTS

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Guest Editor
Department of Cardiac Surgery, University Hospitals of Leicester, Leicester, UK
Interests: cardiac surgery; aortic surgery; coronary artery bypass surgery; heart valve surgery; minimally invasive cardiac surgery; mechanical circulatory support
Special Issues, Collections and Topics in MDPI journals
Dr. Nandor Marczin

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Guest Editor
Department of Anesthesia and Critical Care, Harefield Hospital, Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, Harefield, UK Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
Interests: anesthesiology; cardiothoracic transplantation; lung transplantation; acute lung injury; biomarkers
Prof. Dr. Vladimir Trkulja

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Guest Editor
Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Interests: clinical pharmacology; translational research; biostatistics; cardiovascular research
Dr. Alessandra Verzelloni

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Guest Editor
Department of Anesthesia and Critical Care, Harefield Hospital, Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, Harefield, UK
Interests: anesthesiology; cardiothoracic transplantation; lung transplantation; critical care medicine; hemodynamics; perioperative management

Special Issue Information

Dear Colleagues,

With improved outcomes, lung transplantation has evolved into a well-recognized treatment option for patients with end-stage lung failure. With improvements in perioperative management and operative techniques and a greater understanding of donor and recipient selection criteria, we have observed continuous development in this challenging field. However, according to the most recent registry data from the International Society of Heart and Lung Transplantation (ISHLT), the total number of lung transplants performed in the world has continued to increase to approximately 4500 annually, but survival has not improved significantly in the last decade. There remain many aspects that need more clarification and understanding such as the pathophysiological mechanisms related to donor lungs, DCD donation, size matching, primary graft dysfunction, and long-term complications. The further development of specific clinical care pathways and improvements in the postoperative management of these highly demanding transplant patients are required.

This Special Issue aims to address the most current and challenging topics in lung transplantation, and we encourage all specialists engaged in the treatment of end-stage lung failure, including cardiothoracic and transplant surgeons, anesthetists, intensivists, respiratory physicians, physiotherapists, pathologists and researchers, to submit their work. We particularly welcome the submission of original research and clinical trials.

We look forward to your contribution.

Dr. Davorin Sef
Dr. Nandi Marczin
Prof. Dr. Vladimir Trkulja
Dr. Alessandra Verzelloni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lung transplantation
  • donor selection
  • donor lung allograft
  • recipient selection
  • postoperative complications
  • organ preservation
  • mortality risk factors
  • treatment outcome

 

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Published Papers (5 papers)

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Editorial

Jump to: Research, Review

4 pages, 184 KiB  
Editorial
Current Perspectives and Future Directions in Lung Transplantation
by Alessandra Verzelloni Sef, Davorin Sef, Vladimir Trkulja and Nandor Marczin
Life 2023, 13(7), 1432; https://doi.org/10.3390/life13071432 - 23 Jun 2023
Cited by 1 | Viewed by 1577
Abstract
This Special Issue of Life features compelling original research and reviews related to current trends in lung transplantation (LTx) [...] Full article
(This article belongs to the Special Issue Current Trends in Lung Transplantation)

Research

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11 pages, 1994 KiB  
Article
Transbronchial Cryobiopsy Compared to Forceps Biopsy for Diagnosis of Acute Cellular Rejection in Lung Transplants: Analysis of 63 Consecutive Procedures
by Carolin Steinack, Ariana Gaspert, Fiorenza Gautschi, René Hage, Bart Vrugt, Alex Soltermann, Macé Matthew Schuurmans and Daniel Franzen
Life 2022, 12(6), 898; https://doi.org/10.3390/life12060898 - 15 Jun 2022
Cited by 15 | Viewed by 2764
Abstract
Background: Acute cellular rejection (ACR) is a complication after lung transplantation (LTx). The diagnosis of ACR is based on histologic findings using transbronchial forceps biopsy (FB). However, its diagnostic accuracy is limited because of the small biopsy size and crush artifacts. Transbronchial cryobiopsy [...] Read more.
Background: Acute cellular rejection (ACR) is a complication after lung transplantation (LTx). The diagnosis of ACR is based on histologic findings using transbronchial forceps biopsy (FB). However, its diagnostic accuracy is limited because of the small biopsy size and crush artifacts. Transbronchial cryobiopsy (CB) provides a larger tissue size compared with FB. Methods: FB and CB were obtained consecutively during the same bronchoscopy (February 2020–April 2021). All biopsies were scored according to the ISHLT criteria by three pathologists. Interobserver agreement was scored by the kappa index. We assessed the severity of bleeding and the presence of pneumothorax. Results: In total, 35 lung transplant recipients were included, and 126 CBs and 315 FBs were performed in 63 consecutive bronchoscopies. ACR (A1–A3, minimal–moderate) was detected in 18 cases (28.6%) by CB, whereas ACR was detected in 3 cases (4.8%) by FB. Moderate and severe bleeding complicated FB and CB procedures in 23 cases (36.5%) and 1 case (1.6%), respectively. Pneumothorax occurred in 6.3% of patients. The interobserver agreement was comparable for both CB and FB. Conclusions: CB provided an improved diagnostic yield for ACR diagnosis, leading to reclassification and changes in treatment strategies in 28.6% of cases. Prospective studies should better define the role of CB after LTx. Full article
(This article belongs to the Special Issue Current Trends in Lung Transplantation)
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Review

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19 pages, 434 KiB  
Review
Lung Transplant Rehabilitation—A Review
by Yafet Abidi, Zsuzsanna Kovats, Aniko Bohacs, Monika Fekete, Saoussen Naas, Ildiko Madurka, Klara Torok, Levente Bogyo and Janos Tamas Varga
Life 2023, 13(2), 506; https://doi.org/10.3390/life13020506 - 11 Feb 2023
Cited by 9 | Viewed by 4537
Abstract
Background: Both lung transplant recipients and candidates are characterised by reduced training capacity and low average quality of life (QoL). This review investigates the impact of training on exercise ability and QoL in patients before and after lung transplant. Methods: Searches were conducted [...] Read more.
Background: Both lung transplant recipients and candidates are characterised by reduced training capacity and low average quality of life (QoL). This review investigates the impact of training on exercise ability and QoL in patients before and after lung transplant. Methods: Searches were conducted from the beginning to 7 March 2022 using the terms “exercise,” “rehabilitation,” “lung transplant,” “exercise ability,” “survival,” “quality of life” and “telerehabilitation” in six databases, including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL, Nursing and Allied Health, and Scopus. The inclusion criteria were studies evaluating the effects of an exercise training programme concurrent with lung transplantation as well as patients and candidates (>18 years old) through any lung diseases. The term “lung transplant rehabilitation” was used to refer to all carefully thought-out physical activities with the ultimate or intermediate objective of improving or maintaining physical health. Results: Out of 1422 articles, 10 clinical- and 3 telerehabilitation studies, candidates (n = 420) and recipients (n = 116) were related to the criteria and included in this review. The main outcome significantly improved in all studies. The 6-min walk distance, maximum exercise capacity, peak oxygen uptake, or endurance for constant load rate cycling improved measuring physical activity [aerobic exercises, breathing training, and aerobic and inspiratory muscle training sessions (IMT)]. Overall scores for dyspnoea improved after exercise training. Furthermore, health-related quality of life (HRQOL) also improved after aerobic exercise training, which was performed unsupervised or accompanied by breathing sessions. Aerobic training alone rather than combined with inspiratory muscle- (IMT) or breathing training enhanced exercise capacity. Conclusion: In conclusion, rehabilitation programmes seem to be beneficial to patients both preceding and following lung transplantation. More studies are required to determine the best training settings in terms of time scale, frequency, and work intensity in terms of improving exercise ability, dyspnoea, and HRQOL. Full article
(This article belongs to the Special Issue Current Trends in Lung Transplantation)
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14 pages, 647 KiB  
Review
New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management
by Julien Fessler, Michaël Finet, Marc Fischler and Morgan Le Guen
Life 2023, 13(1), 92; https://doi.org/10.3390/life13010092 - 28 Dec 2022
Cited by 4 | Viewed by 2617
Abstract
The management of lung transplant patients has continued to evolve in recent years. The year 2021 was marked by the publication of the International Consensus Recommendations for Anesthetic and Intensive Care Management of Lung Transplantation. There have been major changes in lung transplant [...] Read more.
The management of lung transplant patients has continued to evolve in recent years. The year 2021 was marked by the publication of the International Consensus Recommendations for Anesthetic and Intensive Care Management of Lung Transplantation. There have been major changes in lung transplant programs over the last few years. This review will summarize the knowledge in anesthesia management of lung transplantation with the most recent data. It will highlight the following aspects which concern anesthesiologists more specifically: (1) impact of COVID-19, (2) future of transplantation for cystic fibrosis patients, (3) hemostasis management, (4) extracorporeal membrane oxygenation management, (5) early prediction of primary graft dysfunction, and (6) pain management. Full article
(This article belongs to the Special Issue Current Trends in Lung Transplantation)
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14 pages, 679 KiB  
Review
Intraoperative Circulatory Support in Lung Transplantation: Current Trend and Its Evidence
by Henning Starke, Vera von Dossow and Jan Karsten
Life 2022, 12(7), 1005; https://doi.org/10.3390/life12071005 - 7 Jul 2022
Cited by 6 | Viewed by 2853
Abstract
Lung transplantation has a high risk of haemodynamic complications in a highly vulnerable patient population. The effects on the cardiovascular system of the various underlying end-stage lung diseases also contribute to this risk. Following a literature review and based on our own experience, [...] Read more.
Lung transplantation has a high risk of haemodynamic complications in a highly vulnerable patient population. The effects on the cardiovascular system of the various underlying end-stage lung diseases also contribute to this risk. Following a literature review and based on our own experience, this review article summarises the current trends and their evidence for intraoperative circulatory support in lung transplantation. Identifiable and partly modifiable risk factors are mentioned and corresponding strategies for treatment are discussed. The approach of first identifying risk factors and then developing an adjusted strategy is presented as the ERSAS (early risk stratification and strategy) concept. Typical haemodynamic complications discussed here include right ventricular failure, diastolic dysfunction caused by left ventricular deconditioning, and reperfusion injury to the transplanted lung. Pre- and intra-operatively detectable risk factors for the occurrence of haemodynamic complications are rare, and the therapeutic strategies applied differ considerably between centres. However, all the mentioned risk factors and treatment strategies can be integrated into clinical treatment algorithms and can influence patient outcome in terms of both mortality and morbidity. Full article
(This article belongs to the Special Issue Current Trends in Lung Transplantation)
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