Primary Graft Dysfunction
Lung Transplantation
Collagen Type V
Tissue Donors
Bronchiolitis Obliterans
Graft Survival
Graft Rejection
Biological Markers
Prospective Studies
Liver Transplantation
Association between primary graft dysfunction among lung, kidney and heart recipients from the same multiorgan donor. (1/98)
(+info)Impact of human donor lung gene expression profiles on survival after lung transplantation: a case-control study. (2/98)
(+info)Late primary graft dysfunction after lung transplantation and bronchiolitis obliterans syndrome. (3/98)
(+info)Plasma cytokines and chemokines in primary graft dysfunction post-lung transplantation. (4/98)
(+info)Participation of autophagy in the initiation of graft dysfunction after rat liver transplantation. (5/98)
Better ways to prevent the cold ischemia-warm reperfusion (CI/WR) injury associated with liver transplantation are needed, and many investigations have focused on the molecular mechanisms of this injury. However, the mechanisms reported to date are controversial and no improvement in therapy has resulted. Here, using prolonged CI and orthotopic transplantation of rat liver grafts, we found that the CI/WR injury was closely associated with autophagy. By 15 minutes after the start of WR, small masses of hepatocytes that possessed abundant autophagosomes and autolysosomes frequently dissociated from the hepatic cords and obstructed the sinusoid, causing massive necrosis of hepatocytes within 2 hours. The cell masses included TUNEL-positive nuclei without caspase-3 and -7 activation. Autophagy suppression with the phosphatidylinositol 3-kinase (PI3K) inhibitors, wortmannin or LY294002, reduced both liver damage and the mortality rate of recipient rats. To elucidate the downstream mechanisms of this autophagic pathway, liver grafts were treated with aspartic and cysteine proteinase inhibitors, pepstatin and leupeptin. This treatment also significantly improved the survival rate of recipient rats. These data suggest that autophagy-associated hepatocyte death triggers liver graft dysfunction. The protective effects of suppressing autophagy may suggest new ways to prevent CI/WR injury of the liver. (+info)Does anaesthetic management affect early outcomes after lung transplant? An exploratory analysis. (6/98)
(+info)Concurrent Kaposi's sarcoma, tuberculosis, and allograft dysfunction in a renal transplant patient. (7/98)
The major long-term complications of renal transplantation (RT) include cardio-vascular disease, opportunistic infections, malignancies, and chronic allograft nephropathy. Long-term complications are generally considered as those occurring more than 1 year post trans-plantation; however, some of the complications can occur earlier. We present a 58-year-old man who presented with multiple complications of RT concurrently and relatively early post trans-plantation including Kaposi's sarcoma, tuberculosis and allograft dysfunction. (+info)Soluble p-selectin and the risk of primary graft dysfunction after lung transplantation. (8/98)
(+info)Primary graft dysfunction (PGD) is a severe complication that can occur after an organ transplant, such as a lung or heart transplant. It refers to the early functional impairment of the grafted organ that is not due to surgical complications, rejection, or recurrence of the original disease.
In the case of lung transplants, PGD is defined as the evidence of poor oxygenation and stiffness in the lungs within the first 72 hours after the transplant. It is typically caused by inflammation, injury to the blood vessels, or other damage to the lung tissue during the transplant procedure or due to pre-existing conditions in the donor organ.
PGD can lead to serious complications, including respiratory failure, and is associated with increased morbidity and mortality after transplantation. Treatment may include supportive care, such as mechanical ventilation and medications to support lung function, as well as strategies to reduce inflammation and prevent further damage to the grafted organ.
Lung transplantation is a surgical procedure where one or both diseased lungs are removed and replaced with healthy lungs from a deceased donor. It is typically considered as a treatment option for patients with end-stage lung diseases, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, idiopathic pulmonary fibrosis, and alpha-1 antitrypsin deficiency, who have exhausted all other medical treatments and continue to suffer from severe respiratory failure.
The procedure involves several steps, including evaluating the patient's eligibility for transplantation, matching the donor's lung size and blood type with the recipient, and performing the surgery under general anesthesia. After the surgery, patients require close monitoring and lifelong immunosuppressive therapy to prevent rejection of the new lungs.
Lung transplantation can significantly improve the quality of life and survival rates for some patients with end-stage lung disease, but it is not without risks, including infection, bleeding, and rejection. Therefore, careful consideration and thorough evaluation are necessary before pursuing this treatment option.
Collagen Type V is a specific type of collagen, which is a protein that provides structure and strength to connective tissues in the body. Collagen Type V is found in various tissues, including the cornea, blood vessels, and hair. It plays a crucial role in the formation of collagen fibers and helps regulate the diameter of collagen fibrils. Mutations in the genes that encode for Collagen Type V can lead to various connective tissue disorders, such as Ehlers-Danlos syndrome and osteogenesis imperfecta.
A tissue donor is an individual who has agreed to allow organs and tissues to be removed from their body after death for the purpose of transplantation to restore the health or save the life of another person. The tissues that can be donated include corneas, heart valves, skin, bone, tendons, ligaments, veins, and cartilage. These tissues can enhance the quality of life for many recipients and are often used in reconstructive surgeries. It is important to note that tissue donation does not interfere with an open casket funeral or other cultural or religious practices related to death and grieving.
Bronchiolitis obliterans is a medical condition characterized by the inflammation and scarring (fibrosis) of the bronchioles, which are the smallest airways in the lungs. This results in the narrowing or complete obstruction of the airways, leading to difficulty breathing and reduced lung function.
The condition is often caused by a respiratory infection, such as adenovirus or mycoplasma pneumonia, but it can also be associated with exposure to certain chemicals, drugs, or radiation therapy. In some cases, the cause may be unknown.
Symptoms of bronchiolitis obliterans include cough, shortness of breath, wheezing, and crackles heard on lung examination. Diagnosis typically involves a combination of medical history, physical exam, imaging studies (such as chest X-ray or CT scan), and pulmonary function tests. In some cases, a biopsy may be necessary to confirm the diagnosis.
Treatment for bronchiolitis obliterans is focused on managing symptoms and preventing further lung damage. This may include bronchodilators to help open up the airways, corticosteroids to reduce inflammation, and oxygen therapy to help with breathing. In severe cases, a lung transplant may be necessary.
Graft survival, in medical terms, refers to the success of a transplanted tissue or organ in continuing to function and integrate with the recipient's body over time. It is the opposite of graft rejection, which occurs when the recipient's immune system recognizes the transplanted tissue as foreign and attacks it, leading to its failure.
Graft survival depends on various factors, including the compatibility between the donor and recipient, the type and location of the graft, the use of immunosuppressive drugs to prevent rejection, and the overall health of the recipient. A successful graft survival implies that the transplanted tissue or organ has been accepted by the recipient's body and is functioning properly, providing the necessary physiological support for the recipient's survival and improved quality of life.
Graft rejection is an immune response that occurs when transplanted tissue or organ (the graft) is recognized as foreign by the recipient's immune system, leading to the activation of immune cells to attack and destroy the graft. This results in the failure of the transplant and the need for additional medical intervention or another transplant. There are three types of graft rejection: hyperacute, acute, and chronic. Hyperacute rejection occurs immediately or soon after transplantation due to pre-existing antibodies against the graft. Acute rejection typically occurs within weeks to months post-transplant and is characterized by the infiltration of T-cells into the graft. Chronic rejection, which can occur months to years after transplantation, is a slow and progressive process characterized by fibrosis and tissue damage due to ongoing immune responses against the graft.
In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.
For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.
Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.
Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.
A biological marker, often referred to as a biomarker, is a measurable indicator that reflects the presence or severity of a disease state, or a response to a therapeutic intervention. Biomarkers can be found in various materials such as blood, tissues, or bodily fluids, and they can take many forms, including molecular, histologic, radiographic, or physiological measurements.
In the context of medical research and clinical practice, biomarkers are used for a variety of purposes, such as:
1. Diagnosis: Biomarkers can help diagnose a disease by indicating the presence or absence of a particular condition. For example, prostate-specific antigen (PSA) is a biomarker used to detect prostate cancer.
2. Monitoring: Biomarkers can be used to monitor the progression or regression of a disease over time. For instance, hemoglobin A1c (HbA1c) levels are monitored in diabetes patients to assess long-term blood glucose control.
3. Predicting: Biomarkers can help predict the likelihood of developing a particular disease or the risk of a negative outcome. For example, the presence of certain genetic mutations can indicate an increased risk for breast cancer.
4. Response to treatment: Biomarkers can be used to evaluate the effectiveness of a specific treatment by measuring changes in the biomarker levels before and after the intervention. This is particularly useful in personalized medicine, where treatments are tailored to individual patients based on their unique biomarker profiles.
It's important to note that for a biomarker to be considered clinically valid and useful, it must undergo rigorous validation through well-designed studies, including demonstrating sensitivity, specificity, reproducibility, and clinical relevance.
Kidney transplantation is a surgical procedure where a healthy kidney from a deceased or living donor is implanted into a patient with end-stage renal disease (ESRD) or permanent kidney failure. The new kidney takes over the functions of filtering waste and excess fluids from the blood, producing urine, and maintaining the body's electrolyte balance.
The transplanted kidney is typically placed in the lower abdomen, with its blood vessels connected to the recipient's iliac artery and vein. The ureter of the new kidney is then attached to the recipient's bladder to ensure proper urine flow. Following the surgery, the patient will require lifelong immunosuppressive therapy to prevent rejection of the transplanted organ by their immune system.
Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.
Liver transplantation is a surgical procedure in which a diseased or failing liver is replaced with a healthy one from a deceased donor or, less commonly, a portion of a liver from a living donor. The goal of the procedure is to restore normal liver function and improve the patient's overall health and quality of life.
Liver transplantation may be recommended for individuals with end-stage liver disease, acute liver failure, certain genetic liver disorders, or liver cancers that cannot be treated effectively with other therapies. The procedure involves complex surgery to remove the diseased liver and implant the new one, followed by a period of recovery and close medical monitoring to ensure proper function and minimize the risk of complications.
The success of liver transplantation has improved significantly in recent years due to advances in surgical techniques, immunosuppressive medications, and post-transplant care. However, it remains a major operation with significant risks and challenges, including the need for lifelong immunosuppression to prevent rejection of the new liver, as well as potential complications such as infection, bleeding, and organ failure.
Delayed graft function (DGF) is a term used in the medical field, particularly in transplant medicine. It refers to a situation where a transplanted organ, most commonly a kidney, fails to function normally immediately after the transplantation procedure. This failure to function occurs within the first week after the transplant and is usually associated with poor urine output and elevated levels of creatinine in the blood.
DGF can be caused by several factors, including pre-existing conditions in the recipient, such as diabetes or hypertension, poor quality of the donor organ, or complications during the surgery. It may also result from the immune system's reaction to the transplanted organ, known as rejection.
In many cases, DGF can be managed with medical interventions, such as administering medications to help reduce inflammation and improve blood flow to the organ. However, in some instances, it may lead to more severe complications, including acute or chronic rejection of the transplanted organ, which could require additional treatments or even another transplant.
It's important to note that not all cases of DGF lead to long-term complications, and many patients with DGF can still go on to have successful transplants with proper management and care.