Publications by authors named "Arne P Neyrinck"
Objectives: Lung volume reduction surgery (LVRS) is an established therapeutic option for advanced emphysema. To improve patients' safety and reduce complications, an enhanced recovery protocol (ERP) was implemented. This study aims to describe and evaluate the short-term outcome of this ERP.
View Article and Find Full Text PDFBackground: Extracorporeal life support (ECLS) is not routinely used at our center during sequential single-lung transplantation (LTx), but is restricted to anticipate and overcome hemodynamic and respiratory problems occurring peri-operatively. In this retrospective descriptive cohort study, we aim to describe our single-center experience with ECLS in LTx, analyzing ECLS-related complications.
Methods: All transplantations with peri-operative ECLS use [2010-2020] were retrospectively analyzed.
Article Synopsis
- Lung re-transplantation (re-LTx) is a treatment option for patients with serious lung graft issues, and this study focuses on the safety and feasibility of a less invasive surgical technique that avoids a clamshell incision.
- A total of 42 patients were analyzed, with findings indicating that the off-pump method led to shorter surgery times and lower rates of severe primary graft dysfunction compared to more invasive techniques using clamshell incisions.
- Both surgical approaches showed similar long-term survival rates, suggesting that the off-pump method could be a viable option for certain patients needing re-LTx.
Background: Bronchiolitis obliterans syndrome (BOS) after lung transplantation is characterized by fibrotic small airway remodeling, recognizable on high-resolution computed tomography (HRCT). We studied the prognostic value of key HRCT features at BOS diagnosis after lung transplantation.
Methods: The presence and severity of bronchiectasis, mucous plugging, peribronchial thickening, parenchymal anomalies, and air trapping, summarized in a total severity score, were assessed using a simplified Brody II scoring system on HRCT at BOS diagnosis, in a cohort of 106 bilateral lung transplant recipients transplanted between January 2004 and January 2016.
Article Synopsis
- - The assessment of donor lungs for transplantation is mostly subjective and varies greatly, lacking standardized criteria; researchers explored using a CT-based machine learning algorithm to evaluate donor lungs before surgery.
- - The study collected clinical data and CT scans from 100 cases, training a machine learning method called dictionary learning to identify specific image patterns related to lung health.
- - The algorithm successfully detected lung abnormalities, highlighting patients with a higher risk of complications post-transplant and emphasizing the need for objective screening methods as the use of less-than-ideal donor lungs increases.
The hemodynamic interplay between pulmonary ischemia-reperfusion injury and right ventricular function in lung transplantation: a translational porcine model.
Am J Physiol Lung Cell Mol Physiol
November 2023
Article Synopsis
- - The study investigates the relationship between right ventricular function and lung injury during lung transplantation, focusing on how ischemia-reperfusion injury affects the transplanted lung itself, using a porcine model for research.
- - Researchers observed that forcing blood through a lung affected by ischemia-reperfusion injury significantly increased resistance and led to right ventricular failure in some animals, highlighting distinct responses in failing versus non-failing ventricles.
- - The findings suggest a complex interplay between lung injury and right ventricular function, emphasizing the potential benefits of using extracorporeal life support during lung transplantation procedures to mitigate these effects.
Surgical resection is still the standard treatment for early-stage lung cancer. A multimodal treatment consisting of chemotherapy, radiotherapy and/or immunotherapy is advised for more advanced disease stages (stages IIb, III and IV). The role of surgery in these stages is limited to very specific indications.
View Article and Find Full Text PDFBackground: Assessment and selection of donor lungs remains largely subjective and experience based. Criteria to accept or decline lungs are poorly standardized and are not compliant with the current donor pool. Using ex vivo CT images, we investigated the use of a CT-based machine learning algorithm for screening donor lungs prior to transplantation.
View Article and Find Full Text PDFFungal exposure and sensitization negatively affect outcomes in various respiratory diseases, however, the effect of fungal sensitization in lung transplant (LTx) recipients is still unknown. We performed a retrospective cohort study of prospectively collected data on circulating fungal specific IgG/IgE antibodies, and their correlation with fungal isolation, chronic lung allograft dysfunction (CLAD) and overall survival after LTx. 311 patients transplanted between 2014 and 2019 were included.
View Article and Find Full Text PDFObjective: To describe our experience with lung transplantation (LTx) from donors ≥70 years and compare short and long-term outcomes to a propensity-matched cohort of donors <70 years.
Background: Although extended-criteria donors have been widely used to enlarge the donor pool, the experience with LTx from older donors (≥70 years) remains limited.
Methods: All single-center bilateral LTx between 2010 and 2020 were retrospectively analyzed.
Pulmonary vein stenosis (PVS) and pulmonary vein occlusion (PVO) represent rare complications after lung transplantation (LTx), with limited therapeutic options and a high risk of graft loss. We present 2 cases of successful endovascular transatrial stenting following double LTx. A 60-year-old woman with chronic obstructive pulmonary disease who underwent double lobar LTx was diagnosed at postoperative day 72 with a high-grade PVS on the left side.
View Article and Find Full Text PDFBackground Interstitial lung abnormalities (ILAs) reflect imaging features on lung CT scans that are compatible with (early) interstitial lung disease. Despite accumulating evidence regarding the incidence, risk factors, and prognosis of ILAs, the histopathologic correlates of ILAs remain elusive. Purpose To determine the correlation between radiologic and histopathologic findings in CT-defined ILAs in human lung explants.
View Article and Find Full Text PDFArticle Synopsis
- This study looked at a problem called primary graft dysfunction that can happen after lung transplants, where the new lungs don't work well due to injury during the operation.
- Researchers tested whether using a special filter that removes harmful substances from the blood right after transplant would help the new lungs work better in pigs.
- The results showed that the filter didn't actually help, as the levels of some proteins that cause inflammation were even higher in the group that got the filter, and there were no big differences in how well the lungs worked.
Lung transplant outcome following donation after euthanasia.
J Heart Lung Transplant
June 2022
Article Synopsis
- Organ transplantation faces challenges due to a lack of suitable organs, with "donation after cardio-circulatory death category V" (DCD-V) emerging as a potential solution following euthanasia.
- A study of lung transplants from 2007 to 2020 showed that lung transplants from DCD-V donors had similar rates of primary graft dysfunction and chronic lung allograft dysfunction compared to those from DCD-III and donation after brain death (DBD) donors.
- The findings suggest that lung transplants from DCD-V donors are both feasible and safe, with comparable patient survival rates, indicating that DCD-V could be a viable option in organ transplantation.
Primary graft dysfunction (PGD) is the clinical syndrome of acute lung injury after lung transplantation (LTx). However, PGD is an umbrella term that encompasses the ongoing pathophysiological and -biological mechanisms occurring in the lung grafts. Therefore, we aim to provide a focused review on the clinical, physiological, radiological, histological and cellular level of PGD.
View Article and Find Full Text PDFArticle Synopsis
- Primary graft dysfunction (PGD) significantly impacts early recovery and survival rates after lung transplantation (LTx), with this study investigating the role of prolonged anastomosis time (AT) as a risk factor for PGD.
- Data from 427 patients who underwent double lung transplants between 2008 and 2016 revealed that 30.2% developed severe PGD3 within 72 hours, and longer AT was independently linked to increased risk of PGD3.
- The findings emphasize the importance of minimizing AT during LTx procedures and ensuring proper lung cooling to reduce the incidence of PGD and related complications.
Bronchiolitis obliterans syndrome (BOS) is considered an airway-centered disease, with bronchiolitis obliterans (BO) as pathologic hallmark. However, the histologic spectrum of pure clinical BOS remains poorly characterized. We provide the first in-depth histopathologic description of well-characterized BOS patients and patients without chronic lung allograft dysfunction (CLAD), defined according to the recent consensus guidelines.
View Article and Find Full Text PDFArticle Synopsis
- In donation after circulatory death (DCD), regional perfusion (RP) is used to restore blood circulation in organs after the declaration of death, and a systematic review of 88 studies explored the outcomes of various organ transplants following this procedure.
- The studies varied in type, including case reports, case series, and retrospective studies, and most were considered of fair quality; two main categories emerged based on temperature: hypothermic (≤20°C) and normothermic (>20°C) perfusion.
- The findings suggest that normothermic regional perfusion (NRP) is generally safer and may lead to fewer post-transplant complications compared to traditional cold preservation methods, particularly for liver transplants, though more evidence
Acute respiratory distress syndrome (ARDS) is a rapidly progressive lung disease with a high mortality rate. Although lung transplantation (LTx) is a well-established treatment for a variety of chronic pulmonary diseases, LTx for acute lung failure (due to ARDS) remains controversial. We reviewed posttransplant outcome of ARDS patients from three high-volume European transplant centers.
View Article and Find Full Text PDFInteralveolar Pores Increase in Aging and Severe Airway Obstruction.
Am J Respir Crit Care Med
October 2021
Article Synopsis
- * This document provides evidence-based recommendations and outlines essential ethical, logistical, and technical requirements for implementing NRP programs in both uncontrolled and controlled DCD settings.
- * The recommendations are based on insights from a panel of European experts involved in the Transplantation Learning Journey project under the European Society for Organ Transplantation.
Background: Connective tissue growth factor (CTGF) is an important mediator in several fibrotic diseases, including lung fibrosis. We investigated CTGF-expression in chronic lung allograft dysfunction (CLAD) and pulmonary graft-versus-host disease (GVHD).
Materials And Methods: CTGF expression was assessed by quantitative real-time polymerase chain reaction (qPCR) and immunohistochemistry in end-stage CLAD explant lung tissue (bronchiolitis obliterans syndrome (BOS), n=20; restrictive allograft syndrome (RAS), n=20), pulmonary GHVD (n=9).
Article Synopsis
- Primary graft dysfunction (PGD) is a significant issue following lung transplantation, often linked to ischemia-reperfusion injury.
- In a study with 12 pigs, researchers compared low-flow (LF) and high-flow (HF) conditions during single-left lung transplants, assessing the effects on lung function and injury.
- Results showed no significant differences in survival or lung injury between the LF and HF groups in the first 6 hours post-transplant, suggesting that increased blood flow didn’t impact ischemia-reperfusion injury but may inform future transplantation studies.