Adoption of a semi-elective lung transplantation practice by safely extending cold ischemic times.

Objective: Lung transplantation is a complex surgical procedure performed by specialized teams. Practice changes to eliminate overnight lung transplants were implemented at our center and patient outcomes were evaluated.

Methods: Patient and donor organ selection were performed in the standard fashion.

Performance status at the time of lung retransplant predicts long-term function.

Background: Lung retransplantation is offered to select patients with chronic allograft dysfunction. Given the increased risk of morbidity and mortality conferred by retransplantation, post-transplant function should be considered in the decision of who and when to list. The aim of this study is to identify predictors of post-operative disability in patients undergoing lung retransplantation.

Immediate Postoperative COVID-19 Infection after Lung Transplantation: A Systematic Review and Case Series.

Background: With new variants challenging the effectiveness of preventive measures, we are beginning to recognize the reality that COVID-19 will continue to pose an endemic threat. The manifestations of COVID-19 in lung transplant recipients during index admission are poorly understood with very few cases reported in recent lung transplant recipients. Optimal management of immunosuppression and antiviral therapy in recent transplant recipients is challenging.

Impact of gastro-jejunostomy tube in lung transplant patients: a propensity-matched analysis.

Objectives: During the postoperative phase of lung transplantation, the surgical creation of a gastro-jejunostomy (GJ) may be deemed necessary for patients with severe oesophageal dysmotility, prolonged oral intake difficulties stemming from use of a ventilator or marked malnutrition. We explored the effects of postoperative GJ tube on survival and bronchiolitis obliterans syndrome in lung transplant recipients.

Methods: We retrospectively reviewed all lung transplants performed at our institution between 2011 and 2022.

Pneumatocele after lung transplantation.

Pneumatoceles are a known complication of pneumonia or trauma, especially in young children. A 44-year-old male with pulmonary veno-occlusive disease and pulmonary hypertension underwent double lung transplantation with cardiopulmonary support. The patient had experienced severe primary graft dysfunction and bilateral lower lobe pneumonia.

Effects of Intraoperative Support Strategies on Endothelial Injury and Clinical Lung Transplant Outcomes.

In lung transplantation, postoperative outcomes favor intraoperative use of extracorporeal membrane oxygenation (ECMO) over cardiopulmonary bypass (CBP). We investigated the effect of intraoperative support strategies on endothelial injury biomarkers and short-term posttransplant outcomes. Adults undergoing bilateral lung transplantation with No-Support, venoarterial (V-A) ECMO, or CPB were included.

Lung transplantation from donation after circulatory death, evolution, and current status in the United States.

Background: The number of lung transplants from donors after circulatory death has increased over the last decade. This study aimed to describe the evolution and outcomes following lung transplantation donation after circulatory death (DCD) and report the practices and outcomes of ex vivo lung perfusion (EVLP) in this donor population.

Methods: This was a retrospective study using a prospectively collected national registry.

Induction Strategies in Lung Transplantation: Alemtuzumab vs. Basiliximab a Single-Center Experience.

Background: Induction therapy is used in about 80% of lung transplant centers and is increasing globally. Currently, there are no standards or guidelines for the use of induction therapy. At our institution, we have two induction strategies, basiliximab, and alemtuzumab.

A Novel Technique for Muscle Flap Preservation in Posterolateral Muscle-Sparing Thoracotomy.

The muscle-sparing thoracotomy offers several benefits over the traditional posterolateral thoracotomy approach for surgically accessing the chest cavity. Some of the potential advantages of preserving the latissimus dorsi and serratus anterior muscles include both functional benefits and potential use of these muscles for future flap reconstruction. Nevertheless, the muscle-sparing thoracotomy technique has traditionally been described with a wide exposure and, as a result, a theoretically higher risk of seroma and hematoma formation due to the increased dead space.

Extracorporeal life support during lung transplantation.

Lung transplantation surgeries are performed without extracorporeal life support (ECLS) by using an off-pump technique; however, in cases of hypoxemia or hemodynamic instability, intraoperative ECLS may be required. Cardiopulmonary bypass (CPB) has traditionally been the standard practice for ECLS but has been associated with an increased risk of bleeding in the perioperative period, increased transfusion requirements, prolonged postoperative intubation, and possibly primary graft dysfunction. More recently, because of the flexibility of using extracorporeal membrane oxygenation (ECMO) in bridging to transplantation and during postoperative recovery, its use has increased.

Surgery for Locally Advanced and Oligometastatic Non-Small Cell Lung Cancer.

Locally advanced non-small cell lung cancer is a heterogeneous group of tumors that require multidisciplinary treatment. Although there is much debate with regard to their management, a multimodal treatment strategy for carefully selected patients that includes surgery can extend survival compared with nonoperative definitive therapy. As the role of targeted therapies and immune checkpoint inhibitors for these tumors becomes better defined, practices will continue to evolve.