Publications by authors named "John C Keech"
Article Synopsis
- Lung transplantation (LT) can be a life-saving option for patients with severe COVID-19-related lung issues, and this study aimed to assess the outcomes of these recipients compared to others with similar lung dysfunction.
- Researchers analyzed data from the Organ Procurement and Transplant Network, finding that COVID-19 recipients tended to be younger, primarily male, and had worse lung function at the time of transplantation.
- Ultimately, the study concluded that six-month survival rates for LT recipients due to COVID-19 were similar to those of other lung transplant patients, indicating that LT can be an effective treatment option in these cases.
Direct Caverno-Pleural Fistula Closure using an Amplatzer Vascular Plug.
J Bronchology Interv Pulmonol
January 2023
Background: Rarely performed procedures can cause stress and communication challenges in emergency situations. A simulation was developed to practice and improve team performance and procedural workflow when it has been determined that a liver transplant patient will need veno-veno bypass. The scenario involved a patient predetermined to need veno-veno bypass to allow team members to practice procedural workflow and communication.
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- This study explored the use of stereotactic body radiation therapy (SBRT) as a potential treatment for patients with locally recurrent esophageal cancer after initial curative treatments, hypothesizing that SBRT would control tumors effectively with low side effects.
- Nine patients with locoregional recurrences received SBRT, with most being primarily diagnosed with advanced adenocarcinoma, and a follow-up period of about 10.5 months was recorded.
- Results showed limited toxicity, with only mild side effects reported, and median progression-free survival of 5.0 months and overall survival of 12.9 months, indicating SBRT's feasibility as a salvage option in this patient group.*
Article Synopsis
- Esophagectomy combined with preoperative chemoradiation is the most effective treatment for early stage esophageal cancer.
- The traditional method of transhiatal esophagectomy has limited access to the mediastinum area.
- This text introduces a new technique for better mediastinal dissection during transhiatal esophagectomy using an innovative retractor.
Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy.
Korean J Thorac Cardiovasc Surg
April 2016
Background: Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy.
Methods: Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated.
Background: Bronchial anastomotic complications develop in 31% of lung transplant recipients, leading to additional operative procedures and increased morbidity. Advances in surgical technique have thus far resulted in only modestly improved outcomes. We hypothesized that creating the bronchial anastomosis at the secondary carina using a combination of running and figure-of-eight sutures would minimize donor bronchial ischemia and airway complications.
View Article and Find Full Text PDFBackground: Ischemia-reperfusion injury impairs lung transplant outcomes. The transcription factors, activator protein-1, and nuclear factor kappa B, are activated early in reperfusion and drive the development of injury. Thrombin inhibition with hirudin, and calcineurin inhibition with tacrolimus have independently been shown to ameliorate lung ischemia-reperfusion injury by reducing activator protein-1 and nuclear factor kappa B activation, respectively.
View Article and Find Full Text PDFBackground: The availability of suitable lung donors has remained a significant barrier to lung transplantation. The clinical relevance of an isolated positive Gram stain in potential donor lungs, which occurs in >80%, is unclear. Low doses of lipopolysaccharide (LPS) have been protective in several models of ischemia-reperfusion injury through a pre-conditioning response.
View Article and Find Full Text PDFBackground: Activation of the alveolar macrophage is centrally important to the development of lung ischemia reperfusion injury. Alveolar macrophages and type 2 pneumocytes secrete a variety of proinflammatory mediators in response to oxidative stress. The manner in which they interact and how the macrophage may influence pneumocyte responses in lung ischemia reperfusion injury is unknown.
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