Insomnia and Relationship With Immunosuppressant Therapy After Lung Transplantation.

Background: Lung transplant recipients are at high risk of developing sleep disorders such as insomnia, but the prevalence and features are currently poorly characterized within this population. Since these disorders are associated with increased morbidity and mortality, it is important to identify them to optimize the care of lung transplant recipients. We sought to evaluate the prevalence of insomnia within our university-based lung transplant clinic and determine whether a relationship exists between insomnia and exposure to immunosuppressant medications following transplantation.

Lung transplantation for high-risk patients with idiopathic pulmonary fibrosis.

Background: Survival for patients with idiopathic pulmonary fibrosis (IPF) and high lung allocation score (LAS) values may be significantly reduced in comparison to those with lower LAS values.

Objectives: To evaluate outcomes for high-risk IPF patients as defined by LAS values ≥46 (N=42) versus recipients with LAS values <46 (N=89).

Methods: We retrospectively reviewed records of 131 consecutive patients with IPF who received lung transplants at our institution between 1999 and 2013.

Restless Legs Syndrome Following Lung Transplantation: Prevalence and Relationship With Tacrolimus Exposure.

Context: Complications following lung transplantation are common and significantly reduce quality of life, and increase morbidity and mortality. Increasing evidence suggests sleep disorders are prevalent following lung transplantation, but factors associated with their development are not known.

Objectives: We sought to evaluate the prevalence of restless legs syndrome (RLS) in a lung transplant population and determine if a relationship exists between RLS and exposure to immunosuppressant medications.

Timing and Frequency of Unplanned Readmissions After Lung Transplantation Impact Long-Term Survival.

Background: Adverse events that require hospital readmission frequently occur long after lung transplantation (LT) that has been successfully performed. We sought to identify the causes and rate of unplanned readmissions after LT and to determine whether unplanned readmissions have a significant impact on post-LT survival.

Methods: We retrospectively reviewed the outcomes in 174 LT recipients who underwent LT at our center from June 2005 to May 2014.

The presence or severity of pulmonary hypertension does not affect outcomes for single-lung transplantation.

Advanced lung disease (ALD) that requires lung transplantation (LTX) is frequently associated with pulmonary hypertension (PH). Whether the presence of PH significantly affects the outcomes following single-lung transplantation (SLT) remains controversial. Therefore, we retrospectively examined the outcomes of 279 consecutive SLT recipients transplanted at our centre, and the patients were split into four groups based on their mean pulmonary artery pressure values.

Safety of and cellular response to segmental bronchoprovocation in allergic asthma.

Rationale: Despite its incorporation into research studies, the safety aspects of segmental allergen bronchoprovocation and differences in cellular response among different allergens have received limited consideration.

Methods: We performed 87 segmental challenges in 77 allergic asthma subjects. Allergen dose was based on each subject's response to whole lung allergen challenge.

Lung transplant for interstitial lung disease: outcomes before and after implementation of the united network for organ sharing lung allocation scoring system.

Objectives: This study was undertaken to evaluate whether the adoption of the united network for organ sharing lung allocation score (LAS) was associated with significant changes in lung transplantation (LTX) outcomes for patients with interstitial lung disease (ILD) who underwent LTX at the University of Wisconsin Hospital and Clinics.

Methods: Outcomes for 107 consecutive patients with various forms of ILD who underwent LTX between January 1993 and March 2009 were examined. Patients transplanted following the implementation of the LAS system (LAS, n = 56) were compared with those transplanted prior to LAS implementation (pre-LAS, n = 51) for whom LAS scores were calculated.

Lung transplant for interstitial lung disease: outcomes for single versus bilateral lung transplantation.

This study was undertaken to evaluate outcomes for single (SLT) vs. bilateral lung transplantation (BLT) in patients with interstitial lung disease (ILD). One hundred and eleven patients with ILD who underwent lung transplantation between January 1993 and March 2009 were evaluated.

Colon cancer in lung transplant recipients with CF: increased risk and results of screening.

Objective: To determine the incidence of colon cancer in lung transplant recipients with cystic fibrosis (CF) and review screening colonoscopic findings in other recipients with CF.

Methods: A retrospective chart review was performed for all patients with CF transplanted at the University of Wisconsin Hospital and Clinics (January 1994 through December 2010).

Results: Four of 70 transplant recipients with CF developed fatal colon carcinoma following transplantation, and the cancer was advanced in all 4 recipients (age 31, 44, 44, 64) at the time of diagnosis.

The impact of the lung allocation scoring system at the single national Veterans Affairs Hospital lung transplantation program.

Objective: The lung allocation score (LAS) has changed the distribution of donor lungs for transplantation. This study was undertaken to evaluate the impact of the LAS on a unique patient population undergoing lung transplantation (LTX) at the single national Veterans Affairs (VA) LT center.

Methods: One hundred and ten consecutive VA patients underwent LTX between 1994 and 2007.

Redo lung transplantation for acute and chronic lung allograft failure: long-term follow-up in a single center.

Objective: This study was undertaken to evaluate outcomes of redo lung transplantation (LT) for acute and chronic graft failure.

Methods: Between 1988 and 2007, 388 LT procedures were performed on 369 patients. From those, 17 (4.

Quantitative and qualitative analysis of rhinovirus infection in bronchial tissues.

Although rhinovirus (RV) infections can cause asthma exacerbations and alter lower airway inflammation and physiology, it is unclear how important bronchial infection is to these processes. To study the kinetics, location, and frequency of RV appearance in lower airway tissues during an acute infection, immunohistochemistry and quantitative polymerase chain reaction analysis were used to analyze the presence of virus in cells from nasal lavage, sputum, bronchoalveolar lavage, bronchial brushings, and biopsy specimens from 19 subjects with an experimental RV serotype 16 (RV16) cold. RV was detected by polymerase chain reaction analysis on cells from nasal lavage and induced sputum samples from all subjects after RV16 inoculation, as well as in 5 of 19 bronchoalveolar lavage cell samples and in 5 of 18 bronchial biopsy specimens taken 4 days after virus inoculation.

Aspergillus infection in lung transplant recipients with cystic fibrosis: risk factors and outcomes comparison to other types of transplant recipients.

Study Objectives: To characterize Aspergillus infections in lung transplant recipients with cystic fibrosis (CF).

Design: A retrospective analysis of 32 consecutive lung transplant recipients with CF who underwent bilateral lung transplant at the University of Wisconsin from 1994 to 2000 to determine the incidence, risk factors, and consequences of Aspergillus infection. The findings were compared to 101 non-CF recipients of lung transplants (93) and heart-lung transplants (8) for other transplant indications.

Bronchoscopy-guided transtracheal and transbronchial fine-needle aspiration biopsy: a 5-year institutional review of 111 cases.

We reviewed 111 bronchoscopy-guided transtracheal and transbronchial fine-needle aspiration (TT/TBNA) specimens from 97 patients to determine the sensitivity and specificity for diagnosing neoplasia compared to surgical biopsy and clinical follow-up and to determine the optimal number of passes. Fifty were positive for neoplasia, seven were suspicious, one was atypical, 51 were negative, and two were unsatisfactory. Of 57 positive/suspicious cases, 56 were confirmed neoplastic, with one patient lost to follow-up (specificity with follow-up: 100%).

Reproducibility of the mechanical properties of Vivostat system patient-derived fibrin sealant.

Conventional "autologous" fibrin sealants, prepared from fibrinogen concentrates are inconsistent in their physical properties; this reflects the wide variation in the fibrinogen level of the single donor plasma from which they are made. In contrast, the Vivostat System produces a fibrin sealant of reproducible concentration and mechanical properties that are independent of the source plasma fibrinogen concentration. Fibrin solution concentrations prepared with the Vivostat System were 22.