Background: Oropharyngeal swallowing impairment frequently occurs following lung transplantation, placing patients at risk of aspiration-related complications and mortality. The primary objectives of this study were to characterize swallowing impairment and explore potential risk factors for aspiration after lung transplantation.
Methods: A retrospective review of lung transplant recipients treated between January 2018 and December 2022 that received an instrumental swallow study was conducted. Clinical characteristics, post-operative outcomes, and results of swallow studies were evaluated. Airway invasion was classified using the Penetration-Aspiration Scale (PAS). Swallowing physiology was characterized using the Modified Barium Swallow Impairment Profile. Chi-squared, Wilcoxon signed-rank, Kaplan-Meier, Student's -tests, and regression analyses were conducted.
Results: One hundred eighteen patients underwent lung transplantation and had an instrumental swallow study. Fifty-nine percent (70/118) demonstrated airway invasion. Delayed swallow initiation occurred in all patients that had videofluoroscopy (39/118). Body mass index (BMI) and body surface area (BSA) were significantly lower in patients with airway invasion (24.7±4.5 26.8±4.6 kg/m, P=0.02; 1.8±0.2 1.9±0.2 m, P=0.02, respectively), and were associated with airway invasion [odds ratio (OR): 0.91, P=0.02; OR: 0.13, P=0.02]. Intra- and post-operative outcomes and long-term survival did not differ significantly in our cohort.
Conclusions: Oropharyngeal swallowing impairment and airway invasion occurred with high frequency, and linkages to low BMI or frailty were found. Although the true prevalence of aspiration after lung transplantation might be underestimated by referral patterns in this cohort, the negative impact of aspiration after lung transplantation may be mitigated by appropriate recognition and intervention.
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http://dx.doi.org/10.21037/jtd-24-707 | DOI Listing |
Life (Basel)
December 2024
Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Via Albertoni 15, 40138 Bologna, Italy.
(1) Background: Ex Vivo Lung Perfusion (EVLP) is a technique designed to assess and recondition marginal lungs, potentially expanding the donor pool and improving transplant outcomes (2) Methods: This retrospective study evaluated lung transplantation outcomes after EVLP. Donor lungs were assessed using the Toronto protocol, with data on hemodynamics, gas exchange, and perfusion parameters collected and analyzed. Post-transplant complications and survival rates were also examined.
View Article and Find Full Text PDFMicroorganisms
January 2025
Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy.
Background: Despite kidney transplantation being a life-saving procedure, patients experience a high risk of developing fungal infections (FIs), with an increased risk of both morbidity and mortality, especially during the first year after transplant.
Methods: We herein conducted a narrative review of the most common FIs in kidney transplant recipients (KTRs), with a focus on prevalence, risk factors, mortality, and prevention strategies.
Results: The most common fungal pathogens in KTRs include species (up to 70% of the overall FIs), species, , and species.
Biomolecules
January 2025
Department of Tissue Engineering and Regenerative Medicine (DTERM), Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Cheras, Kuala Lumpur 56000, Malaysia.
Background/objective: Metabolic syndrome (MetS) is characterized by abdominal obesity, increased blood pressure (BP), fasting blood glucose (FBG) and triglyceride levels, and reduced high-density lipoprotein (HDL) levels. This study aims to investigate the efficacy of the Wharton's jelly mesenchymal stem cells (WJMSCs)-derived small extracellular vesicles' (sEVs) preparations in managing MetS.
Method: Twenty-four rats were fed with a high-fat and high-fructose diet to induce MetS for 16 weeks and randomized into three groups ( = 8/group): a MetS Control group treated with normal saline, MetS Low Dose (LD) group treated with a LD of sEVs preparations (3 × 10 particle/rat), and MetS High Dose (HD) group treated with a HD of sEVs preparations (9 × 10 particles/rat).
Cancers (Basel)
January 2025
Medical Oncology Division, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Background: thymic basaloid carcinoma (BTC) is an extremely rare tumor, and very little data are available on BTC's biology, clinical behavior, drug sensitivity, and patient outcomes.
Methods: We performed a retrospective observational study on patients diagnosed with BTC in 11 referral centers of TYME. All BTC diagnoses were reviewed by the referring pathologist.
Reumatol Clin (Engl Ed)
January 2025
Servicio de Reumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Objective: The aim is to describe clinical and serological features, previous and current therapies, and adverse events in four systemic sclerosis patients (SSc) who undergo autologous hematopoietic stem cells transplantation (AHSCT).
Methods: Descriptive, cross-sectional study including SSc patients according ACR/EULAR 2013 criteria. Clinical and serological data, data related to current and previous therapy and adverse events were collected from 2014 to 2023.
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