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Lung transplantation technology

Tomonari Kinoshita, Hideki Ujiie, Juan Chen, Lili Ding, Harley Chan, Alexander Gregor, Nicholas Bernards, Patrick Z McVeigh, Kosuke Fujino, Chang Young Lee, Yamato Motooka, Terunaga Inage, Michael S Valic, Andrew Effat, Robert Weersink, Brian C Wilson, Gang Zheng, Hisao Asamura, Kazuhiro Yasufuku
BACKGROUND: Non-surgical and minimally-invasive approaches for early stage peripheral lung cancer are needed to avoid the known morbidity of surgery, particularly in high-risk patients. We have previously demonstrated the utility of multifunctional porphyrin-phospholipid nanoparticles (porphysomes) for fluorescence imaging and phototherapy following preferential accumulation into tumors. The objective of this study was to demonstrate the feasibility of porphysome-mediated imaging and photothermal therapy using a newly-developed fiberscope and thoracoscope...
February 8, 2019: Annals of Thoracic Surgery
Shashank Shankar Chetty, Selvarasu Praneetha, Kavitha Govarthanan, Rama Shanker Verma, Arumugam Vadivel Murugan
Acute liver injury is a critical syndrome ascribed to prevalent death of hepatocyte and imperatively requires a liver transplantation. Such methodology is certainly hampered due to deficit of healthy donors. In this regard, stem cells-based regenerative therapies are attractive in repairing injured tissues and organs for medical applications. However, it is crucial to understand the migration, engraftment and regeneration capabilities of transplanted stem cells in the living animal models. For the first time, we demonstrate rapid labeling of umbilical cord-derived mesenchymal stem cells (MSCs) with near-infrared (NIR) fluorescent CuInS2-ZnS nanocrystals (CIZS-NCs) to develop an innovative nano-bioconjugates (MSCs-CIZS-NBCs) that exhibit 98% labeling efficiency...
February 11, 2019: ACS Applied Materials & Interfaces
Peter M George, Caroline M Patterson, Anna K Reed, Muhunthan Thillai
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with a poor prognosis. Lung transplantation is the only intervention shown to increase life expectancy for patients with IPF, but it is associated with disease-specific challenges. In this Review, we discuss the importance of a proactive approach to the management of IPF comorbidities, including gastro-oesophageal reflux, pulmonary hypertension, coronary artery disease, and malignancy. With a donor pool too small to meet demand and unacceptably high mortality on transplant waiting lists, we discuss different systems used internationally to facilitate organ allocation...
February 6, 2019: Lancet Respiratory Medicine
Antonio Citro, Philipp T Moser, Erica Dugnani, Konrad T Rajab, Xi Ren, Daniele Evangelista-Leite, Jonathan M Charest, Andrea Peloso, Bruno K Podesser, Fabio Manenti, Silvia Pellegrini, Lorenzo Piemonti, Harald C Ott
Islet transplantation is superior to extrinsic insulin supplementation in the treating severe Type 1 diabetes. However, its efficiency and longevity are limited by substantial islet loss post-transplantation due to lack of engraftment and vascular supply. To overcome these limitations, we developed a novel approach to bio-fabricate functional, vascularized islet organs (VIOs) ex vivo. We endothelialized acellular lung matrixes to provide a biocompatible multicompartment scaffold with an intact hierarchical vascular tree as a backbone for islet engraftment...
January 24, 2019: Biomaterials
Margaret M Hannan, Rongbing Xie, Jennifer Cowger, Stephan Schueler, Theo de By, Anne I Dipchand, Vivian H Chu, Ryan S Cantor, Christine E Koval, Thomas Krabatsch, Christopher S Hayward, Takeshi Nakatani, James K Kirklin
BACKGROUND: Despite advances in device technology and treatment strategies, infection remains a major cause of adverse events (AEs) in mechanical circulatory support (MCS) patients. To characterize the epidemiology of MCS infection, we examined the type, location, and timing of infection in the International Society for Heart and Lung Transplantation Registry (ISHLT) for Mechanically Assisted Circulatory Support (IMACS) over 3 years, 2013 to 2015. METHODS: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) definitions were used to categorize AE infections occurring in MCS patients within IMACS...
January 17, 2019: Journal of Heart and Lung Transplantation
Jun Kobayashi, Akihiko Kikuchi, Takao Aoyagi, Teruo Okano
Cell sheet tissue engineering is a concept for creating transplantable two-dimensional (2D) and three-dimensional (3D) tissues and organs. This review describes three elements of cell sheet tissue engineering in terms of the chemical and physical effects of material surfaces and the interfacial properties of cell sheets: preparation, harvesting/manipulation and transplantation of cell sheets. An essential technology for the preparation of cell sheets is the use of a temperature-responsive cell culture surface, where the surface of tissue culture polystyrene (TCPS) dish is modified with thin layer of temperature-responsive polymer, poly(N-isopropylacrylamide) (PIPAAm)...
January 26, 2019: Journal of Biomedical Materials Research. Part A
Matthias J Arlt, Aleksandar Kuzmanov, Jess G Snedeker, Bruno Fuchs, Unai Silvan, Adam A Sabile
BACKGROUND: Fascin-1, a prominent actin-bundling protein, is found to be upregulated in several human carcinomas. While it is accepted that Fascin-1 expression correlates with poor clinical outcome and decreased survival in various carcinomas, its role in sarcoma such as osteosarcoma (OS) remains unknown. In the present study, we evaluated the prognostic value and biological relevance of Fascin-1 in OS. METHODS: The correlation between Fascin-1 expression and the outcome of OS patients was determined by immunohistochemistry analysis of Fascin-1 expression in a tissue microarray of OS tissue specimens collected during primary tumor resection...
January 17, 2019: BMC Cancer
Wa Xian, Marcin Duleba, Yusuke Yamamoto, Matthew Vincent, Frank McKeon
Autologous transplantation of human epidermal stem cells cultured in Green's method is one of the first examples of utilizing adult stem cells in regenerative medicine. Using the same method, we cloned p63-expressing distal airway stem cells and showed their essential role in lung regeneration in a mouse model of acute respiratory distress syndrome. However, adult stem cells of columnar epithelial tissues had until recently evaded all attempts at cloning. To address this issue, we developed a novel technology that enabled cloning ground-state stem cells of the columnar epithelium...
December 16, 2018: Journal of Clinical Medicine
Paul A Reyfman, James M Walter, Nikita Joshi, Kishore R Anekalla, Alexandra C McQuattie-Pimentel, Stephen Chiu, Ramiro Fernandez, Mahzad Akbarpour, Ching-I Chen, Ziyou Ren, Rohan Verma, Hiam Abdala-Valencia, Kiwon Nam, Monica Chi, SeungHye Han, Francisco J Gonzalez-Gonzalez, Saul Soberanes, Satoshi Watanabe, Kinola J N Williams, Annette S Flozak, Trevor T Nicholson, Vince K Morgan, Deborah R Winter, Monique Hinchcliff, Cara L Hrusch, Robert D Guzy, Catherine A Bonham, Anne I Sperling, Remzi Bag, Robert B Hamanaka, Gökhan M Mutlu, Anjana V Yeldandi, Stacy A Marshall, Ali Shilatifard, Luis A N Amaral, Harris Perlman, Jacob I Sznajder, A Christine Argento, Colin T Gillespie, Jane Dematte, Manu Jain, Benjamin D Singer, Karen M Ridge, Anna P Lam, Ankit Bharat, Sangeeta M Bhorade, Cara J Gottardi, G R Scott Budinger, Alexander V Misharin
RATIONALE: The contributions of diverse cell populations in the human lung to pulmonary fibrosis pathogenesis are poorly understood. Single-cell RNA sequencing can reveal changes within individual cell populations during pulmonary fibrosis that are important for disease pathogenesis. OBJECTIVES: To determine whether single-cell RNA sequencing can reveal disease-related heterogeneity within alveolar macrophages, epithelial cells or other cell types in lung tissue from subjects with pulmonary fibrosis compared with controls...
December 15, 2018: American Journal of Respiratory and Critical Care Medicine
Sherif Assaad, Wolf B Kratzert, Albert C Perrino
PURPOSE OF REVIEW: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates...
February 2019: Current Opinion in Anaesthesiology
Thomas Lung, Lorenz Risch, Martin Risch, Benjamin Sakem, Reinhard Würzner, Urs Nydegger
The multi-tasking organ liver, which is the major synthesis site of most serum proteins, supplies humoral components of the innate, - including proteins of the complement system; and, less intensely, also of the acquired immune system. In addition to hepatocyte origins, C1q, factor D, C3, C7 and other protein components of the complement system are produced at various body locations by monocytes/macrophages, lymphocytes, adipocytes, endometrium, enterocytes, keratinocytes and epithelial cells; but the contribution of these alternate sites to the total serum concentrations is slight...
December 2018: Journal of Autoimmunity
Fozia Noor, Anne Kaysen, Paul Wilmes, Jochen G Schneider
The human gut microbiota gained tremendous importance in the last decade as next-generation technologies of sequencing and multiomics analyses linked the role of the microbial communities to host physiology and pathophysiology. A growing number of human pathologies and diseases are linked to the gut microbiota. One of the main mechanisms by which the microbiota influences the host is through its interactions with the host immune system. These interactions with both innate and adaptive host intestinal and extraintestinal immunity, although usually commensalistic even mutualistic with the host, in some cases lead to serious health effects...
October 4, 2018: Journal of Innate Immunity
Noritsugu Naito, Keith Cook, Yoshiya Toyoda, Norihisa Shigemura
Although lung transplantation is an effective treatment for end-stage lung failure, its limitations have led to renewed interest in artificial lung support for patients with lung failure. The use of ventricular assist devices has significantly improved the quality of life and survival of patients with end-stage heart failure. In contrast, there are no devices that can be used long term as destination therapy for end-stage lung failure, and there is a strong need for them. Extracorporeal membrane oxygenation is widely used as a temporary treatment for acute lung failure and as a bridge to lung transplant...
October 2, 2018: Journal of the American College of Cardiology
Yas Sanaiha, Katherine Bailey, Peter Downey, Young-Ji Seo, Esteban Aguayo, Vishal Dobaria, Richard J Shemin, Peyman Benharash
BACKGROUND: Extracorporeal membrane oxygenation is used as a life-sustaining measure in patients with acute or end-stage cardiac or respiratory failure. We analyzed national trends in extracorporeal membrane oxygenation use and outcomes and assessed the influence of hospital demographics. METHODS: Adult extracorporeal membrane oxygenation patients in the 2008-2014 National Inpatient Sample were evaluated. Patient and hospital characteristics, extracorporeal membrane oxygenation indication, mortality, and hospital costs were analyzed...
September 22, 2018: Surgery
Fabio Ius, Igor Tudorache, Gregor Warnecke
During recent years, continuous technological innovation has provoked an increase of extracorporeal life support (ECLS) use for perioperative cardiopulmonary support in lung transplantation. Initial results were disappointing, due to ECLS-specific complications and high surgical risk of the supported patients. However, the combination of improved patient management, multidisciplinary team work and standardization of ECLS protocols has recently yielded excellent results in several case series from high-volume transplant centres...
August 2018: Journal of Thoracic Disease
Grégory Ehx, Joan Somja, Hans-Jörg Warnatz, Caroline Ritacco, Muriel Hannon, Loïc Delens, Gilles Fransolet, Philippe Delvenne, Joséphine Muller, Yves Beguin, Hans Lehrach, Ludovic Belle, Stéphanie Humblet-Baron, Frédéric Baron
Despite the increasing use of humanized mouse models to study new approaches of graft-versus-host disease (GVHD) prevention, the pathogenesis of xenogeneic GVHD (xGVHD) in these models remains misunderstood. The aim of this study is to describe this pathogenesis in NOD/LtSz-Prkdcscid IL2rγtm1Wjl (NSG) mice infused with human PBMCs and to assess the impact of the expression of HLA-A0201 by NSG mice cells (NSG-HLA-A2/HHD mice) on xGVHD and graft-versus-leukemia (GvL) effects, by taking advantage of next-generation technologies...
2018: Frontiers in Immunology
Katherine A Young, Daniel F Dilling
The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overcome several stumbling blocks, including donor shortage, proper selection of candidates, primary graft dysfunction, and chronic lung allograft dysfunction. The advances and developments surrounding these factors will have a significant impact on shaping the field within the coming years...
August 29, 2018: Chest
Lara Pisani, Massimiliano Polastri, Angela Maria Grazia Pacilli, Stefano Nava
Extracorporeal lung support can be achieved using extracorporeal membrane oxygenation (ECMO) and extracorporeal CO2 removal. The ECMO systems allow a total lung support, providing both blood oxygenation and CO2 removal. Unlike ECMO, extracorporeal CO2 removal refers to an extracorporeal circuit that provides a partial lung support and selectively extracts CO2 from blood. The concept of partial extracorporeal lung support by removing only CO2 without effect on oxygenation was first proposed in 1977 by Kolobow and Gattinoni, with the aim to reduce breathing frequency, ventilator tidal volumes, and inspiratory pressures, facilitating lung-protective ventilation...
September 2018: Respiratory Care
Peter Betit
Although the fundamentals of extracorporeal membrane oxygenation (ECMO) have not changed in 3 decades, the technical elements continue to improve and have evolved from an assemblage of individual components to more integrated systems with added features, enhanced safety, and improved maneuverability. The introduction of polymethylpentene (PMP) fiber technology has expanded the development of artificial membranes that have low resistance, are more biocompatible, and can be used for extended durations. Extracorporeal carbon dioxide removal techniques continue to be enhanced as stand alone technology and modified renal dialysis systems are introduced...
September 2018: Respiratory Care
Francesco Petrella, Lorenzo Spaggiari
Lung transplantation remains the definitive curative treatment for end-stage lung disease. However, future applications of tissue bioengineering could overcome the donor organ shortage and the need for immunosuppression. The final goal of lung tissue engineering is to recreate the whole spectrum of specialized lung tissues and thereby provide physiologic functions through bioengineered conducting airways, vasculature and gas exchange tissue. This review focuses on ongoing research in artificial lung development, open questions, achievements to date and how tissue engineering and stem cell technology may further contribute to the clinical application of bioartificial lungs...
July 2018: Journal of Thoracic Disease
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