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The lowest uric acid in kidney transplant and review of literature. 肾移植中最低尿酸及文献回顾。
IF 0.7 Q3 Medicine Pub Date : 2022-01-01
J Roozbeh, A Dehghani, A Haghpanah, L Malekmakan

Heredity hypouricemia is caused by renal hypouricemia or xanthinuria. Xanthinuria is divided into type 1 with deficiency of xanthine dehydrogenase and type 2 with xanthine dehydrogenase and aldehyde oxidase deficiency. We report a case of xanthinuria type 1 that developed with kidney failure. Hemodialysis was done for him, but kidney function was not improved, so a kidney transplant was performed for him. His serum uric acid was 0.1 mg/dl before and after transplantation.

遗传性低尿酸血症是由肾性低尿酸或黄嘌呤尿引起的。黄嘌呤尿分为黄嘌呤脱氢酶缺乏型和黄嘌呤脱氢酶和醛氧化酶缺乏型。我们报告一例黄嘌呤尿1型发展与肾功能衰竭。虽然进行了血液透析,但肾脏功能没有改善,因此进行了肾脏移植手术。移植前后血清尿酸均为0.1 mg/dl。
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引用次数: 0
Anesthesia Aspects of Multivisceral Transplantation: A Case Series Study. 多脏器移植的麻醉方面:一个案例系列研究。
IF 0.7 Q3 Medicine Pub Date : 2022-01-01
M B Khosravi, V Naderi-Boldaji, F Khalili, M A Sahmeddini, M H Eghbal, P Vatankhah, H Nikoupour, A Shamsaeefar, S Ghazanfar Tehran

Background: Multi-visceral transplantation (MvTx) usually refers to the transplantation of more than three intra-abdominal organs. A successful MvTx requires strong multidisciplinary teamwork of transplant surgeons, anesthesiologists, and intensivists.

Case presentation: We present five cases of MvTx with a history of short bowel syndrome admitted to the Abu-Ali Sina Hospital, Shiraz, Iran from May 2019 to January 2020 and describe anesthetic considerations in MvTx. Subjects were identified (4F/1M) with a mean age of 43 years old (range 35-51). The most frequent cause of intestinal failure was portal vein thrombosis, followed by bowel gangrene and short bowel syndrome. The mean ±SD duration of the operation was 360±60 min. The bleeding volume was approximately 2600±1474 cc, and 4±1 bags of packed red blood cells were transfused. Sepsis was the main cause of death in our series.

Conclusion: Careful preoperative planning, vigilant intraoperative anesthetic management, and prevention of postoperative infection are imperative to achieve the best outcomes.

背景:多脏器移植(MvTx)通常是指腹腔内三个以上脏器的移植。一个成功的MvTx需要强大的多学科团队合作,包括移植外科医生、麻醉师和重症监护医师。病例介绍:我们报告了2019年5月至2020年1月在伊朗设拉子的Abu-Ali Sina医院收治的5例有短肠综合征病史的MvTx病例,并描述了MvTx的麻醉注意事项。受试者被确定(4F/1M),平均年龄43岁(范围35-51岁)。肠衰竭最常见的原因是门静脉血栓形成,其次是肠坏疽和短肠综合征。手术时间平均±SD为360±60 min,出血量约2600±1474 cc,输注红血球4±1袋。脓毒症是我们研究的主要死亡原因。结论:严密的术前计划,术中麻醉管理,预防术后感染是达到最佳效果的关键。
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引用次数: 0
Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country. 欧盟国家联合心肺移植的现状及预后演变。
IF 0.7 Q3 Medicine Pub Date : 2022-01-01
R Lopez-Vilella, M Gomez Bueno, F Gonzalez Vflchez, A Sole Jover, R Laporta Hernandez, R Vicente Guillen, A I Gonzalez Roman, I Sanchez-Lazaro, F Hernandez Perez, G Sales Badfa, M D M Cordoba Pelaez, S Torregrosa Puerta, A Forteza Gil, L Martinez Dolz, J Segovia Cubero, L Almenar Bonet

Background: This study aims to evaluate the entire experience in heart-lung transplantation (HLTx) in a country of the European Union with 47 million inhabitants according to the etiologies that motivated the procedure.

Methods: A retrospective study on 1,751 consecutive transplants (HLTx: 78) was performed from 1990 to 2020 in two centers. Overall survival, adjusted for clinical profile and etiological subgroups, was compared. 7 subgroups were considered: 1) Cardiomyopathy with pulmonary hypertension (CM + PH). 2) Eisenmenger syndrome. 3) Congenital heart disease (CHD). 4) Idiopathic pulmonary arterial hypertension (IPAH). 5) Cystic fibrosis. 6) Chronic obstructive pulmonary disease (COPD)/Emphysema. 7) Diffuse interstitial lung disease (ILD).

Results: Early mortality was 44% and that of the rest of the follow-up was 31%. There were differences between HTLx and HTx in survival, also comparing groups with a similar clinical profile with propensity score (p= 0.04). Median survival was low in CM + PH (18 days), ILD (29 days) and CHD (114 days), intermediate in Eisenmenger syndrome (600 days), and longer in IPAH, COPD/Emphysema and cystic fibrosis.

Conclusion: HLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival.

背景:本研究旨在评估一个拥有4700万居民的欧盟国家的心肺移植(HLTx)的整体经验,根据动机的病因进行手术。方法:回顾性研究1990年至2020年在两个中心进行的1,751例连续移植手术(HLTx: 78)。根据临床情况和病因亚组进行调整后的总生存率比较。分为7个亚组:1)心肌病合并肺动脉高压(CM + PH)。2)艾森曼格综合症。3)先天性心脏病(CHD)。4)特发性肺动脉高压(IPAH)。5)囊性纤维化。6)慢性阻塞性肺病(COPD)/肺气肿。7)弥漫性间质性肺疾病。结果:早期死亡率为44%,其余随访期死亡率为31%。HTLx组和HTx组的生存率存在差异,临床特征相似组的倾向评分也存在差异(p= 0.04)。CM + PH(18天)、ILD(29天)和CHD(114天)的中位生存期较低,艾森曼格综合征(600天)的中位生存期中等,IPAH、COPD/肺气肿和囊性纤维化的中位生存期较长。结论:HLTx病死率高。病因分析是最大的兴趣,使器官和提高生存率。
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引用次数: 0
Reversible Calcineurin Inhibitor-associated Sensorimotor Polyneuropathy in a Lung Transplant Recipient: A Case Report. 可逆钙调磷酸酶抑制剂相关的感觉运动多发性神经病在肺移植受体:一个病例报告。
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
T Antychin, J A Zarowski, V Verplancke, J M H Hendriks, S K Yogeswaran, P Lauwers, K Lamote, J M Kwakkel-van Erp

Calcineurin inhibitors (CNIs) are regarded as a corner stone in immunosuppressive therapy after solid organ transplantation. However, neurotoxicity is a common side effect of CNIs, resulting in a wide range of neurological symptoms such as headache, tremor and seizures. In this case report, we describe a patient who developed severe motor and sensory neuron dysfunction related to CNIs after bilateral lung transplantation, which resolved after halting CNI and switching to a mammalian Target of Rapamycin-inhibitor.

钙调磷酸酶抑制剂(CNIs)被认为是实体器官移植后免疫抑制治疗的基石。然而,神经毒性是CNIs的一个常见副作用,可导致广泛的神经系统症状,如头痛、震颤和癫痫发作。在本病例报告中,我们描述了一位患者,他在双侧肺移植后出现了与CNI相关的严重运动和感觉神经元功能障碍,在停止CNI并切换到哺乳动物靶向雷帕霉素抑制剂后,这种功能障碍得到了解决。
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引用次数: 0
Virtual Crossmatching in Kidney Transplantation, Shiraz Experience in Development of a Web-Based Program. 肾移植中的虚拟交叉匹配,设拉子基于web程序开发的经验。
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
N Jamshidian Tehrani, B Geramizadeh, S A Malekhosseini, S Nikeghbalian, A Bahador, S Gholami, G A Raees Jalali, J Roozbeh, M H Anbardar, N Soleimani, N Rasaei, S Mohammadzadeh

Background: Kidney transplantation can increase survival and quality of life in patients with end-stage renal disease. In any allocation system, the crossmatch test plays an essential role in donor-recipient compatibility.

Objective: In this study, we aim to test the benefits of a web-based program that captures HLA antibody analyses and provides a report to allow fast and accurate virtual crossmatches.

Methods: One hundred potential recipients in the waiting list of renal transplants were selected. The included patients all had a complete HLA antibody profile. Also, 10 potential donors from previous kidney transplants (2020), with available HLA typing results for A, B, and DR locus, were also selected. A comparison was made between 100 recipients against ten potential donors, and virtual crossmatching (VXM) was performed by the web-based program and manually by an experienced immunologist.

Results: The average time for a manual VXM was 30 minutes per patient, while the virtual cross web-based program took 5 minutes per patient. In 12% of the manual VXM cases, a secondary review of data improved final results. In two manual virtual crossmatches, the VXM results had errors in matching recipient antibodies with the donor HLA typing that could affect the final decision for transplantation.

Conclusion: In conclusion, a web-based VXM program that assesses HLA data can accurately perform a VXM with fewer human errors. It is especially true for highly sensitized candidates.

背景:肾移植可提高终末期肾病患者的生存和生活质量。在任何分配系统中,交叉配型试验在供体-受体配型中起着至关重要的作用。目的:在本研究中,我们旨在测试基于网络的程序的好处,该程序捕获HLA抗体分析并提供报告,以实现快速准确的虚拟交叉匹配。方法:从肾移植候诊名单中抽取100例潜在受者。纳入的患者均具有完整的HLA抗体谱。此外,还选择了10名来自既往肾脏移植(2020年)的潜在供体,这些供体具有A、B和DR位点的可用HLA分型结果。在100名受者和10名潜在供者之间进行比较,虚拟交叉匹配(VXM)由基于网络的程序和经验丰富的免疫学家手动执行。结果:人工VXM的平均时间为每位患者30分钟,而虚拟跨网络程序的平均时间为每位患者5分钟。在12%的手工VXM病例中,对数据的二次回顾改善了最终结果。在两次人工虚拟交叉配型中,VXM结果在受体抗体与供体HLA分型匹配时存在错误,这可能影响移植的最终决定。结论:总之,基于网络的评估HLA数据的VXM程序可以准确地执行VXM,减少人为错误。对于高度敏感的候选人尤其如此。
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引用次数: 0
Case of Renal Aspergillosis after Heart Transplant: Diagnosis and Treatment. 心脏移植后肾曲霉病1例:诊断与治疗。
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
M Mahdavi, G Mortaz-Hejri, H Shahzadi, H R Pouraliakbar, A Amin, M Hesami, B Naghavi

Invasive aspergillosis (IA) is a severe complication after heart transplantation (HTx), with a high mortality rate. Invasive pulmonary aspergillosis (IPA) is the most common presentation. We herein describe a unique case of Renal aspergillosis (RAsp) diagnosed on month 10 post-HTx with no known risk factors for IPA in cardiac transplant recipients. The diagnosis of RAsp was made based on radiographic findings, renal biopsy, and tissue cultures. The patient initially received combined antifungal therapy (caspofungin and voriconazole) without radical or partial nephrectomy, followed by voriconazole maintenance monotherapy with favorable clinical outcomes.

侵袭性曲霉病(Invasive aspergilllosis, IA)是心脏移植术后的严重并发症,死亡率高。侵袭性肺曲霉病(IPA)是最常见的表现。我们在此描述一个独特的病例肾曲霉病(RAsp)诊断后10个月htx没有已知的危险因素IPA心脏移植受者。RAsp的诊断是基于影像学表现、肾活检和组织培养。患者最初接受联合抗真菌治疗(卡泊芬净和伏立康唑),未进行完全或部分肾切除术,随后接受伏立康唑维持单药治疗,临床结果良好。
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引用次数: 0
COVID-19 in Kidney Transplantation. COVID-19在肾移植中的应用
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
P K Garcia-Padilla, G Elías, P Paola, O Viviana

Increased mortality of COVID-19 has been reported in older patients with diabetes, high blood pressure, lung disease and immunocompromised people such as kidney transplant recipients. Both the behavior of the viral infection and the treatments proposed so far interact with the state of immunosuppression and immunosuppressants. Herein, we report two cases of kidney transplant recipients with COVID-19 infection. The first patient presented with gastrointestinal symptoms and progressively advanced to multilobar pneumonia. The second case presented with fever accompanied by gastrointestinal and urinary symptoms and dry cough. Both patients responded appropriately to treatment.

据报道,患有糖尿病、高血压、肺病和免疫功能低下的老年患者(如肾移植受者)的新冠肺炎死亡率增加。病毒感染的行为和迄今为止提出的治疗方法都与免疫抑制和免疫抑制剂的状态相互作用。在此,我们报告了两例肾移植受者感染新冠肺炎的病例。第一例患者出现胃肠道症状,并逐渐发展为多叶肺炎。第二例出现发烧,伴有胃肠道和泌尿系统症状以及干咳。两名患者对治疗的反应都很好。
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引用次数: 0
Impact of G-CSF Therapy on Leukopenia and Acute Rejection Following Kidney Transplantation. G-CSF治疗对肾移植后白细胞减少和急性排斥反应的影响。
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
J Schneider, M Henningsen, P Pisarski, G Walz, B Jänigen

Background: Leukopenia is a common problem after kidney transplantation. The therapeutic approach typically includes a reduction of the immunosuppressive therapy, which is associated with an increased risk of rejection and allograft loss. Granulocyte colony-stimulating factor (G-CSF) is used as a therapeutic option to raise the leukocyte blood count; however, the effect on acute rejections is controversial.

Objective: The goal of this study is to examine the incidence of acute rejections following G-CSF therapy.

Methods: We retrospectively evaluated patients with leukopenia following kidney transplantation and GCSF therapy between January 2007 and December 2017 at our center compared to controls with matched minimal leucocyte blood count in a matched pair analysis.

Results: We identified 12 patients, who received G-CSF therapy with a cumulative dose of 10.74 µg/kg body weight over a time frame of 4.3 days. G-CSF therapy resulted in a significantly shorter time period with leucocytes <3,000/µL (9.5 vs. 16.6 days), but also trended towards an increased risk of rejection within the next 30 days with three patients in the G-CSF group and no patient in the control group (p=0.06) developing an acute biopsy-proven rejection. Infection and mortality rate in the subsequent year were not different between groups.

Conclusion: G-CSF therapy decreases the duration of leukopenia post-kidney transplantation, but may also increase the risk of an acute rejection.

背景:白细胞减少是肾移植后常见的问题。治疗方法通常包括减少免疫抑制治疗,这与排斥和同种异体移植物丢失的风险增加有关。粒细胞集落刺激因子(G-CSF)被用作提高白细胞计数的治疗选择;然而,对急性排斥反应的影响是有争议的。目的:本研究的目的是检查G-CSF治疗后急性排斥反应的发生率。方法:我们回顾性评估2007年1月至2017年12月在本中心接受肾移植和GCSF治疗后白细胞减少的患者,并在配对对分析中与白细胞计数最小匹配的对照组进行比较。结果:我们确定了12例患者,他们接受了g - csf治疗,累积剂量为10.74µg/kg体重,时间为4.3天。结论:G-CSF治疗可减少肾移植后白细胞减少的持续时间,但也可能增加急性排斥反应的风险。
{"title":"Impact of G-CSF Therapy on Leukopenia and Acute Rejection Following Kidney Transplantation.","authors":"J Schneider,&nbsp;M Henningsen,&nbsp;P Pisarski,&nbsp;G Walz,&nbsp;B Jänigen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Leukopenia is a common problem after kidney transplantation. The therapeutic approach typically includes a reduction of the immunosuppressive therapy, which is associated with an increased risk of rejection and allograft loss. Granulocyte colony-stimulating factor (G-CSF) is used as a therapeutic option to raise the leukocyte blood count; however, the effect on acute rejections is controversial.</p><p><strong>Objective: </strong>The goal of this study is to examine the incidence of acute rejections following G-CSF therapy.</p><p><strong>Methods: </strong>We retrospectively evaluated patients with leukopenia following kidney transplantation and GCSF therapy between January 2007 and December 2017 at our center compared to controls with matched minimal leucocyte blood count in a matched pair analysis.</p><p><strong>Results: </strong>We identified 12 patients, who received G-CSF therapy with a cumulative dose of 10.74 µg/kg body weight over a time frame of 4.3 days. G-CSF therapy resulted in a significantly shorter time period with leucocytes <3,000/µL (9.5 vs. 16.6 days), but also trended towards an increased risk of rejection within the next 30 days with three patients in the G-CSF group and no patient in the control group (p=0.06) developing an acute biopsy-proven rejection. Infection and mortality rate in the subsequent year were not different between groups.</p><p><strong>Conclusion: </strong>G-CSF therapy decreases the duration of leukopenia post-kidney transplantation, but may also increase the risk of an acute rejection.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717965/pdf/ijotm-12-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39788017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Importance of miR-UL-148D Expression Pattern in Cytomegalovirus Infected Transplant Patients. 巨细胞病毒感染移植患者体内 miR-UL-148D 表达模式的重要性
IF 0.3 Q4 TRANSPLANTATION Pub Date : 2021-01-01
M Golshan, R Yaghobi, B Geramizadeh, A Afshari, J Roozbeh, S A Malek-Hosseini

Background: MicroRNAs (miRNAs) are endogenous, 18-22 nucleotide non-coding RNA molecules. Human cytomegalovirus (HCMV) is a ubiquitous and particular herpes virus that encodes miRNAs, which increases gradually in the presence of infection. One of the important viral miRNAs is HCMV-miRUL-148D, which plays a role in establishing and maintaining viral latency.

Objective: The current study aimed to evaluate the expression levels of HCMV-miRUL-148D in active and inactive HCMV infected transplant patient groups compared to healthy individuals.

Methods: Total RNA was extracted from blood samples of 60 solid organ transplant patients and 30healthy controls. In-house SYBR Green Real-Time PCR evaluated the expression levels of studied miRNAand gene.

Results: The expression level of the UL-148D gene was significantly higher in the active HCMV infectedpatients (p=0.001) compared to other groups. While the miRUL-148D expression level significantly increased in the inactive HCMV-infected patients (p<0.001) compared to other groups.

Conclusion: Increased miRUL-148D expression level in the inactive HCMV-infected transplant patients indicates the potential role of this miRUL-148D as a biomarker of the HCMV latent stage.

背景:微小RNA(miRNA)是一种内源性、18-22个核苷酸的非编码RNA分子。人类巨细胞病毒(HCMV)是一种无处不在的特殊疱疹病毒,它编码的 miRNAs 在感染时会逐渐增加。其中一个重要的病毒 miRNA 是 HCMV-miRUL-148D,它在建立和维持病毒潜伏期方面发挥作用:本研究旨在评估活动性和非活动性 HCMV 感染移植患者群体与健康人相比的 HCMV-miRUL-148D 表达水平:方法:从 60 名实体器官移植患者和 30 名健康对照者的血液样本中提取总 RNA。方法:从 60 名实体器官移植患者和 30 名健康对照者的血液样本中提取总 RNA,并在内部用 SYBR Green Real-Time PCR 评估所研究的 miRNA 和基因的表达水平:结果:与其他组别相比,活动性 HCMV 感染者的 UL-148D 基因表达水平明显更高(p=0.001)。而在非活动性 HCMV 感染者中,miRUL-148D 的表达水平明显升高(P=0.001):在非活动性 HCMV 感染移植患者中,miRUL-148D 表达水平的升高表明,miRUL-148D 有可能成为 HCMV 潜伏期的生物标志物。
{"title":"Importance of miR-UL-148D Expression Pattern in Cytomegalovirus Infected Transplant Patients.","authors":"M Golshan, R Yaghobi, B Geramizadeh, A Afshari, J Roozbeh, S A Malek-Hosseini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs (miRNAs) are endogenous, 18-22 nucleotide non-coding RNA molecules. Human cytomegalovirus (HCMV) is a ubiquitous and particular herpes virus that encodes miRNAs, which increases gradually in the presence of infection. One of the important viral miRNAs is HCMV-miRUL-148D, which plays a role in establishing and maintaining viral latency.</p><p><strong>Objective: </strong>The current study aimed to evaluate the expression levels of HCMV-miRUL-148D in active and inactive HCMV infected transplant patient groups compared to healthy individuals.</p><p><strong>Methods: </strong>Total RNA was extracted from blood samples of 60 solid organ transplant patients and 30healthy controls. In-house SYBR Green Real-Time PCR evaluated the expression levels of studied miRNAand gene.</p><p><strong>Results: </strong>The expression level of the <i>UL-148D</i> gene was significantly higher in the active HCMV infectedpatients (p=0.001) compared to other groups. While the miRUL-148D expression level significantly increased in the inactive HCMV-infected patients (p<0.001) compared to other groups.</p><p><strong>Conclusion: </strong>Increased miRUL-148D expression level in the inactive HCMV-infected transplant patients indicates the potential role of this miRUL-148D as a biomarker of the HCMV latent stage.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758995/pdf/ijotm-12-46.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10497125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bicarbonate in Arteries Measured Preoperatively for Cadaveric Single-lung Transplantation is Related to Intraoperative Extra-Corporeal Membrane Oxygenation Use: A Retrospective Preliminary Study. 尸体单肺移植术前测量动脉碳酸氢盐与术中体外膜氧合使用有关:一项回顾性初步研究。
IF 0.7 Q3 Medicine Pub Date : 2021-01-01
N Kobayashi, H Toyama, R Kubo, Y Matsuda, Y Okada, Y Ejima, M Yamauchi

Background: There are no known predictors of extracorporeal membrane oxygenation (ECMO) induction for single lung transplantation.

Objective: The purpose of the present study was to clarify the relationship between variables and ECMO requirements in single lung transplantation.

Methods: This study included adult patients who underwent cadaveric single lung transplantation between 2010 and 2019. After general anesthesia, the transplanted lungs were ventilated in all cases. The analysis included 38 patients in the ECMO required (RQ) group and 12 patients in the ECMO non-required (FR) group. Comparisons were made between the two groups for data affecting ECMO implementation, and data that were significantly different were subjected to multivariate analysis.

Results: Prior to anesthesia, the bicarbonate (HCO3-) value of the FR group was lower than that of the RQ group (24.6±2.7 vs. 29.7±5.3 mmol/L, p=0.005). Multivariate analysis showed that the cut-off bicarbonate value was 29.6. The area under the receiver operating characteristic curve (AUROC) of the model was 0.869 (R2: 0.331), with a sensitivity of 79% and a specificity of 88%. The odds ratio was 1.63 for every unit increase in the bicarbonate value (95%CI: 1.11-2.39, p<0.001). Further, the FR group had higher arterial blood pressure (mean: 79.0±11.5 vs. 68.9±8.3 mmHg, p=0.030), less blood loss (432±385 vs. 1,623±1,997 g, p<0.001), shorter operation time (417±44 vs. 543±111 min, p<0.001), and shorter ICU stay (11±9 vs. 25±38 days, p=0.039).

Conclusion: Preoperative evaluation of bicarbonate could predict the need for ECMO for single lung transplantation.

背景:目前还没有已知的预测单肺移植诱导体外膜氧合(ECMO)的因素。目的:本研究的目的是澄清变量与单肺移植ECMO需求之间的关系。方法:本研究纳入了2010年至2019年间接受尸体单肺移植的成年患者。全麻后,移植肺通气。该分析包括38例需要ECMO (RQ)组患者和12例不需要ECMO (FR)组患者。比较两组影响ECMO实施的数据,对差异显著的数据进行多变量分析。结果:麻醉前,FR组碳酸氢盐(HCO3-)值低于RQ组(24.6±2.7 vs. 29.7±5.3 mmol/L, p=0.005)。多变量分析显示,碳酸氢盐临界值为29.6。该模型的受试者工作特征曲线下面积(AUROC)为0.869 (R2: 0.331),灵敏度为79%,特异性为88%。碳酸氢盐值每增加一个单位,优势比为1.63 (95%CI: 1.11-2.39)。结论:术前碳酸氢盐评估可预测单肺移植是否需要ECMO。
{"title":"Bicarbonate in Arteries Measured Preoperatively for Cadaveric Single-lung Transplantation is Related to Intraoperative Extra-Corporeal Membrane Oxygenation Use: A Retrospective Preliminary Study.","authors":"N Kobayashi,&nbsp;H Toyama,&nbsp;R Kubo,&nbsp;Y Matsuda,&nbsp;Y Okada,&nbsp;Y Ejima,&nbsp;M Yamauchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There are no known predictors of extracorporeal membrane oxygenation (ECMO) induction for single lung transplantation.</p><p><strong>Objective: </strong>The purpose of the present study was to clarify the relationship between variables and ECMO requirements in single lung transplantation.</p><p><strong>Methods: </strong>This study included adult patients who underwent cadaveric single lung transplantation between 2010 and 2019. After general anesthesia, the transplanted lungs were ventilated in all cases. The analysis included 38 patients in the ECMO required (RQ) group and 12 patients in the ECMO non-required (FR) group. Comparisons were made between the two groups for data affecting ECMO implementation, and data that were significantly different were subjected to multivariate analysis.</p><p><strong>Results: </strong>Prior to anesthesia, the bicarbonate (HCO3-) value of the FR group was lower than that of the RQ group (24.6±2.7 vs. 29.7±5.3 mmol/L, p=0.005). Multivariate analysis showed that the cut-off bicarbonate value was 29.6. The area under the receiver operating characteristic curve (AUROC) of the model was 0.869 (R2: 0.331), with a sensitivity of 79% and a specificity of 88%. The odds ratio was 1.63 for every unit increase in the bicarbonate value (95%CI: 1.11-2.39, p<0.001). Further, the FR group had higher arterial blood pressure (mean: 79.0±11.5 vs. 68.9±8.3 mmHg, p=0.030), less blood loss (432±385 vs. 1,623±1,997 g, p<0.001), shorter operation time (417±44 vs. 543±111 min, p<0.001), and shorter ICU stay (11±9 vs. 25±38 days, p=0.039).</p><p><strong>Conclusion: </strong>Preoperative evaluation of bicarbonate could predict the need for ECMO for single lung transplantation.</p>","PeriodicalId":14242,"journal":{"name":"International Journal of Organ Transplantation Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758997/pdf/ijotm-12-37.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10497130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International Journal of Organ Transplantation Medicine
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