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TP23. TP023 LUNG TRANSPLANT: OUTCOME PREDICTORS AND THERAPEUTIC OPTIONS最新文献

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Utility of Remote Monitoring and Telemedicine in Lung Transplant Recipients During COVID19 Pandemic Restrictions covid - 19大流行期间肺移植受者远程监测和远程医疗的应用
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1791
E.S. Randhawa, R. Gupta, N. Marchetti, M. Gordon, G. Criner, S. Sehgal
Introduction: COVID19 pandemic has led to a significant increase in telemedicine utilization due to risk of healthcare acquired infection. Lung transplant recipients are high risk for infection and have extraordinary health care needs. The HGE remote symptom monitoring has been shown to be beneficial in COPD patients to decrease exacerbations and time to treatment1-8. During peak pandemic restrictions we transitioned to a telemedicine only system and patients were encouraged to enroll in the “HGE COVIDCare” for reporting daily symptoms suspicious for COVID19. With a combination of remote symptom monitoring and telemedicine, we aimed to provide early intervention and necessary care, while decreasing the risk of infection. This study assesses the feasibility and short-term outcomes of using this combination in lung transplant recipients. Methods: Single center, retrospective study of lung transplant recipients of who were enrolled in the HGE COVIDCare symptoms tracker program in March 2020. Pre-pandemic data was collected prior to March 15 and post pandemic restriction data was collected after July 15th, 2020. Patients were asked to report daily symptoms via HGE-COVID website, which was triaged by transplant nurses. We recorded self-reported symptoms from the symptom tracker, details of tele medicine visits and hospitalizations, and changes in pulmonary function tests. Results: The first 50 lung transplant recipients enrolled were included in this short-term analysis with most patients within one-year post transplant (66%). During the four-month pandemic restriction, 6 patients (12%) had “symptom events” reported via the tracker. None of the symptoms were due to COVID19. Etiologies included pneumonia, bronchial stenosis, diarrhea due to C diff and medication or symptoms self-resolving prior to team outreach. 8 patients (16%) were admitted to the hospital for non COVID indications and 2 patients died during this period due to sepsis. Post pandemic limitation PFTs were available for 35 (70%) patients. None of the patients had a decline in PFTs, compared to the “pre pandemic” values. The incidence of hospitalization or acute rejection was similar in the months preceding the pandemic compared to the 4-month pandemic restriction period. Conclusions: In lung transplant recipients, a combination of telemedicine and remote symptom monitoring is feasible and safe. It did not lead to increased rate of hospitalization, acute rejection or worsening lung function in this short term follow up. This model could be potentially followed to help decrease risk of healthcare acquired infections, patient visits and health care costs without impacting outcomes. .
导言:由于医疗保健获得性感染的风险,covid - 19大流行导致远程医疗使用率大幅增加。肺移植受者感染风险高,有特殊的保健需求。HGE远程症状监测已被证明对COPD患者减少恶化和治疗时间有益1-8。在大流行高峰期间,我们过渡到只使用远程医疗系统,并鼓励患者注册“HGE covid - care”,以便每天报告疑似covid - 19的症状。通过远程症状监测和远程医疗相结合,我们旨在提供早期干预和必要的护理,同时降低感染风险。本研究评估了在肺移植受者中使用这种组合的可行性和短期结果。方法:对2020年3月纳入HGE covid - care症状追踪项目的肺移植受者进行单中心、回顾性研究。大流行前数据收集于2020年3月15日之前,大流行后限制数据收集于2020年7月15日之后。患者被要求通过HGE-COVID网站报告每日症状,由移植护士进行分类。我们记录了症状追踪者自我报告的症状、远程医疗访问和住院的细节以及肺功能测试的变化。结果:入组的前50名肺移植受者被纳入这项短期分析,大多数患者在移植后一年内(66%)。在4个月的大流行限制期间,6名患者(12%)通过追踪器报告了“症状事件”。这些症状都不是由covid - 19引起的。病因包括肺炎、支气管狭窄、腹泻(C - diff所致)以及在团队外展前服药或症状自行消退。8例患者(16%)因非COVID适应症入院,2例患者在此期间因败血症死亡。35例(70%)患者可获得大流行后限制性pft。与“大流行前”的值相比,没有患者的pft下降。与4个月的大流行限制期相比,大流行前几个月住院或急性排斥反应的发生率相似。结论:在肺移植受者中,远程医疗与远程症状监测相结合是可行且安全的。在这个短期随访中,没有导致住院率增加、急性排斥反应或肺功能恶化。这一模式可能有助于降低医疗保健获得性感染的风险,患者就诊和医疗保健成本,而不会影响结果。
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引用次数: 0
Diaphragmatic Plication as a Strategy to Overcome Donor/Recipient Size Mismatch in Lung Transplantation 膈肌应用作为克服肺移植供体/受体大小不匹配的策略
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1792
E. Hyzny, E. Chan, T. Harano, P. Sanchez
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引用次数: 0
Impact of Blood Products Transfusion on Patients in the Immediate Post Lung Transplant Period: A Cohort Study 输血对肺移植术后患者的影响:一项队列研究
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1786
S. Beshay, Y. Wang, A. Siddiqui, E. Graviss, D. Nguyen, M. Al-Saadi
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引用次数: 0
Evaluating In Vivo Biomolecular Outcomes of Tacrolimus Immunosuppression in Lung Transplantation Using Novel Functional Assays 使用新的功能测定法评估他克莫司免疫抑制肺移植的体内生物分子结果
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1789
J. Macleod, M. He, K. Earasi, Z. Zhang, S. Floyd, M. Czarnecki, S. Struchen, R. Herrera, R. Nunoo-Asare, M. Burdick, H. Mannem, M. Weder, Y. Shim
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引用次数: 0
Characteristics of Bilateral Orthotopic Lung Transplant Patients that Develop Severe Perioperative Acute Kidney Injury 双侧原位肺移植患者发生严重围手术期急性肾损伤的特点
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1782
B. Bottiger, K. Subramaniam, F. Ius, G. Warnecke, M. Hartwig, G. Loor, D. Daoud, Q. Wei, M. Villavicencio-Theoduloz, A. Osho, D. Van raemdonck, S. Chandrashekaran, T. Machuca, Y. Toyoda, M. Kashem, S. Huddleston, M. Landeweer, P. Sanchez, N. Ryssel, A. Neyrinck
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引用次数: 0
Increased Cell Cycle Inhibitor Dosing Has Limited Impact on Clinical Outcomes After Lung Transplantation 增加细胞周期抑制剂剂量对肺移植后临床结果的影响有限
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1788
Eli Schwartz, J. Lawson, I. Robbins, C. Shaver
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引用次数: 0
Lung Transplantation Disparities Based on Diagnosis for Patients Bridging to Transplant on Extracorporeal Membrane Oxygenation 体外膜氧合诊断过渡性肺移植患者的差异
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1771
D. Furfaro, E. Rosenzweig, L. Shah, H. Robbins, M. Anderson, H. Kim, D. Abrams, C. Agerstrand, D. Brodie, J. Costa, P. Lemaitre, B. Stanifer, F. D'Ovidio, J. Sonett, S. Arcasoy, L. Benvenuto
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引用次数: 0
Epidemiology of Acute Cellular Rejection (ACR) Post-Lung Transplant - A Single Center Experience 肺移植后急性细胞排斥(ACR)的流行病学-单中心经验
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1779
A. Alsaghayer, A. Rabie, P. Garcha
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引用次数: 0
First Machine Learning, Web-Based Application That Predicts Post-Lung Transplantation Outcomes for Any Given Recipient-Donor Match 首个基于网络的机器学习应用程序,预测任何给定受体-供体匹配的肺移植后结果
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1772
F. Zafar, M. Hossain, Y. Zhang, A. Dani, M. Schecter, D. Hayes, M. Macaluso, C. Towe, D. Morales
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引用次数: 0
Increasing Relative Abundance of Pseudomonas Aeruginosa and Stenotrophomonas Maltophilia via 16S Sequencing Predicts Chronic Rejection After Lung Transplant 通过16S测序增加铜绿假单胞菌和嗜麦芽窄养单胞菌的相对丰度预测肺移植后的慢性排斥反应
Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1777
M. Combs, J. Luth, N. Falkowski, R. Chanderraj, N. Walker, J. Erb-Downward, V. Lama, R. Dickson
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引用次数: 0
期刊
TP23. TP023 LUNG TRANSPLANT: OUTCOME PREDICTORS AND THERAPEUTIC OPTIONS
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