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5. Broad Decline in Viral Infections During COVID-19 Lockdown: Association with Lung Function in Lung Transplant Recipients

Author

de Zwart, A.E., Riezebos-Brilman, A., Lunter, G., Neerken, E., Van Leer, C., Alffenaar, J.C., Van Gemert, J.P., Erasmus, M.E., Gan, C.T., Kerstjens, H.A., Vonk, J.M., Verschuuren, E.A., Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), and Groningen Research Institute for Asthma and COPD (GRIAC)

Subjects
Coronavirus, Pulmonary and Respiratory Medicine, Transplantation, COVID-19, Surgery, Cardiology and Cardiovascular Medicine
Abstract

Purpose In April 2020 COVID-19 lockdown measures were instigated leading to a dramatic drop in non-COVID respiratory virus infections (RVI). This provided a unique situation to assess the impact of RVI on annual FEV1 decline, episodes of temporary drop in lung function suggestive of infection (TDLF) and CLAD in lung transplant recipients (LTR). Methods All lung function tests (LFT) of LTR transplanted between 2009-April 2020 were used from post-transplant baseline onward. LFT were censored after COVID-19 infection. Weekly RVI counts from the virology department defined RVI pressure over time. TDLF was defined as sudden, reversible FEV1 drop compared to previous 4 values (any TDLF ≥10% and ≥200ml, severe TDLF ≥20% and ≥500ml). Annual FEV1 decline was estimated using linear mixed effects models with separate estimates for 2009/20 and 2020/21. Effect modification by TDLF frequency of individual LTR (two subgroups, split at median) and RVI pressure was tested. Rates of CLAD and TDLF were analyzed over time. Results 479 LTR (12,775 LFT) were included. Annual FEV1 change in 2009/20 was -114ml [95%CI -133; -94], while in 2020/21 this was significantly less: 5ml [-38; 48] (p

Published
2022

7. TTV Load is Associated with SARS-CoV-2 Vaccination Response in Lung Transplant Recipients

Author

Verschuuren, E.A., primary, Hoek, R., additional, de Vries, R.D., additional, van Baarle, D., additional, van der Heiden, M., additional, van Gemert, J., additional, Gore, E., additional, Niesters, H.G., additional, Erasmus, M.E., additional, Hellemons, M.E., additional, Scherbeijn, S., additional, van Kessel, C.H. Geurts, additional, and van Leer Buter, C., additional

Published
2022
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9. Muscle mass, muscle strength and mortality in kidney transplant recipients: results of the TransplantLines Biobank and Cohort Study.

Author

van Vliet, Iris M.Y., Post, Adrian, Kremer, Daan, Boslooper‐Meulenbelt, Karin, van der Veen, Yvonne, de Jong, Margriet F.C., Pol, Robert A., Dijkstra, G., de Meijer, V.E., Leuvenink, H.G.D., Bakker, S.J.L., Gan, C.T., Sanders, J.S.F., Verschuuren, E.A.M., Damman, K., Lexmond, W.S., Blokzijl, J., de Borst, M.H., Erasmus, M.E., and Porte, R.J.

Published
2022
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11. Muscle mass, muscle strength and mortality in kidney transplant recipients: results of the TransplantLines Biobank and Cohort Study

Author

Vliet, Iris M.Y., Post, Adrian, Kremer, Daan, Boslooper‐Meulenbelt, Karin, Veen, Yvonne, Jong, Margriet F.C., Pol, Robert A., Dijkstra, G., Meijer, V.E., Leuvenink, H.G.D., Bakker, S.J.L., Gan, C.T., Sanders, J.S.F., Verschuuren, E.A.M., Damman, K., Lexmond, W.S., Blokzijl, J., Borst, M.H., Erasmus, M.E., Porte, R.J., Boer, M.T., Pol, R.A., Berger, S.P., Eisenga, M.F., Neto, A.W. Gomes, Kremer, D., Londen, M., Jong, J.H. Annema‐de, Siebelink, M.J., Pelt, L.J., Niesters, H.G.M., Bodewes, F.A.J.A., Hepkema, B.G., Ranchor, A.V., Douwes, R.M., Jager‐Wittenaar, Harriët, Navis, Gerjan J., and Bakker, Stephan J.L.

Abstract

Survival of kidney transplant recipients (KTR) is low compared with the general population. Low muscle mass and muscle strength may contribute to lower survival, but practical measures of muscle status suitable for routine care have not been evaluated for their association with long‐term survival and their relation with each other in a large cohort of KTR. Data of outpatient KTR ≥ 1 year post‐transplantation, included in the TransplantLines Biobank and Cohort Study (ClinicalTrials.govIdentifier: NCT03272841), were used. Muscle mass was determined as appendicular skeletal muscle mass indexed for height2(ASMI) through bio‐electrical impedance analysis (BIA), and by 24‐h urinary creatinine excretion rate indexed for height2(CERI). Muscle strength was determined by hand grip strength indexed for height2(HGSI). Secondary analyses were performed using parameters not indexed for height2. Cox proportional hazards models were used to investigate the associations between muscle mass and muscle strength and all‐cause mortality, both in univariable and multivariable models with adjustment for potential confounders, including age, sex, body mass index (BMI), estimated glomerular filtration rate (eGFR) and proteinuria. We included 741 KTR (62% male, age 55 ± 13 years, BMI 27.3 ± 4.6 kg/m2), of which 62 (8%) died during a median [interquartile range] follow‐up of 3.0 [2.3–5.7] years. Compared with patients who survived, patients who died had similar ASMI (7.0 ± 1.0 vs. 7.0 ± 1.0 kg/m2; P= 0.57), lower CERI (4.2 ± 1.1 vs. 3.5 ± 0.9 mmol/24 h/m2; P< 0.001) and lower HGSI (12.6 ± 3.3 vs. 10.4 ± 2.8 kg/m2; P< 0.001). We observed no association between ASMI and all‐cause mortality (HR 0.93 per SD increase; 95% confidence interval [CI] [0.72, 1.19]; P= 0.54), whereas CERI and HGSI were significantly associated with mortality, independent of potential confounders (HR 0.57 per SD increase; 95% CI [0.44, 0.81]; P= 0.002 and HR 0.47 per SD increase; 95% CI [0.33, 0.68]; P< 0.001, respectively), and associations of CERI and HGSI with mortality remained independent of each other (HR 0.68 per SD increase; 95% CI [0.47, 0.98]; P= 0.04 and HR 0.53 per SD increase; 95% CI [0.36, 0.76]; P= 0.001, respectively). Similar associations were found for unindexed parameters. Higher muscle mass assessed by creatinine excretion rate and higher muscle strength assessed by hand grip strength are complementary in their association with lower risk of all‐cause mortality in KTR. Muscle mass assessed by BIA is not associated with mortality. Routine assessment using both 24‐h urine samples and hand grip strength is recommended, to potentially target interdisciplinary interventions for KTR at risk for poor survival to improve muscle status.

Published
2022
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12. Histological Analysis of Donor Lung Derived Thrombi

Author

Bergtop, J., primary, Zhang, K.L., additional, Timens, W., additional, Venema, L.H., additional, van de Wauwer, C., additional, Erasmus, M.E., additional, Gan, C.T., additional, Lisman, T., additional, and Verschuuren, E.A., additional

Published
2021
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18. Distribution of Cardioembolic Stroke: A Cohort Study

Author

Pierik, R., Algra, A., Dijk, E. van, Erasmus, M.E., Gelder, I.C. van, Koudstaal, P.J., Luijckx, G.J.R., Nederkoorn, P.J., Oostenbrugge, R.J. van, Ruigrok, Y.M., Scheeren, T.W.L., Uyttenboogaart, M., Visser, M.C., Wermer, M.J.H., Bergh, W.M. van den, Parelsnoer Inst-Cerebrovasc Accid, Neurology, Cardiovascular Centre (CVC), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Groningen Institute for Organ Transplantation (GIOT), ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, MUMC+: Hersen en Zenuw Centrum (3), RS: Carim - B05 Cerebral small vessel disease, MUMC+: MA Neurologie (3), and Klinische Neurowetenschappen

Subjects
Male, Thromboembolic stroke, SUBCLINICAL ATRIAL-FIBRILLATION, 030204 cardiovascular system & hematology, Brain Ischemia, Coronary artery disease, 0302 clinical medicine, Risk Factors, Prospective Studies, Registries, Child, Stroke, Netherlands, Aged, 80 and over, RISK, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Cardiovascular diseases, Neurology, Cerebrovascular Circulation, Child, Preschool, symbols, Cardiology, Female, Cardiology and Cardiovascular Medicine, Cohort study, Adult, medicine.medical_specialty, Adolescent, Heart Diseases, Clinical Neurology, Risk Assessment, CLASSIFICATION, 03 medical and health sciences, symbols.namesake, Young Adult, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Thromboembolism, Journal Article, medicine, Humans, Poisson regression, cardiovascular diseases, Aged, business.industry, Infant, Newborn, Infant, medicine.disease, Posterior circulation brain infarction, Intracranial embolism and thrombosis, Relative risk, Etiology, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: A cardiac origin in ischemic stroke is more frequent than previously assumed, but it is not clear which patients benefit from cardiac work-up if obvious cardiac pathology is absent. We hypothesized that thromboembolic stroke with a cardiac source occurs more frequently in the posterior circulation compared with thromboembolic stroke of another etiology. Methods: We performed a multicenter observational study in 3,311 consecutive patients with ischemic stroke who were enrolled in an ongoing prospective stroke registry of 8 University hospitals between September 2009 and November 2014 in The Netherlands. In this initiative, the so-called Parelsnoer Institute-Cerebrovascular Accident Study Group, clinical data, imaging, and biomaterials of patients with stroke are prospectively and uniformly collected. We compared the proportions of posterior stroke location in patients with a cardiac stroke source with those with another stroke etiology and calculated risk ratios (RR) with corresponding 95% CI with Poisson regression analyses. To assess which patient or disease characteristics were most strongly associated with a cardiac etiology in patients with ischemic stroke, we performed a stepwise backward regression analysis. Results: For the primary aim, 1,428 patients were eligible for analyses. The proportion of patients with a posterior stroke location among patients with a cardiac origin of their stroke (28%) did not differ statistically significant to those with another origin (25%), age and sex adjusted RR 1.16; 95% CI 0.96–1.41. For the secondary aim, 1,955 patients were eligible for analyses. No recent history of smoking, no hyperlipidemia, coronary artery disease, a higher age, and a higher National Institutes of Health Stroke Scale (NIHSS) score were associated with a cardiac etiology of ischemic stroke. Conclusions: We could not confirm our hypothesis that thromboembolic stroke localized in the posterior circulation is associated with a cardioembolic source of ischemic stroke, and therefore posterior stroke localization on itself does not necessitate additional cardiac examination. The lack of determinants of atherosclerosis, for example, no recent history of smoking and no hyperlipidemia, coronary artery disease, a higher age, and a higher NIHSS score are stronger risk factors for a cardiac source of ischemic stroke.

Published
2020

19. Distribution of Cardioembolic Stroke: A Cohort Study

Author

Pierik, R. (Ramon), Algra, A. (Ale), Dijk, E.J. (Ewoud) van, Erasmus, M.E. (Michiel E.), Van Gelder, I.C. (Isabella C.), Koudstaal, P.J. (Peter J.), Luijckx, G.-J. (Gert-Jan), Nederkoorn, P.J. (Paul), Oostenbrugge, R.J. (Robert) van, Ruigrok, Y.M. (Ynte), Scheeren, T.W.L. (Thomas W.L.), Uyttenboogaart, M. (Maarten), Visser, M.C. (Marieke C.), Wermer, M.J.H. (Marieke), Van Den Bergh, H. (Huub), Pierik, R. (Ramon), Algra, A. (Ale), Dijk, E.J. (Ewoud) van, Erasmus, M.E. (Michiel E.), Van Gelder, I.C. (Isabella C.), Koudstaal, P.J. (Peter J.), Luijckx, G.-J. (Gert-Jan), Nederkoorn, P.J. (Paul), Oostenbrugge, R.J. (Robert) van, Ruigrok, Y.M. (Ynte), Scheeren, T.W.L. (Thomas W.L.), Uyttenboogaart, M. (Maarten), Visser, M.C. (Marieke C.), Wermer, M.J.H. (Marieke), and Van Den Bergh, H. (Huub)

Abstract

Background: A cardiac origin in ischemic stroke is more frequent than previously assumed, but it is not clear which patients benefit from cardiac work-up if obvious cardiac pathology is absent. We hypothesized that thromboembolic stroke with a cardiac source occurs more frequently in the posterior circulation compared with thromboembolic stroke of another etiology. Methods: We performed a multicenter observational study in 3,311 consecutive patients with ischemic stroke who were enrolled in an ongoing prospective stroke registry of 8 University hospitals between September 2009 and November 2014 in The Netherlands. In this

Published
2020
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20. Employment Status and Work Functioning among Kidney Transplant Recipients

Author

Knobbe, Tim J., Kremer, Daan, Abma, Femke I., Annema, Coby, Berger, Stefan P., Navis, Gerjan J., van der Mei, Sijrike F., B?ltmann, Ute, Visser, Annemieke, Bakker, Stephan J.L., Annema-de Jong, C., Bakker, S.J.L., Berger, S.P., Blokzijl, H., Bodewes, F.A.J.A., de Boer, M.T., Damman, K., de Borst, M.H., Diepstra, A., Dijkstra, G., Douwes, R.M., Eisenga, M.F., Erasmus, M.E., Gan, C.T., Gomes Neto, A.W., Hak, E., Hepkema, B.G., Klont, F., Knobbe, T.J., Kremer, D., Leuvenink, H.G.D., Lexmond, W.S., de Meijer, V.E., Niesters, H.G.M., van Pelt, L.J., Pol, R.A., Porte, R.J., Ranchor, A.V., Sanders, J.S.F., Siebelink, M.J., Slart, R.J.H.J.A., Swarte, J.C., Touw, D.J., van den Heuvel, M.C., van Leer-Buter, C., van Londen, M., Verschuuren, E.A.M., Vos, M.J., and Weersma, R.K.

Published
2022
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21. Expanding the Donor Pool by Extended DCD Lung Donation

Author

Koffeman, E.M., primary, Droogh, J.M., additional, Erasmus, M.E., additional, Veen, A., additional, Wauwer, C.Van De, additional, Gan, T., additional, van der Bij, W., additional, Kerstjens, H.A., additional, Mariani, M.A., additional, and Verschuuren, E.A., additional

Published
2020
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23. 5-Year Results from the ISHLT DCD Lung Transplant Registry Confirm Excellent Recipient Survival from Donation after Circulatory Death Donors

Author

Van Raemdonck, D.E., primary, Keshavjee, S., additional, Levvey, B., additional, Cherikh, W.S., additional, Snell, G., additional, Erasmus, M.E., additional, Simon, A., additional, Glanville, A., additional, Clark, S., additional, D'Ovidio, F., additional, Catarino, P., additional, McCurry, K., additional, Hertz, M., additional, Venkateswaran, R., additional, Hopkins, P., additional, Inci, I., additional, Walia, R., additional, Kreisel, D., additional, Mascaro, J., additional, Dilling, D.F., additional, Camp, P., additional, Mason, D., additional, Musk, M., additional, Burch, M., additional, Fisher, A., additional, Yusen, R., additional, Stehlik, J., additional, and Cypel, M., additional

Published
2019
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25. The ISHLT 2017 Updated DCD Registry Report

Author

Van Raemdonck, D.E., primary, Keshavjee, S., additional, Levvey, B., additional, Snell, G., additional, Erasmus, M.E., additional, Cherikh, W.S., additional, Kucheryavaya, A.Y., additional, Stehlik, J., additional, McCurry, K.R., additional, Glanville, A., additional, D'Ovidio, F., additional, Hertz, M., additional, Inci, I., additional, Hopkins, P., additional, Walia, R., additional, Patterson, G.A., additional, Yusen, R.D., additional, Mason, D., additional, Musk, M., additional, Dilling, D.F., additional, Camp, P., additional, and Cypel, M., additional

Published
2018
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26. Patient-reported health outcomes in long-term lung transplantation survivors

Author

Shahabeddin Parizi, A., Krabbe, P.F.M. (Paul), Verschuuren, E.A., Hoek, R.A.S. (Rogier), Kwakkel-van Erp, H. (Hanneke), Erasmus, M.E. (M. E.), Bij, W. (Wim) van der, Vermeulen, K.M. (Karin), Shahabeddin Parizi, A., Krabbe, P.F.M. (Paul), Verschuuren, E.A., Hoek, R.A.S. (Rogier), Kwakkel-van Erp, H. (Hanneke), Erasmus, M.E. (M. E.), Bij, W. (Wim) van der, and Vermeulen, K.M. (Karin)

Abstract

During the last three decades lung transplantation (LTx) has become a proven modality for increasing both survival and health-related quality of life (HRQoL) in patients with various end-stage lung diseases. Most previous studies have reported improved HRQoL shortly after LTx. With regard to long-term effects on HRQoL, however, the evidence is less solid. This prospective cohort study was started with 828 patients who were on the waiting list for LTx. Then, in a longitudinal follow-up, 370 post-LTx patients were evaluated annually for up to 15 years. For all wait-listed and follow-up patients, the following four HRQoL instruments were administered: State-Trait Anxiety Inventory, Zung Self-rating Depression Scale, Nottingham Health Profile, and a visual analogue scale. Cross-sectional and generalized estimating equation (GEE) analysis for repeated measures were performed to assess changes in HRQoL during follow-up. After LTx, patients showed improvement in all HRQoL domains except pain, which remained steady throughout the long-term follow-up. The level of anxiety and depressive symptoms decreased significantly and remained constant. In conclusion, this study showed that HRQoL improves after LTx and tends to remain relatively constant for the entire life span.

Published
2017
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27. A Multicenter Study on Long-Term Outcomes After Lung Transplantation Comparing Donation After Circulatory Death and Donation After Brain Death

Author

van Suylen, V. (V.), Luijk, B. (Bart), Hoek, R.A.S. (Rogier), van de Graaf, E.A. (Ed A.), Verschuuren, E.A., Van De Wauwer, C. (C.), Bekkers, J.A. (Jos), Meijer, R.C.A. (Ronald C.A.), Bij, W. (Wim) van der, Erasmus, M.E. (M. E.), van Suylen, V. (V.), Luijk, B. (Bart), Hoek, R.A.S. (Rogier), van de Graaf, E.A. (Ed A.), Verschuuren, E.A., Van De Wauwer, C. (C.), Bekkers, J.A. (Jos), Meijer, R.C.A. (Ronald C.A.), Bij, W. (Wim) van der, and Erasmus, M.E. (M. E.)

Abstract

The implementation of donation after circulatory death category 3 (DCD3) was one of the attempts to reduce the gap between supply and demand of donor lungs. In the Netherlands, the total number of potential lung donors was greatly increased by the availability of DCD3 lungs in addition to the initial standard use of donation after brain death (DBD) lungs. From the three lung transplant centers in the Netherlands, 130 DCD3 recipients were one-to-one nearest neighbor propensity score matched with 130 DBD recipients. The primary end points were primary graft dysfunction (PGD), posttransplant lung function, freedom from chronic lung allograft dysfunction (CLAD), and overall survival. PGD did not differ between the groups. Posttransplant lung function was comparable after bilateral lung transplantation, but seemed worse after DCD3 single lung transplantation. The incidence of CLAD (p = 0.17) nor the freedom from CLAD (p = 0.36) nor the overall survival (p = 0.40) were significantly different between both groups. The presented multicenter results are derived from a national context where one third of the lung transplantations are performed with DCD3 lungs. We conclude that the long-term outcome after lung transplantation with DCD3 donors is similar to that of DBD donors and that DCD3 donation can substantially enlarge the donor pool.

Published
2017
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33. (314) - The ISHLT 2017 Updated DCD Registry Report

Author

Van Raemdonck, D.E., Keshavjee, S., Levvey, B., Snell, G., Erasmus, M.E., Cherikh, W.S., Kucheryavaya, A.Y., Stehlik, J., McCurry, K.R., Glanville, A., D'Ovidio, F., Hertz, M., Inci, I., Hopkins, P., Walia, R., Patterson, G.A., Yusen, R.D., Mason, D., Musk, M., Dilling, D.F., Camp, P., and Cypel, M.

Published
2018
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37. Aortic dissection presenting as acute myocardial infarction: potential harm of antithrombin and antiplatelet therapy

Author

Gu, Y.L., van den Heuvel, A.F.M., Erasmus, M.E., and Zijlstra, F.

Subjects
cardiovascular system, Case Report, cardiovascular diseases, circulatory and respiratory physiology
Abstract

In the treatment of acute myocardial infarction, antithrombin and antiplatelet therapy are indicated according to the current guidelines. When a patient presents with symptoms and signs of acute myocardial infarction, an extensive list of diagnoses should be considered. Because of the nonspecific symptoms of aortic dissection, the disease may be easily misdiagnosed. A high clinical suspicion of aortic dissection is therefore required. Once aortic dissection has been diagnosed, surgical intervention provides the only definitive treatment for these patients, regardless of antithrombin and antiplatelet therapy.

Published
2006

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