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7. Incidence and clinical implications of intraoperative bilateral internal thoracic artery graft conversion: Insights from the Arterial Revascularization Trial

Author

Ratnatunga, C., Westaby, S., Cook, J., Wallis, C., Wos, S., Jasinski, M., Widenka, K., Blach, A., Gocol, R., Hudziak, D., Zurek, P., Deja, M., Bachowski, R., Mrozek, R., Kargul, T., Domarardzki, W., Frackiewicz, J., Zamvar, V., Ezakadan, D., Buxton, B., Seevanayagam, S., Matalanis, G., Rosalion, A., Negri, J., Moten, S., Atkinson, V., Newcomb, A., Polidano, P., Pana, R., Gerbo, S., O'Keefe, P., von Oppell, U., Mehta, D., Azzu, A., Szafranek, A., Kulatilake, E., Evans, J., Martin, N., Banner, D., Trivedi, U., Forsyth, A., Hyde, J., Cohen, A., Lewis, M., Gardner, E., MacKenzie, A., Cooter, N., Joyce, E., Parker, J., Champney, F., Clark, S., Dark, J., Tocewicz, K., Pillay, T., Rowling, S., Adams-Hall, J., Bochenek, A., Cisowski, M., Bolkowski, M., Morawski, W., Guc, M., Krejca, M., Wilczynski, M., Duralek, A., Gerber, W., Skarysz, J., Shrestha, R., Swiech, W., Szmagala, P., Krzych, L., Pawlak, A., Kepa, K., Hasan, R., Keenan, D., Prendergast, B., Odom, N., McLaughlin, K., Cummings-Fosong, G., Mathew, C., Iles-Smith, H., Oomen, A., Desai, J., El-Gamel, A., John, L., Wendler, O., Andrews, M., Rance, K., Williams, R., Hogervorst, V., Gregory, J., Jessup, J., Knighton, A., Hoare, A., Ritchie, A., Choong, C., Nair, S., Jenkins, D., Large, S., Sudarshan, C., Barman, M., Dhital, K., Routledge, T., Rosengard, B., Munday, H., Rintoul, K., Jarrett, E., Lao-Sirieix, S., Wilkinson, A., Garner, L., Osmond, J., Holcombe, H., Cale, A., Griffin, S., Dickson, J., Spyt, T., Hickey, M., Sosnowski, A., Peek, G., Szostek, J., Hadjinikalaou, L., Logtens, E., Oakley, M., Leji, S., Gaer, J., Amrani, M., Dreyfus, G., Bahrami, T., de Robertis, F., Baig, K., Asimakopoulos, G., Vohra, H., Pai, V., Tadjkarimi, S., Soleimani, B., Stavri, G., Bull, G., Collappen, H., Sadowksi, J., Gaweda, B., Rudzinski, P., Stolinski, J., Konstanty-Kalandyk, J., Moraes, F., Moraes, C., Wanderley, J., Pepper, J., De Souza, A., Petrou, M., Trimlett, R., Morgan, T., Gavino, J., Wang, S.F., Chandrasekaran, V., Kanagasaby, R., Sarsam, M., Ryan, H., Billings, L., Ruddick, L., Achampong, A., Forster, E., Pawlaczyk, R., Siondalski, P., Rogowski, J., Roszak, K., Jarmoszewicz, K., Jagielak, D., Gafka, S., Mannam, G., Naguboyin, G., Rao Sajja, L., Dandu, B., Briffa, N., Braidley, P., Cooper, G., Allen, K., Sangha, G., Bridge, C., McMellon, H., Casabona, R., Actis Dato, G., Bardi, G., Del Ponte, S., Forsennati, P., Parisi, F., Punta, G., Flocco, R., Sansone, F., Zingarelli, E., Dihmis, W., Kuduvali, M., Prince, C., Rogers, H., McQuade, L., Anisimowicz, L., Bokszanski, M., Pawliszak, W., Kolakowski, J., Lau, G., Ogorzeja, W., Gumanska, I., Kulinski, P., Podesser, B., Trescher, K., Bernecker, O., Holzinger, C., Binder, K., Schor, I., Bergmann, P., Kassal, H., Motovova, B., Trehan, N., Meharwal, Z., Malhotra, R., Goel, M., Kumer, B., Bazaz, S., Bake, N., Singh, A., Mishka, Y., Gupta, R., Basumatary, S., Zembala, M., Szafron, B., Pacholewicz, J., Krason, M., Farmas, A., Wojarski, J., Zych, B., Szymanik, I., Kolwca, M., Mazur, W., Kurowicki, A., Zurek, S., Stacel, T., Jaworska, I., Sleight, P., Channon, K., Farrell, B., Stables, R., Vermes, G., Pearson, J., Pitman, M., Yusuf, S., Pocock, S., Julian, D., Treasure, T., Von Oppel, U., Kanagasabay, R., Collinson, J., Bakhai, A., O'Hanlon, R., Kotecha, D., Qureshi, K., Geisler, T., Manzano-Espinosa, L., Benedetto, Umberto, Altman, Douglas G., Flather, Marcus, Gerry, Stephen, Gray, Alastair, Lees, Belinda, and Taggart, David P.

Published
2018
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14. Incidence and clinical implications of intraoperative bilateral internal thoracic artery graft conversion: Insights from the Arterial Revascularization Trial

Author

Benedetto, Umberto, primary, Altman, Douglas G., additional, Flather, Marcus, additional, Gerry, Stephen, additional, Gray, Alastair, additional, Lees, Belinda, additional, Taggart, David P., additional, Ratnatunga, C., additional, Westaby, S., additional, Cook, J., additional, Wallis, C., additional, Wos, S., additional, Jasinski, M., additional, Widenka, K., additional, Blach, A., additional, Gocol, R., additional, Hudziak, D., additional, Zurek, P., additional, Deja, M., additional, Bachowski, R., additional, Mrozek, R., additional, Kargul, T., additional, Domarardzki, W., additional, Frackiewicz, J., additional, Zamvar, V., additional, Ezakadan, D., additional, Buxton, B., additional, Seevanayagam, S., additional, Matalanis, G., additional, Rosalion, A., additional, Negri, J., additional, Moten, S., additional, Atkinson, V., additional, Newcomb, A., additional, Polidano, P., additional, Pana, R., additional, Gerbo, S., additional, O'Keefe, P., additional, von Oppell, U., additional, Mehta, D., additional, Azzu, A., additional, Szafranek, A., additional, Kulatilake, E., additional, Evans, J., additional, Martin, N., additional, Banner, D., additional, Trivedi, U., additional, Forsyth, A., additional, Hyde, J., additional, Cohen, A., additional, Lewis, M., additional, Gardner, E., additional, MacKenzie, A., additional, Cooter, N., additional, Joyce, E., additional, Parker, J., additional, Champney, F., additional, Clark, S., additional, Dark, J., additional, Tocewicz, K., additional, Pillay, T., additional, Rowling, S., additional, Adams-Hall, J., additional, Bochenek, A., additional, Cisowski, M., additional, Bolkowski, M., additional, Morawski, W., additional, Guc, M., additional, Krejca, M., additional, Wilczynski, M., additional, Duralek, A., additional, Gerber, W., additional, Skarysz, J., additional, Shrestha, R., additional, Swiech, W., additional, Szmagala, P., additional, Krzych, L., additional, Pawlak, A., additional, Kepa, K., additional, Hasan, R., additional, Keenan, D., additional, Prendergast, B., additional, Odom, N., additional, McLaughlin, K., additional, Cummings-Fosong, G., additional, Mathew, C., additional, Iles-Smith, H., additional, Oomen, A., additional, Desai, J., additional, El-Gamel, A., additional, John, L., additional, Wendler, O., additional, Andrews, M., additional, Rance, K., additional, Williams, R., additional, Hogervorst, V., additional, Gregory, J., additional, Jessup, J., additional, Knighton, A., additional, Hoare, A., additional, Ritchie, A., additional, Choong, C., additional, Nair, S., additional, Jenkins, D., additional, Large, S., additional, Sudarshan, C., additional, Barman, M., additional, Dhital, K., additional, Routledge, T., additional, Rosengard, B., additional, Munday, H., additional, Rintoul, K., additional, Jarrett, E., additional, Lao-Sirieix, S., additional, Wilkinson, A., additional, Garner, L., additional, Osmond, J., additional, Holcombe, H., additional, Cale, A., additional, Griffin, S., additional, Dickson, J., additional, Spyt, T., additional, Hickey, M., additional, Sosnowski, A., additional, Peek, G., additional, Szostek, J., additional, Hadjinikalaou, L., additional, Logtens, E., additional, Oakley, M., additional, Leji, S., additional, Gaer, J., additional, Amrani, M., additional, Dreyfus, G., additional, Bahrami, T., additional, de Robertis, F., additional, Baig, K., additional, Asimakopoulos, G., additional, Vohra, H., additional, Pai, V., additional, Tadjkarimi, S., additional, Soleimani, B., additional, Stavri, G., additional, Bull, G., additional, Collappen, H., additional, Sadowksi, J., additional, Gaweda, B., additional, Rudzinski, P., additional, Stolinski, J., additional, Konstanty-Kalandyk, J., additional, Moraes, F., additional, Moraes, C., additional, Wanderley, J., additional, Pepper, J., additional, De Souza, A., additional, Petrou, M., additional, Trimlett, R., additional, Morgan, T., additional, Gavino, J., additional, Wang, S.F., additional, Chandrasekaran, V., additional, Kanagasaby, R., additional, Sarsam, M., additional, Ryan, H., additional, Billings, L., additional, Ruddick, L., additional, Achampong, A., additional, Forster, E., additional, Pawlaczyk, R., additional, Siondalski, P., additional, Rogowski, J., additional, Roszak, K., additional, Jarmoszewicz, K., additional, Jagielak, D., additional, Gafka, S., additional, Mannam, G., additional, Naguboyin, G., additional, Rao Sajja, L., additional, Dandu, B., additional, Briffa, N., additional, Braidley, P., additional, Cooper, G., additional, Allen, K., additional, Sangha, G., additional, Bridge, C., additional, McMellon, H., additional, Casabona, R., additional, Actis Dato, G., additional, Bardi, G., additional, Del Ponte, S., additional, Forsennati, P., additional, Parisi, F., additional, Punta, G., additional, Flocco, R., additional, Sansone, F., additional, Zingarelli, E., additional, Dihmis, W., additional, Kuduvali, M., additional, Prince, C., additional, Rogers, H., additional, McQuade, L., additional, Anisimowicz, L., additional, Bokszanski, M., additional, Pawliszak, W., additional, Kolakowski, J., additional, Lau, G., additional, Ogorzeja, W., additional, Gumanska, I., additional, Kulinski, P., additional, Podesser, B., additional, Trescher, K., additional, Bernecker, O., additional, Holzinger, C., additional, Binder, K., additional, Schor, I., additional, Bergmann, P., additional, Kassal, H., additional, Motovova, B., additional, Trehan, N., additional, Meharwal, Z., additional, Malhotra, R., additional, Goel, M., additional, Kumer, B., additional, Bazaz, S., additional, Bake, N., additional, Singh, A., additional, Mishka, Y., additional, Gupta, R., additional, Basumatary, S., additional, Zembala, M., additional, Szafron, B., additional, Pacholewicz, J., additional, Krason, M., additional, Farmas, A., additional, Wojarski, J., additional, Zych, B., additional, Szymanik, I., additional, Kolwca, M., additional, Mazur, W., additional, Kurowicki, A., additional, Zurek, S., additional, Stacel, T., additional, Jaworska, I., additional, Sleight, P., additional, Channon, K., additional, Farrell, B., additional, Stables, R., additional, Vermes, G., additional, Pearson, J., additional, Pitman, M., additional, Yusuf, S., additional, Pocock, S., additional, Julian, D., additional, Treasure, T., additional, Von Oppel, U., additional, Kanagasabay, R., additional, Collinson, J., additional, Bakhai, A., additional, O'Hanlon, R., additional, Kotecha, D., additional, Qureshi, K., additional, Geisler, T., additional, and Manzano-Espinosa, L., additional

Published
2018
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17. Safety of Perioperative Aprotinin Administration During Isolated Coronary Artery Bypass Graft Surgery: Insights From the ART (Arterial Revascularization Trial)

Author

Benedetto, Umberto, primary, Altman, Douglas G., additional, Gerry, Stephen, additional, Gray, Alastair, additional, Lees, Belinda, additional, Angelini, Gianni D., additional, Flather, Marcus, additional, Taggart, David P., additional, Ratnatunga, C., additional, Westaby, S., additional, Cook, J., additional, Wallis, C., additional, Wos, S., additional, Jasinski, M., additional, Widenka, K., additional, Blach, A., additional, Gocol, R., additional, Hudziak, D., additional, Zurek, P., additional, Deja, M., additional, Bachowski, R., additional, Mrozek, R., additional, Kargul, T., additional, Domarardzki, W., additional, Frackiewicz, J., additional, Zamvar, V., additional, Ezakadan, D., additional, Buxton, B., additional, Seevanayagam, S., additional, Matalanis, G., additional, Rosalion, A., additional, Negri, J., additional, Moten, S., additional, Atkinson, V., additional, Newcomb, A., additional, Polidano, P., additional, Pana, R., additional, Gerbo, S., additional, O'Keefe, P., additional, von Oppell, U., additional, Mehta, D., additional, Azzu, A., additional, Szafranek, A., additional, Kulatilake, E., additional, Evans, J., additional, Martin, N., additional, Banner, D., additional, Trivedi, U., additional, Forsyth, A., additional, Hyde, J., additional, Cohen, A., additional, Lewis, M., additional, Gardner, E., additional, MacKenzie, A., additional, Cooter, N., additional, Joyce, E., additional, Parker, J., additional, Champney, F., additional, Clark, S., additional, Dark, J., additional, Tocewicz, K., additional, Pillay, T., additional, Rowling, S., additional, Adams‐Hall, J., additional, Bochenek, A., additional, Cisowski, M., additional, Bolkowski, M., additional, Morawski, W., additional, Guc, M., additional, Krejca, M., additional, Wilczynski, M., additional, Duralek, A., additional, Gerber, W., additional, Skarysz, J., additional, Shrestha, R., additional, Swiech, W., additional, Szmagala, P., additional, Krzych, L., additional, Pawlak, A., additional, Kepa, K., additional, Hasan, R., additional, Keenan, D., additional, Prendergast, B., additional, Odom, N., additional, McLaughlin, K., additional, Cummings‐Fosong, G., additional, Mathew, C., additional, Iles‐Smith, H., additional, Oomen, A., additional, Desai, J., additional, El‐Gamel, A., additional, John, L., additional, Wendler, O., additional, Andrews, M., additional, Rance, K., additional, Williams, R., additional, Hogervorst, V., additional, Gregory, J., additional, Jessup, J., additional, Knighton, A., additional, Hoare, A., additional, Ritchie, A., additional, Choong, C., additional, Nair, S., additional, Jenkins, D., additional, Large, S., additional, Sudarshan, C., additional, Barman, M., additional, Dhital, K., additional, Routledge, T., additional, Rosengard, B., additional, Munday, H., additional, Rintoul, K., additional, Jarrett, E., additional, Lao‐Sirieix, S., additional, Wilkinson, A., additional, Garner, L., additional, Osmond, J., additional, Holcombe, H., additional, Cale, A., additional, Griffin, S., additional, Dickson, J., additional, Spyt, T., additional, Hickey, M., additional, Sosnowski, A., additional, Peek, G., additional, Szostek, J., additional, Hadjinikalaou, L., additional, Logtens, E., additional, Oakley, M., additional, Leji, S., additional, Gaer, J., additional, Amrani, M., additional, Dreyfus, G., additional, Bahrami, T., additional, de Robertis, F., additional, Baig, K., additional, Asimakopoulos, G., additional, Vohra, H., additional, Pai, V., additional, Tadjkarimi, S., additional, Soleimani, B., additional, Stavri, G., additional, Bull, G., additional, Collappen, H., additional, Sadowksi, J., additional, Gaweda, B., additional, Rudzinski, P., additional, Stolinski, J., additional, Konstanty‐Kalandyk, J., additional, Moraes, F., additional, Moraes, C., additional, Wanderley, J., additional, Pepper, J., additional, De Souza, A., additional, Petrou, M., additional, Trimlett, R., additional, Morgan, T., additional, Gavino, J., additional, Wang, S.F., additional, Chandrasekaran, V., additional, Kanagasaby, R., additional, Sarsam, M., additional, Ryan, H., additional, Billings, L., additional, Ruddick, L., additional, Achampong, A., additional, Forster, E., additional, Pawlaczyk, R., additional, Siondalski, P., additional, Rogowski, J., additional, Roszak, K., additional, Jarmoszewicz, K., additional, Jagielak, D., additional, Gafka, S., additional, Mannam, G., additional, Naguboyin, G., additional, Rao Sajja, L., additional, Dandu, B., additional, Briffa, N., additional, Braidley, P., additional, Cooper, G., additional, Allen, K., additional, Sangha, G., additional, Bridge, C., additional, McMellon, H., additional, Casabona, R., additional, Actis Dato, G., additional, Bardi, G., additional, Del Ponte, S., additional, Forsennati, P., additional, Parisi, F., additional, Punta, G., additional, Flocco, R., additional, Sansone, F., additional, Zingarelli, E., additional, Dihmis, W., additional, Kuduvali, M., additional, Prince, C., additional, Rogers, H., additional, McQuade, L., additional, Anisimowicz, L., additional, Bokszanski, M., additional, Pawliszak, W., additional, Kolakowski, J., additional, Lau, G., additional, Ogorzeja, W., additional, Gumanska, I., additional, Kulinski, P., additional, Podesser, B., additional, Trescher, K., additional, Bernecker, O., additional, Holzinger, C., additional, Binder, K., additional, Schor, I., additional, Bergmann, P., additional, Kassal, H., additional, Motovova, B., additional, Trehan, N., additional, Meharwal, Z., additional, Malhotra, R., additional, Goel, M., additional, Kumer, B., additional, Bazaz, S., additional, Bake, N., additional, Singh, A., additional, Mishka, Y., additional, Gupta, R., additional, Basumatary, S., additional, Zembala, M., additional, Szafron, B., additional, Pacholewicz, J., additional, Krason, M., additional, Farmas, A., additional, Wojarski, J., additional, Zych, B., additional, Szymanik, I., additional, Kolwca, M., additional, Mazur, W., additional, Kurowicki, A., additional, Zurek, S., additional, Stacel, T., additional, Jaworska, I., additional, Sleight, P., additional, Channon, K., additional, Farrell, B., additional, Stables, R., additional, Vermes, G., additional, Pearson, J., additional, Pitman, M., additional, Yusuf, S., additional, Pocock, S., additional, Julian, D., additional, Treasure, T., additional, Von Oppel, U., additional, Kanagasabay, R., additional, Collinson, J., additional, Bakhai, A., additional, O'Hanlon, R., additional, Kotecha, D., additional, Qureshi, K., additional, Geisler, T., additional, and Manzano‐Espinosa, L., additional

Published
2018
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21. Usefulness of the Impulse Oscillometry System in Graft Function Monitoring in Lung Transplant Recipients.

Author

Wojarski, J., Wiórek, A., Slezak, W., Maruszewski, M., Karolak, W., Zeglen, S., Ochman, M., Przybyłowski, P., and Krzych, Ł.

Subjects
*TRANSPLANTATION of organs, tissues, etc., *OSCILLOMETER, *LUNG transplantation, *PATIENT monitoring, *PULMONARY function tests, *FUNCTIONAL assessment, *PHYSIOLOGY, *PATIENTS
Abstract

Abstract Background After successful lung transplantation, patients are monitored for chronic lung allograft dysfunction. Pulmonary function tests and 6-minute-walk tests are commonly used for functional graft monitoring. As these methods require substantial effort, however, many patients are unable to complete testing fully. The impulse oscillometry system is a noninvasive method that requires minimal patient cooperation and is suitable for use for patients incapable of strenuous activity. We compared impulse oscillometry system with pulmonary function tests and 6-minute-walk tests to determine if impulse oscillometry system could serve as a substitute measure. Methods This prospective, observational study evaluated 25 consecutive patients (19 men, median age 54.5 years) admitted to a single institution from January to October 2016 (double-lung = 13, single-lung = 13). Patients were assessed using pulmonary function tests, impulse oscillometry system, and 6-minute-walk tests. Results Eighty-eight percent of patients reached high-resonance frequency (F res) and, in 84% of patients, the value of Ax (area of reactance) increased above the norm (N < 0.33 kPa/L) indicating peripheral airways obstruction. High resistance of small airways, measured with an R5 – R20 difference, followed higher Ax values. The increase of resistance at 5 Hz in 31% of patients (R5 >150% predicted value) also indicated small airway obstruction. Airway obturation in patients with elevated Ax and R5 was confirmed by decreased FEV 1 (<75% predictive value) and FEV 1 /FVC ratio in 38% of patients. Conclusions Study results confirm the impulse oscillometry system method could be a substitute for pulmonary function tests in determining the occurrence of chronic lung allograft dysfunction. 6-minute-walk tests showed neither strong correlations regarding impulse oscillometry system and pulmonary function tests nor any base for differentiation of results regarding main factor codes. Highlights • IOS parameters rule out the possibility of post-transplantation obstruction. • IOS helped to confirm that the lung allograft did not possess the correct elasticity. • IOS method may substitute PFTs in determining the occurrence of CLAD. [ABSTRACT FROM AUTHOR]

Published
2018
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24. Osteoporosis in patients referred for lung transplantation

Author

Jastrzebski, D., primary, Lutogniewska, W., additional, Ochman, M., additional, Margas, A., additional, Kowalski, K., additional, Wyrwol, J., additional, Ksiazek, B., additional, Wojarski, J., additional, Zeglen, S., additional, Ziora, D., additional, and Kozielski, J., additional

Published
2010
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26. Outcomes of surgical revascularization in women

Author

Kucewicz-Czech, E., primary, Urbanska, E., additional, Knapik, M., additional, Latasiewicz, H., additional, Czech, B., additional, Pacholewicz, J., additional, Wojarski, J., additional, and Przybylski, R., additional

Published
2007
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37. Right ventricular function in patients with severe interstitial lung disease: A tissue doppler imaging study

Author

Nowak, J., Jastrzebski, D., Witold Streb, Rozentryt, P., Wojarski, J., Greif, M., Kozielski, J., Polonski, L., Zembala, M., and Kukulski, T.

Subjects
Male, Oxygen, Echocardiography, Vital Capacity, Ventricular Function, Right, Humans, Pulmonary Diffusing Capacity, Female, Carbon Dioxide, Middle Aged, Lung Diseases, Interstitial, Lung Transplantation
Abstract

Tissue Doppler imaging (TDI) can be useful in the evaluation of right ventricular (RV) regional dysfunction due to pulmonary diseases. The aim of the study was to assess RV dysfunction in patients with severe interstitial lung diseases (ILD), using both TDI and conventional transthoracic echocardiography (TTE). The study group consisted of 40 consecutive patients with end-stage ILD referred for lung transplantation (LT). Eighteen of them, mean age 47 +/-12 yr, who fulfilled the ATS/ERS criteria for LT (mean forced vital capacity (FVC) 1.4 +/-0.8 l, mean diffusing capacity for carbon dioxide (DLCO)50% of predicted) constituted the active group, and 22 age-matched patients (mean age 49 +/-12 yr), who did not fulfill these criteria, were placed in the waiting group for LT. We found that among the TDI parameters, the longitudinal peak systolic strain rate (SR) measured at the RV outflow tract, was significantly more negative (-1.1 +/-0.3 vs. -3.2 +/-1.2 s(-1), P=0.03) and the time to peak velocity (TpVEL) in the medial and apical septal segments were shorter (129.9 +/-47.9 vs. 159.2 +/-38.1 ms, P=0.018 and 126.8 +/-44.3 vs. 154.6 +/-40.9 ms, P=0.019) in the patients from the active than those from the waiting group. TTE showed that patients from the active group had significantly lower values of tricuspid annulus plane systolic excursion (TAPSE) (14.3 +/-3.3 vs. 20.6 +/-6.2 mm, P=0.0003) and pulmonary artery acceleration time (PVAT) (70.3 +/-23.3 vs. 96.9 +/-12.4 ms, P=0.0001)compared with those from the waiting group. No other differences were found for other parameters of RV function between the examined groups. In conclusion, severity of lung disease in patients with ILD influences RV systolic dysfunction, which is reflected in both TDI and conventional echocardiographic parameters.

38. Atrial pacing of transplanted heart

Author

Kutarski, A., Zakliczyński, M., Oleszczak, K., Wojarski, J., Foremny, J., Kuśnierz, J., Jaworska, M., Puszczewicz, D., Łakomski, B., Zbigniew Kalarus, Religa, Z., Widomska-Czekajska, T., and Zembala, M.

44. Nordic Walking in Pulmonary Rehabilitation of Patients Referred for Lung Transplantation.

Author

Maruszewski, M., Latos, M., Wojarski, J., Karolak, W., Zeglen, S., Ochman, M., Przybyłowski, P., and Jastrzębski, D.

Subjects
*LUNG transplantation, *PHYSIOLOGICAL aspects of walking, *LUNG physiology, *QUALITY of life, *DYSPNEA, *MEDICAL rehabilitation, *PREVENTION, *PATIENTS
Abstract

Abstract Background Although the effectiveness of pulmonary rehabilitation in patients with chronic obstructive lung disease, cystic fibrosis, and interstitial lung disease is well documented, little is known about pulmonary rehabilitation in patients who are referred for lung transplantation. Nordic walking is a low-cost and accessible form of physical exercise with proven benefits. The purpose of this prospective study was to examine the effects of Nordic walking on lung function, perception of dyspnea, and health-related quality of life in patients referred for lung transplantation. Methods Twenty-two of 40 patients who was qualified for lung transplantation at the Department of Lung Diseases in Zabrze, Poland, completed a rehabilitation program consisting of 12 weeks of Nordic walking. Lung function tests, exercise tolerance, and perception of dyspnea and quality of life were assessed before and after completion of the program. Results No adverse events were observed during the rehabilitation program. After 12 weeks, there was a significant increase in mean 6-minute walk distance (374 meters vs 288 meters, P <.034) and a significant reduction in perception of dyspnea after completion of the rehabilitation program. Assessment of general health and quality of life showed significant improvement (P <.05). No significant changes in lung function tests were noted. Conclusion Nordic walking is a safe and feasible physical activity for pulmonary rehabilitation in patients with end-stage lung disease who are referred for lung transplantation. This rehabilitation technique results in significant improvements in patient mobility and quality of life. Highlights • Nordic walking (NW) is beneficial in patients referred for lung transplantation. • Improvement in the 6MWT distance was noted with the NW rehabilitation technique. • NW had a positive impact on quality of life and perception of dyspnea. [ABSTRACT FROM AUTHOR]

Published
2018
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45. Lymphocyte Subtypes CD3+, CD19+, CD16+CD56+, CD4+, CD8+, and CD3+HLA-DR+ in Peripheral Blood Obtained From Patients After Thoracic Organ Transplantation

Author

Żegleń, S., Łaszewska, A., Wojarski, J., Woźniak-Grygiel, E., Zakliczyński, M., Ochman, M., Wilczek, P., Karolak, W., Nożyński, J., and Zembala, M.

Subjects
*LYMPHOCYTES, *LUNG transplantation, *BODY mass index, *KILLER cells, *HLA histocompatibility antigens, *T cells, *PATIENTS
Abstract

Abstract: Introduction: The aim of this study was to assess peripheral blood lymphocyte subtypes (CD3+, CD19+, CD16+CD56+, CD4+, CD8+, and CD3+HLA-DR+) obtained from thoracic organ recipients at various periods after transplantation. Material and Methods: Seventeen patients after lung transplantation (LT) and 5 patients after heart transplantation (HT) included 13 males (76.5%) and 4 females (23.5%) of overall mean age at the time of transplantation of 46.7 ± 11.55 years and mean body mass index of 21.1 ± 4. Lymphocyte phenotypes were estimated using Simultest IMK Plus. Results: A significant decrease in lymphocytes of the majority of subtypes was observed at 1 year posttransplantation compared with normal ranges: CD19+ B lymphocytes in 56% of patients, CD8+ T cells among 48% and CD16+CD56+ natural killer elements, 56%. In contrast, there were increased numbers of activated lymphocytes (CD3+HLA-DR+). Beyond the 1-year observation, we observed a trend to normalize parameters among the majority of subjects. Conclusion: A clear tendency to a decrease number of peripheral blood lymphocytes of various subtypes was observed among thoracic organ recipients in the first year posttransplantation with the exception of activated HLA-DR+ cells. After the first year, there was slow restoration of lymphocytes. [Copyright &y& Elsevier]

Published
2011
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46. The role of transbronchial cryobiopsy in the detection of pulmonary GvHD.

Author

Sadowska-Klasa A, Karolak W, Piekarska A, Kowalski J, Żegleń S, Janowicz A, Nadolny T, Wojarski J, and Zaucha JM

Abstract

Purpose of the study We investigated the incidence of chronic pulmonary complications in allogeneic hematopoietic cell transplantation (allo-HCT) recipients and analyzed the role of transbronchial cryobiopsy (cryoTBB) as a tool to determine the nature of pulmonary changes and to guide clinical decisions., Methods: Patients who survived at least 6 months post HCT were included in the study. Pulmonary functional tests (PFTs) were performed in all patients as a screening tool. In case of abnormal results computed tomography (CT) was done to verify inflammatory changes and the presence of air-trapping. Next, patients were qualified for microbiological analysis of bronchoalveolar lavage fluid. If the results of non-invasive tests were inconclusive, cryoTBB was performed., Results: Among 186 patients, we identified 13 cases (7%) with abnormal PFTs. Mild, moderate, and severe chronic graft versus host disease (GvHD) was diagnosed in 1 (8%), 6 (46%), and 2 (15%) patients, respectively. Four (31%) patients did not present any manifestations of cGvHD at FEV1 decline. Eight 8 (62%) patients met the bronchiolitis obliterans syndrome criteria, 5 (48%) had restrictive disease, or mixed phenotype based on PFTs, only in 1 case air-trapping was present in CT. Pulmonary GvHD was confirmed by cryoTBB histopathology in 5 of 11 (45%) cases. Immunosuppression was either stopped or decreased in 6 patients with negative results for GvHD with further clinical improvement., Conclusion: CryoTBB can be a helpful tool to verify the cause of chronic pulmonary complications in the HCT population. Based on negative biopsy results, some patients may benefit from IST discontinuation or reduction to mitigate recurrences of infectious complications and further lung destruction., (S. Karger AG, Basel.)

Published
2024
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47. Anti-HLA Immunization in Patients After Lung Transplantation: A Comparative Study Before and During the Pandemic.

Author

Dukat-Mazurek A, Karolak W, Zielińska H, Moszkowska G, Wojarski J, Lipka K, Fercho J, Gallas M, Rystwej D, Sunesson F, Akily L, Karlsen W, Sawczuk M, Stachowicz-Chojnacka K, Nojek R, and Żegleń S

Subjects
Humans, Retrospective Studies, Male, Female, Middle Aged, Adult, SARS-CoV-2 immunology, Histocompatibility Testing, Graft Survival, Isoantibodies blood, Pandemics, COVID-19 Vaccines immunology, COVID-19 Vaccines administration & dosage, Graft Rejection immunology, Graft Rejection prevention & control, Immunization, Lung Transplantation, COVID-19 prevention & control, COVID-19 immunology, COVID-19 epidemiology, HLA Antigens immunology
Abstract

Anti-human leukocyte antigen (anti-HLA) sensitization in lung transplant recipients (LTRs) can significantly impact graft survival and patient outcomes. The global pandemic, induced by the SARS-CoV-2 virus, brought about numerous challenges in the medical sphere, including potential alterations in HLA immunization patterns among LTRs. A retrospective analysis of LTRs group transplanted from July 2018 to 1 March 2020 (pre-pandemic) was compared with patients transplanted from 1 March 2020 to December 2022 (during the pandemic). Totally 92 patients were controlled. Patients were also divided into 2 groups: vaccinated and non-vaccinated. The results of cytotoxic crossmatch, results of anti-HLA antibody testing, presence of DSA before and after transplantation, and early and late graft function were compared between groups. In the pandemic and vaccinated groups, an increase was observed in the number of positive crossmatch tests performed with a pool of B lymphocytes. However, the presence of dithiothreitol abolished the positive reaction in 90% of cases. We also observed an increased percentage of patients immunized based on the results of solid phase tests both in the pandemic group and in the group of patients who received vaccination against the SARS-CoV-2 virus. It might be that the pandemic/vaccination has influenced the prevalence of anti-HLA immunization in LTRs. Further studies are essential to establish causative factors and develop targeted interventions for this population of patients., Competing Interests: Declaration of competing interest The authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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48. Treatment of Patients After Lung Transplantation With Covid Infection During Long-Term Follow-Up.

Author

Żegleń S, Nagajewski A, Górski D, Wojarski J, Karlsen W, Akily L, Sunesson F, Sawczuk M, Nojek R, Lipka K, Gallas M, Dukat-Mazurek A, and Karolak W

Subjects
Humans, Middle Aged, Female, Male, Follow-Up Studies, Adult, SARS-CoV-2, Immunosuppressive Agents therapeutic use, Immunosuppressive Agents adverse effects, COVID-19 Drug Treatment, Aged, Lung Transplantation adverse effects, COVID-19 epidemiology, Antiviral Agents therapeutic use
Abstract

Background: Patients undergoing lung transplantation are routinely managed with lifelong immunosuppression, which is associated with a heightened risk for infections. This study delves into the therapeutic challenges and strategies for managing lung transplant recipients (LTRs) infected with COVID-19 during long-term follow-up., Methods: The was a case series analysis, among which nonstandard therapies consisting of targeted antibody treatment, antiviral drugs, or anti-interleukin-6 drugs were applied in patients after lung transplantation. Additional analysis of laboratory test results for systemic inflammation and imaging studies was also carried out. The study was limited to a dedicated COVID-19 center, commonly known as a temporary hospital, and included patients infected with COVID-19 in the late post-lung transplant period (home-related infection)., Results: Fifteen post-lung transplantation patients with current COVID-19 infection were treated with antibodies such as tocilizumab, casirivimab, imdevimab, and regdanvimab. Of these patients, 1 was given tocilizumab (7%), 8 casirivimab and imdevimab (53%), and 2 regdanvimab (13%). Of the 15 lung transplant recipients studied, 8 presented COVID-19-associated lung changes in computed tomography scans (53%). Common clinical manifestations included dyspnea, fever, and fatigue. Antiviral agents, like remdesivir, were employed in the remaining 4 cases (27%), and adjunctive therapies, such as corticosteroids and anticoagulants, were used selectively. All treated patients survived the infection without complications; the treatment proved effective and safe., Competing Interests: Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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49. Antibody-mediated rejection with detection of de novo donor-specific anti-human leukocyte antigen Class II antibodies after lung transplantation: Problems in diagnosis, treatment and monitoring on a case report basis.

Author

Dukat-Mazurek A, Stachowicz-Chojnacka K, Karolak W, Zielińska H, Moszkowska G, Kałęka P, Wojarski J, and Żegleń S

Subjects
Humans, Middle Aged, Immunoglobulins, Intravenous therapeutic use, Isoantibodies, HLA Antigens, Immunoglobulin G, Graft Rejection, Tissue Donors, Graft Survival, Kidney Transplantation, Lung Transplantation
Abstract

Lung transplantation, like other transplants, carries a risk of graft rejection due to genetic differences between the donor and the recipient. In this paper, we focus on antibody-mediated rejection, which can cause acute and more importantly chronic graft dysfunction and subsequently shortened allograft survival. We present the case of a 46-year-old patient who, two months after lung transplantation (LTx), developed AMR manifested by the deterioration of graft function and de novo production of donor-specific antibodies (DSA): DQ3 (DQ7, DQ8, DQ9). As the patient was after left single LTx and heavily oxygen dependent a transbronchial biopsy was deemed to be high risk and it was decided to determine the clinical significance of the detected antibodies by their ability to bind complement. The test confirmed that the detected DSAs have the ability cause cytotoxicity of the transplanted organ. After treatment with methotrexate, intravenous immunoglobulin G (IVIg) and alemtuzumab, the patient's condition improved and a complete decrease in DSA was obtained. However, after a year, the production of antibodies increased sharply. Treatment with IVIg, cyclophosphamide and plasmapheresis slightly improved the patient's condition, reducing the MFI DSA values by half, but leaving them at high levels. Based on this clinical case, we discuss problems with making a diagnosis, choosing the right AMR treatment and monitoring the patient's condition during treatment. We also indicate a poor prognosis in the case of the production of DSA antibodies at the DQ locus., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Published
2023
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50. Demographic and Psychosocial Characteristics of Lung Transplant Candidates: Single-Center Analysis.

Author

Karolak W, Stańska A, Wojarski J, Shinde R, Ciak E, Polishchuk A, Łojko M, Sheikhsagha E, Ulstrup IH, Łacka M, Maruszewski M, Woźniak-Grygiel E, Abba ME, Górski D, and Zeglen S

Subjects
Aged, Demography, Female, Humans, Male, Middle Aged, Lung Transplantation adverse effects
Abstract

Background: Lung transplantation has changed the course of treatment of lung diseases for the better; however, there are various factors that should be considered to increase the probability of a better outcome. Factors such as the patient's background, level of education, and income could affect their perception and eventually the results of the procedure., Methods: The present study involved patients who underwent the qualification process for lung transplant along with psychological and sociologic assessment at the Lung Transplant Unit in the Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk. The following data were identified in the patients' medical history: marital status, size of the city, source of income, profession, voivodeship, and their Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) score for psychosocial prediction of the outcome., Results: A group of 121 patients were included in the study: 77 (63.64%) men and 44 (36.36%) women. The average age of the patients was 55.4 ± 9.81 years. Eighty (66.12%) lived in the city, and 26 (21.49%) of patients were professionally active with a fixed salary as their source of income. One hundred two patients were married. The median SIPAT score was 10.0 ± 3.0 for men and 10.0 ± 2.75 for women (P = .0974)., Conclusion: For optimum care and results of the lung transplant procedure, it is important to consider these background patient factors because they play a crucial role in determining the course of the surgery. The analysis of demographic data is undoubtedly one of the elements helpful in the further fate of the whole process., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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