With the deepening of current study and the innovation of perioperative management concept, there have been great advances in lung transplantation in recent years. The prognosis of patients has been significantly improved. At the same time, the role of various types of blood purification in the clinical monitoring and treatment of lung transplant patients is becoming increasingly prominent. This review aims to summarize the application and latest progress of in vitro blood purification such as renal replacement therapy, plasmapheresis and hemadsorption in the perioperative period of lung transplantation, and to provide a basis for further study.
Objective To explore the research hotspots and latest progress of lung transplantation nursing at home and abroad, and to provide reference ideas and directions for the future related research. Methods Through the collection of CNKI and Web of Science core database, the related literature of lung transplantation nursing from inception to December 2023 was retrieved and CiteSpace software was used to focus on keyword co-occurrence, clustering and emergence. Results A total of 352 Chinese literature and 126 English literature were included in this study, and the number of papers published at home and abroad showed an overall upward trend. There were 34 core authors of Chinese literature and 83 core authors of English literature. The core authors led the team to promote research and promote cooperation at home and abroad. At present, the cooperation among research teams needed to be strengthened. Chinese literature keywords included nursing, lung transplantation, extracorporeal membrane oxygenation, lung rehabilitation, lung transplantation surgery, complications. English literature keywords included lung transplanation, quality of life, international society, disease, bone marrow transplantation. There were 15 clusters and 25 emergent keywords in the CNKI database, and 12 clusters and 25 emergent keywords in the Web of Science core database. ConclusionThe study of lung transplantation nursing at home and abroad has been paid more and more attention, and the research is getting more and more sophisticated. The future study can realize the holistic care of patients during perioperative period on the basis of clinical diagnosis and nursing technology, and improve the survival of patients after operation.
Objective To examine the effect of endothelial progenitor cell (EPC) on lung ischemia-reperfusion injury (LIRI). Methods Twenty-four recipients were randomized into 3 groups including a sham group, a LIRI group, and an EPC group. Rats in the sham group only received anesthesia. Rats in the LIRI and EPC groups received left lung transplantation and received saline or EPC immediately after reperfusion. The partial pressure of oxygen to fraction of inspiratory oxygen (PaO2/FiO2) ratio, wet-to-dry weight ratio and protein levels in the transplanted lung and inflammation-related factors levels in serum were examined. Histological change of transplanted lung were analyzed. The nuclear factor (NF)-κB in the transplanted lung was detected. Results Compared with the LIRI group, the PaO2/FiO2 ratio dramaticly increased, and the wet-to-dry weight ratio and protein level significantly decreased by EPC after reperfusion. The lung histological injury was attenuated by EPC. The pro-inflammatory factors in serum were down-regulated, whereas IL-10 was up-regulated in the EPC group. The expression of NF-κB was decreased by EPC. Conclusion EPC ameliorated LIRI after lung transplantation. The protection of EPC partly associated with anti-inflammation.
[Abstract]It is an effective way of constructing a lung transplantation quality control system suitable for China's national conditions to break through the many dilemmas in China. Under the leadership of the National Quality Control Center, a stage-by-stage and full-scale quality control system for lung transplantation in China has been gradually constructed and extended to many lung transplantation centers nationwide, which has strongly promoted the development of lung transplantation in China. This article outlines the construction, promotion and experience of China's lung transplantation quality control system, aiming to provide reference for further development of relevant measures to promote the homogenization of lung transplantation in China.
Lung transplantation has been proved to be an effective treatment after more than forty years of fast development, while more than 4000 cases of lung transplantation performed globally each year. Recently, lung transplantation in China has been advanced rapidly, and the number of transplants has increased year by year. Respiratory and Critical Care Medicine team has been recognized to play a crucial role in lung transplantation. It has an irreplaceable role and status in promoting lung transplantation, improving the preoperative evaluation of lung transplantation and the maintenance of donors, and carrying out perioperative management, as well as long-term follow-up. Lung transplantation is a systematic project, requiring the perfect cooperation and collaboration of team members and contributing to recipients’ recovery.
ObjectiveTo investigate the risk factors of dysphagia in lung transplant recipients through meta-analysis. MethodCohort studies and case-control studies on risk factors for dysphagia after lung transplantation in Science, Scopus and ProQuest databases were searched from the establishment of the database to July 2023. After literature screening, data extraction and quality evaluation, Meta-analysis was performed using Rev Man 5.4 and Stata17.0 software. Results12 literatures were included, and the results of meta-analysis showed: The incidence of dysphagia in lung transplant recipients was 67% (95%CI 0.59~0.75, I2 =92.44%, P<0.001). There were three risk factors for dysphagia in lung transplant recipients, namely, reintubation (OR=5.34, 95%CI 3.07~9.28, I2 =0%, P<0.001), mechanical ventilation (OR= 4.25, 95%CI 2.95~6.12, I2 =0%, P<0.001), extracorporeal life support (OR=2.13, 95%CI 1.69~2.67, I2 =0%, P<0.001).ConclusionsLung transplant recipients with re-intubation, mechanical ventilation and extracorporeal life support are more likely to have dysphagia after surgery. Nursing staff can combine risk factors and formulate targeted nursing measures to reduce the incidence of dysphagia after lung transplantation.
Objective To assess the effects of lung transplantation (LT) in the treatment of end-stage pulmonary arterial hypertension (PAH) and evaluated its impact on quality of life (QoL). Methods A total of 54 patients with end-stage PAH admitted to the LT center of Wuxi People’s Hospital between January 2007 and June 2019 were retrospectively analyzed. The patients were divided into surgical and non-surgical groups. Clinical data were compared between the groups. The clinical data such as symptoms, signs, biochemistry, survival rate and quality of life were compared between the two groups. The effects of lung transplantation on survival and quality of life were analyzed. The quality of life was scored by SF-36 scale. Results A total of 54 patients with end-stage pulmonary arterial hypertension who met the indications for lung transplantation were enrolled. Among them, 36 patients underwent lung transplantation and 18 patients did not undergo surgery. There were no statistical differences in gender, course of disease, disease type, symptoms between the two groups. The uric acid of the non-operation group was significantly higher than that of the lung transplantation group (P=0.014). The systolic pulmonary artery pressure (SPAP) of the non-operation group was significantly lower than that of the lung transplantation group (P=0.046). Kaplan-Meier survival curve showed that the survival rate of the operation group was higher than that of the non-operation group (P=0.0087). The quality of life assessment showed that after lung transplantation, the physical component summary and mental component summary scores of operation group were higher than those before operation (P<0.01), and also higher than non-operation group in the same period (P<0.05). Preoperative low systemic circulation blood pressure, poor cardiac function, high NT-proBNP and high uric acid may be the risk factors for early death of patients with pulmonary arterial hypertension after lung transplantation. Conclusions Lung transplantation can effectively improve survival and also QoL for patients with end-stage PH. Early detection of risk factors and preoperative assessment can help improve the perioperative survival.
From December 2022 to January 2023, 4 lung transplant recipients (3 males and 1 female, aged 52-60 years, all received transplantation less than 1 year) were hospitalized in the Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University due to COVID-19 after surgery. The clinical manifestations were mostly characterized by elevated body temperature accompanied by shortness of breath, and indicators such as heart rate, oxygen saturation, and oxygenation index could reflect the severity of the condition. The therapy was timely adjusted to immunosuppressive drugs, upgraded oxygen therapy, anti-bacterial and anti-fungal therapy, prone ventilation, general treatment, and anticoagulant therapy, depending on the situation. Finally, 3 patients were cured and discharged from hospital, and 1 died.
The rehabilitation experience of 20 patients with tracheostomy after lung transplantation was reported, and the key points of rehabilitation nursing included sequential oxygen therapy, airway clearance, diaphragm pacing, respiratory training, swallowing training, speech training, exercise training, and gastrointestinal function rehabilitation. Tracheostomy is conducive to airway management and offline extubation in patients assisted by long-term breathing, and promotes patient recovery and discharge through multidisciplinary collaborative rehabilitation nursing integrated case management.
Lung cancer is the most prevalent malignant tumor worldwide. For lung cancer patients with multiple intrapulmonary metastases or impaired lung function, complete tumor resection is challenging, and the prognosis is poor. Lung transplantation demonstrates potential therapeutic value in achieving complete tumor resection, improving lung function, and enhancing quality of life. Advances in tumor detection technologies such as positron emission tomography-computed tomography and circulating tumor DNA, along with the development of comprehensive treatment strategies for lung cancer, provide powerful tools for accurately predicting tumor recurrence and treatment outcomes following lung transplantation. The feasibility of lung transplantation as a treatment for lung cancer is receiving increasing attention. This article reviews the history and clinical management of lung transplantation for lung cancer.