International Perfusion Association

Social:

Facebook Instagram Linkedin
IPA

Category: Transplantation

Monitoring Oxygen Delivery

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.

READ MORE
December 21, 2024
Lungs Feature

The Incidence, Risk Factors, and Hospital Mortality of Prolonged Mechanical Ventilation Among Cardiac Surgery Patients: A Systematic Review and Meta-Analysis

This systematic review analyzes prolonged mechanical ventilation (PMV) post-cardiac surgery, finding an incidence rate of 20%. PMV, defined as ventilation lasting ≥24 hours, is linked to in-hospital mortality (odds ratio: 14.13). Key risk factors include advanced age, female sex, ejection fraction <50%, and body mass index >28 kg/m². PMV also correlates with conditions like chronic renal failure and prolonged cardiopulmonary bypass time. These insights highlight the need for targeted prevention and management strategies.

READ MORE
December 20, 2024
ECMO Lung

Intraoperative Extracorporeal Support for Lung Transplant: A Systematic Review and Network Meta-Analysis

This systematic review and network meta-analysis investigates the comparative effectiveness of veno-arterial extracorporeal membrane oxygenation (V-A ECMO), cardiopulmonary bypass (CPB), and OffPump strategies for lung transplantation (LT). Based on 27 observational studies with 6113 patients, the study finds that OffPump approaches outperform both ECMO and CPB in all major outcomes, including reduced ICU stay, mechanical ventilation duration, and mortality. Among extracorporeal supports, V-A ECMO showed better performance than CPB. Factors such as age, gender, and BMI significantly influenced postoperative outcomes.

READ MORE
December 20, 2024
Hypertrophic Cardiomyopathy

Anesthetic Precision in Severe Hypertrophic Cardiomyopathy: Navigating Perioperative Challenges

This case report details the anesthetic management of a 77-year-old female with hypertrophic obstructive cardiomyopathy (HOCM), undergoing surgery for ileal adenocarcinoma. It highlights challenges such as preventing left ventricular outflow tract obstruction and maintaining hemodynamic stability. A tailored approach, including vigilant monitoring, goal-directed fluid therapy, and careful use of vasopressors, ensured successful outcomes. The report underscores the importance of meticulous perioperative planning in HOCM cases.

READ MORE
December 10, 2024
Liver Bypass

Venovenous Bypass in Liver Transplantation: Exploring the Benefits, Efficacy, and Safety

This article explores the utilization of venovenous bypass (VVB) in liver transplantation (LT), highlighting its benefits, efficacy, and safety. Although VVB helps maintain hemodynamic stability and improve patient outcomes, its global use has declined due to concerns about heparinization, major bleeding, and the need for specialized expertise. Recent advancements in percutaneous cannulation techniques and extracorporeal technology have enhanced the safety of VVB. Studies show that VVB reduces the incidence of acute kidney injury, operative time, and blood loss without increasing morbidity or mortality. Despite these benefits, alternative techniques are being increasingly adopted. The article emphasizes the role of VVB in complex clinical scenarios and calls for continued research to optimize its application in liver transplantation.

READ MORE
June 19, 2024
N Regional Lung

Lung Transplantation in Controlled Donation After Circulatory-Determination-of-Death Using Normothermic Abdominal Perfusion

The shortage of suitable lung donors remains a significant challenge in lung transplantation. While brain-death donors (DBD) currently provide most lung allografts, only 20% are suitable for transplantation. This review discusses the potential of using donors after circulatory-determination-of-death (DCD) to increase the donor pool. Emphasizing controlled DCD (cDCD) donors, the article outlines the importance of ICU management and expertise in organ procurement, presenting a protocol for lung retrieval using normothermic abdominal perfusion.

READ MORE
June 1, 2024
LVAD

Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score

This study evaluates the mortality risk associated with infections in patients with left ventricular assist devices (LVAD). It highlights the development of a clinical risk prediction score based on factors like diabetes, type of Staphylococcus aureus infection, and treatment approaches including surgical debridement and flap reconstruction. Results indicate varying survival rates based on risk scores, suggesting that tailored surgical interventions may improve outcomes for patients with LVAD infections.

READ MORE
April 23, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

READ MORE
April 22, 2024
Transplant Heart

Novel Portable Hypothermic Machine Perfusion Preservation Device Enhances Cardiac Viability of Donated Human Hearts

This study investigates a novel portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE®, designed to extend preservation times for donated human hearts. Utilizing hearts from 11 brain-dead donors, the research compared the efficacy of preservation across different durations (4, 6, and 8 hours) against standard static cold storage (SCS). Findings indicate that the VP.S ENCORE® significantly maintains cardiac viability and function, matching levels observed in healthy hearts, particularly in 6-hour perfusion scenarios which showed improved ventricular relaxation and reduced inflammation marker expression.

READ MORE
April 18, 2024
ECMO Nexk

Alternative Venous Access Sites for Dual-Lumen Extracorporeal Membrane Oxygenation Cannulation

This multicenter case series examines the safety and feasibility of using alternative venous access sites for dual-lumen cannulas in veno-venous (VV) extracorporeal membrane oxygenation (ECMO) when the right internal jugular vein (RIJV) is inaccessible. Data from three high-volume ECMO centers were analyzed, involving 20 patients who required alternative access due to inaccessible RIJV. The study found no procedural complications with alternative sites, which included the left internal jugular, subclavian, and femoral veins. The outcomes were promising with half of the patients successfully bridged to lung transplantation or recovery, highlighting the viability of these alternative sites for critical ECMO support.

READ MORE
April 11, 2024
Load More

Post Categories