Category Archives: Pulmonary Function : Part 21

Donor Selection for Single and Double Lung Transplantation: Discussion (2)

Despite this intention, the donors actually chosen for SLT were relatively small in comparison to the recipients (Table 1), and the thoracic dimensions of the donors were very similar to those of the recipients (Table 2). Although the donors for DLT were slightly larger than the recipients (Table 1), their thoracic dimensions were significantly smaller than those of the emphysematous recipients (Table 2). Thus, donor-recipient chest size matching was imprecise in the SLT recipients, but it was more accurate in the DLT group.
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Donor Selection for Single and Double Lung Transplantation: Discussion (1)

Donor Selection for Single and Double Lung Transplantation: Discussion (1)Since 1983, successful SLTs and DLTs have been performed for both severe obstructive and restrictive lung diseases. Although both operations lead to substantial improvement in pulmonary function, limited attention has been given to donor-recipient factors that influence the posttransplantation pulmonary function of the recipient.
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Donor Selection for Single and Double Lung Transplantation: Results (3)

The relationships between the donors predicted normal VC (pred VCD) and the recipients posttransplantation VC (posttx VCr) are shown in Figure 2. After left SLT, a significant correlation (r = 0.83, p<0.05) was found between the left pred VCD and the left posttx VCR. After DLT, however, no correlation was detected between the pred VCD and posttx VCR. The relationships between the recipients predicted normal VC (pred VCr) and the recipients posttransplantation VC (posttx VCr) are shown in Figure 3. After left SLT, there was no correlation between these parameters, but two recipients of right SLTs were located very close to the line of identity. After DLT, a tendency toward correlation (r = 0.75, p<0.1) between these was apparent, but it did not reach statistical significance.
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Donor Selection for Single and Double Lung Transplantation: Results (2)

Donor Selection for Single and Double Lung Transplantation: Results (2)The pretransplantation and posttransplantation pulmonary function data of the eight SLT and six DLT recipients who were studied are presented in Table 3. Before transplantation, pulmonary function tests in the SLT recipients showed a severe restrictive abnormality consistent with their diagnosis of pulmonary fibrosis. After SLT, perfusion shifted to the transplanted lung. When the maximum VC was recorded, the mean scintigraphic perfusion to the allograft was 87 ±6 percent. The maximum VC was reached in 13 ± 10 months (range, three to 36 months), and all categories of routine pulmonary function were significantly improved. Preoperative tests in the DLT recipients demonstrated a severe obstructive abnormality, hyperinflation, and a marked reduction in diffusing capacity. Each parameter returned to normal or near normal in all recipients after lung transplantation, and all of the changes were statistically significant. cialis professional
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Donor Selection for Single and Double Lung Transplantation: Results (1)

The characteristics of recipients and donors are shown in Table 1. In the SLT group, the age was significantly younger in the donors (30 ± 10 years) than the recipients (48 ± 12 years). Thirteen recipients were male and two were female, whereas eight donors were male and seven were female. Weight, height, and body surface area (BSA) were all significantly smaller in the donors than in the recipients.
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Donor Selection for Single and Double Lung Transplantation: Patients and Methods (2)

Donor Selection for Single and Double Lung Transplantation: Patients and Methods (2)Methods
The chest size match between recipient and donor was based on the vertical and transverse radiologic dimensions of the chest. The transverse dimension was measured across the chest at the level of the dome of the diaphragm, and the vertical dimensions on each side were taken from the apex of the lung to the dome of the diaphragm. buy ortho tri-cyclen online
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Donor Selection for Single and Double Lung Transplantation: Patients and Methods (1)

Patients
Between November 1983 and December 1987, 15 SLTs and seven DLTs were performed at the loronto () General Hospital. Thirteen of the 15 SLT recipients had idiopathic pulmonary fibrosis, one had familial pulmonary fibrosis, and one had eosinophilic granuloma. Three of the seven DLT recipients had ax-antitrypsin deficiency emphysema, one had idiopathic emphysema, one had bronchiolitis obliterans, one had eosinophilic granuloma, and one had primary pulmonary hypertension.
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Donor Selection for Single and Double Lung Transplantation

Donor Selection for Single and Double Lung TransplantationSingle lung transplantation (SLT) and double lung transplantation (DLT) have proved successful in patients with end-stage pulmonary diseases. Both SLT and DLT lead to significant improvement in standard parameters of pulmonary function. However, factors that influence or determine posttransplantation pulmonary function have not been carefully studied.
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Comparison of Tucson and Cracow Longitudinal Studies: Discussion (Part 4)

Comparison of Tucson and Cracow Longitudinal Studies: Discussion (Part 4)The effects of continuous smoking were similar in men of both cities, but in women they were markedly greater in Tucson than in Cracow. In both cities the greatest effects were found in women smoking 15 to 24 cigarettes a day, and 60 percent of Tucson smoking women were in this category—twice as many as in Cracow (27 percent). While the effects of cigarette smoking appear greater at the same dose in Tucson (by up to 80 percent for FEVi levels, with very slight differences for slopes), most of the overall difference is due to the quantity of cigarettes smoked. As discussed above, the effects of continuous smoking on FEVi slope were not uniform in the Tucson group and the magnitude appeared to depend on the presence of chronic cough. In Cracow the effects of smoking were more uniform, although the magnitude of the effect was smaller (although the variability was also smaller) than those for significant symptoms. Continue reading

Comparison of Tucson and Cracow Longitudinal Studies: Discussion (Part 3)

The relationship of FEV, decline or final level to bronchitis symptoms (chronic cough or phlegm) was not consistent when the relationships were adjusted for effects of other symptoms. This would suggest a rather limited application of the “British hypothesis” to the populations considered herein. However, the Tucson data suggest that chronic cough may indicate a group of “susceptible” smokers, postulated by Fletcher et al. This result was not confirmed by Cracow data. However, it is possible that a large proportion of Cracow subjects develop cough as a result of factors other than smoking, such as environmental conditions (temperature, air pollution) unlikely to occur in Tucson. Assuming that such cough reflects only an irritation of upper respiratory tract and is not associated with decrease in pulmonary function, it could conceal the effect of smoking in susceptible subjects (reflected by both cough and decrease in FEV,) in Cracow. It is possible that the acceleration of FEV, decline associated with persistent cough in Tucson subjects indicates a beginning of an emphysematous form of chronic obstructive pulmonary disease. In a follow-up of subjects with diagnosed disease, such form was shown to have less favorable prognosis than the asthmatic one. buy prednisone
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