Clinical lung and heart/lung transplantationPlasma Receptor for Advanced Glycation End-products Predicts Duration of ICU Stay and Mechanical Ventilation in Patients After Lung Transplantation
Section snippets
Subjects
Between May and August 2004, 20 consecutive patients undergoing single or bilateral lung transplantation or heart–lung transplantation at the Cleveland Clinic were enrolled in this prospective, observational study. All organs were preserved in Euro-Collins solution during the period of study. The study was approved by the Institutional Review Board for Research of the Cleveland Clinic Foundation.
ISHLT Primary Graft Dysfunction Severity Score Calculation
ISHLT PGD severity scores were calculated for all subjects using data collected within 6 hours of
Results
Demographic characteristics of the 20 study subjects are summarized in Table 2. The mean age of the subjects was 48 years, and the majority of subjects were female. Chronic obstructive pulmonary disease was the most common reason for lung transplantation (n = 10, 50%), and 11 of 20 patients (55%) underwent single lung transplantation. The subjects’ post-operative clinical characteristics and short- and long-term outcomes are described in Table 3. Of note, 11 subjects (55%) had some degree of
Discussion
The most important result of this study is that plasma RAGE levels 4 hours after lung allograft reperfusion predicted the duration of mechanical ventilation and ICU length of stay, even after adjusting for allograft ischemia time. In contrast, markers of alveolar type II cell injury, endothelial injury and acute inflammation were not predictive of these outcomes. Furthermore, in this small sample, plasma RAGE had better prognostic value for these short-term outcomes than the clinical diagnosis
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Identification of regional variation in gene expression and inflammatory proteins in donor lung tissue and ex vivo lung perfusate
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2022, Annals of Thoracic SurgeryCitation Excerpt :Older studies have shown improved thoracic organ yield with high-dose corticosteroid therapy.3,66-68 However high-dose corticosteroid therapy worsens hyperglycemia, which has been associated with worse outcomes of transplanted donor organs.6,69-71 Furthermore much lower doses of corticosteroids have been used for treatment of adrenal insufficiency, septic shock, and cytokine storm.72-74
Microparticles: A new insight into lung primary graft dysfunction?
2016, Human ImmunologyCitation Excerpt :Pharmacological impairment of RAGE may be a way of reducing inflammatory insult to the lung during IRI [48]. RAGE has shown to be a reliable predictive marker for the length of mechanical ventilation the length of intensive care unit stay for patients [49]. RAGEs also demonstrated as a predictive marker of PGD when detected in the donor before lung harvesting [50].
Ex vivo lung graft perfusion
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2015, Journal for Nurse PractitionersCitation Excerpt :Consequently, the hypothesis that RAGE is equally linked to increased inflammation and poor outcomes in illness has been questioned in several recent studies. Lower levels of RAGE, 4 hours post‒lung transplantation, have been associated with increased reperfusion injury, prolonged mechanical ventilation, and prolonged ICU stay.34 If RAGE, with its highest levels generally found in the lungs, is associated with inflammation, it is unclear why lower levels of RAGE would be associated with such a significant pro-inflammatory condition that is the hallmark of reperfusion injury.
Pulmonary Edema
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Supported by NIH/NHLBI HL51856.