1.Gastric Ulcer Perforation in Heart-Lung Transplant Patient: A Successful Case of Early Surgical Intervention and Management.
Hyo Chae PAIK ; Do Hyung KIM ; Doo Yun LEE ; Dong Sup YOON ; Jae Hoon LEE
Yonsei Medical Journal 2003;44(6):1094-1097
Gastrointestinal complications may follow organ transplantation. A patient who underwent heart lung transplantation due to patent ductus arteriosus and Eisenmenger's syndrome had an episode of acute cardiac rejection and was treated with a bolus injection of methylprednisolone followed by a high oral dose of prednisone. On the 22nd postoperative day, the patient complained of acute abdominal pain with muscular rigidity and a plain chest x-ray showed free air in the right subdiaphragmatic area. Under the suspicion of bowel perforation, an emergency laparotomy was performed and the perforated stomach had a wedge-shaped resection that included the perforation. Following the laparotomy, the postoperative course was uneventful and the patient was discharged on post-laparotomy day 10.
Adult
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Heart-Lung Transplantation/*adverse effects
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Human
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Male
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Peptic Ulcer Perforation/*etiology/*surgery
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Stomach Ulcer/*surgery
3.Association of cardiac disease with the risk of post-lung transplantation mortality in Chinese recipients aged over 65 years.
Guohui JIAO ; Shugao YE ; Ji ZHANG ; Bo WU ; Dong WEI ; Dong LIU ; Feng LIU ; Chunxiao HU ; Jingyu CHEN
Frontiers of Medicine 2023;17(1):58-67
The current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≽ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65-70 years (111 recipients, group 65-70) and ≽ 70 years (55 recipients, group ≽ 70) were included. Group D restrictive lung disease was the main indication of a lung transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≽ 70 (30.9% vs. 14.4% in group 65-70, P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65-70) and 7.3% (group ≽ 70) of patients. Kaplan-Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of post-LT mortality (HR 6.37, P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.
Aged
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Humans
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East Asian People
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Heart Diseases/etiology*
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Lung Transplantation/adverse effects*
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Retrospective Studies
4.Infections after lung transplantation: time of occurrence, sites, and microbiologic etiologies.
Ji Hyun YUN ; Sang Oh LEE ; Kyung Wook JO ; Se Hoon CHOI ; Jina LEE ; Eun Jin CHAE ; Kyung Hyun DO ; Dae Kee CHOI ; In Cheol CHOI ; Sang Bum HONG ; Tae Sun SHIM ; Hyeong Ryul KIM ; Dong Kwan KIM ; Seung Il PARK
The Korean Journal of Internal Medicine 2015;30(4):506-514
BACKGROUND/AIMS: Infections are major causes of both early and late death after lung transplantation (LT). The development of prophylaxis strategies has altered the epidemiology of post-LT infections; however, recent epidemiological data are limited. We evaluated infections after LT at our institution by time of occurrence, site of infections, and microbiologic etiologies. METHODS: All consecutive patients undergoing lung or heart-lung transplantation between October 2008 and August 2014 at our institution were enrolled. Cases of infections after LT were initially identified from the prospective registry database, which was followed by a detailed review of the patients' medical records. RESULTS: A total of 108 episodes of post-LT infections (56 bacterial, 43 viral, and nine fungal infections) were observed in 34 LT recipients. Within 1 month after LT, the most common bacterial infections were catheter-related bloodstream infections (42%). Pneumonia was the most common site of bacterial infection in the 2- to 6-month period (28%) and after 6 months (47%). Cytomegalovirus was the most common viral infection within 1 month (75%) and in the 2- to 6-month period (80%). Respiratory viruses were the most common viruses after 6 months (48%). Catheter-related candidemia was the most common fungal infection. Invasive pulmonary aspergillosis developed after 6 months. Survival rates at the first and third years were 79% and 73%, respectively. CONCLUSIONS: Although this study was performed in a single center, we provide valuable and recent detailed epidemiology data for post-LT infections. A further multicenter study is required to properly evaluate the epidemiology of post-LT infections in Korea.
Adult
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Bacterial Infections/diagnosis/*microbiology/mortality
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Catheter-Related Infections/microbiology/virology
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Cytomegalovirus Infections/virology
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Female
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Heart-Lung Transplantation/*adverse effects/mortality
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Humans
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Kaplan-Meier Estimate
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Lung Transplantation/*adverse effects/mortality
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Male
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Medical Records
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Middle Aged
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Mycoses/diagnosis/*microbiology/mortality
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Pneumonia, Bacterial/microbiology
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Registries
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Republic of Korea/epidemiology
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Risk Factors
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Time Factors
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Treatment Outcome
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Virus Diseases/diagnosis/mortality/*virology