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Franz M, Aburahma K, Yablonski P, Carlens J, Saipbaev A, Mueller C, Sommer W, Kuehn C, Haverich A, Warnecke G, Avsar M, Schwerk N, Salman J, Bobylev D, Ius F. Nine-Year Experience with Treatment of Early Detectable Donor Specific Anti-HLA Antibodies in Pediatric Lung Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Heise E, Chichelnitskiy E, Franz M, Aburahma K, Iablonski P, Bobylev D, Saipbaev A, Schwerk N, Sommer W, Greer M, Avsar M, Wiegmann B, Knöfel A, Kühne J, Warnecke G, Haverich A, Kühn C, Salman J, Falk C, Ius F. Perioperative Desensitization Changes the Plasma Cytokine Milieu in Lung Transplant Patients with Preformed Donor Specific Antibodies. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Floethmann K, Aburahma K, de Manna N, Franz M, Yablonski P, Saipbaev A, Greer M, Avsar M, Bobylev D, Schwerk N, Sommer W, Warnecke G, Welte T, Haverich A, Kuehn C, Salman J, Ius F. Impact of Donor Quality on Recipient Outcomes in Lung Transplantation: 12-Year Single-Center Experience Using the Eurotransplant Lung Donor Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Aburahma K, Franz M, Yablonski P, de Manna N, Saipbaev A, Avsar M, Schwerk N, Sommer W, Greer M, Falk C, Welte T, Haverich A, Kuehn C, Warnecke G, Salman J, Ius F. Nine-Year Results of an IgA-And IgM-Enriched Human Immunoglobulin-Based Therapy for Early Detectable Anti-HLA Donor Specific Antibodies after Lung Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Aburahma K, Franz M, Julia C, Heise E, Saipbaev A, Mueller C, Kühn C, Haverich A, Warnecke G, Avsar M, Schwerk N, Salman J, Bobylev D, Ius F. Nine-Year Experience with Treatment of Early Donor Specific Anti-HLA Antibodies in Pediatric Lung Transplant Recipients. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- K. Aburahma
- Hannover Medical School, Hannover, Deutschland
| | - M. Franz
- Hannover Medical School, Hannover, Deutschland
| | - C. Julia
- Hannover Medical School, Hannover, Deutschland
| | - E. Heise
- Hannover Medical School, Hannover, Deutschland
| | - A. Saipbaev
- Hannover Medical School, Hannover, Deutschland
| | - C. Mueller
- Hannover Medical School, Hannover, Deutschland
| | - C. Kühn
- Hannover Medical School, Hannover, Deutschland
| | - A. Haverich
- Hannover Medical School, Hannover, Deutschland
| | - G. Warnecke
- University Hospital Heidelberg, Heidelberg, Deutschland
| | - M. Avsar
- Hannover Medical School, Hannover, Deutschland
| | - N. Schwerk
- Hannover Medical School, Hannover, Deutschland
| | - J. Salman
- Hannover Medical School, Hannover, Deutschland
| | - D. Bobylev
- Hannover Medical School, Hannover, Deutschland
| | - F. Ius
- Hannover Medical School, Hannover, Deutschland
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Salman J, Franz M, Yablonski P, Saipbaev A, Avsar M, Schwerk N, Sommer W, Greer M, Falk C, Welte T, Haverich A, Kuehn C, Warnecke G, Ius F. Eight-Year Results of an IgA- and IgM-Enriched Human Immunoglobulin-Based Therapy for Early Detectable Anti-HLA Donor Specific Antibodies After Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Franz M, Aburahma K, Yablonski P, Flöthmann K, Bobylev D, Schwerk N, Sommer W, Greer M, Avsar M, Welte T, Falk C, Haverich A, Kühn C, Warnecke G, Salman J, Ius F. Perioperative Desensitization with IgA- and IgM-Enriched Human Immunoglobulins Allows Safe Lung Transplantation in Patients with Preformed Donor Specific Antibodies. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hansmann G, Diekmann F, Chouvarine P, Ius F, Carlens J, Schwerk N, Warnecke G, Vogel-Claussen J, Hohmann D, Alten T, Jack T. Full Recovery of Right Ventricular Systolic Function in Children Undergoing Bilateral Lung Transplantation for Severe PAH. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Greer M, Mueller C, Vagi R, Wolf-Maras R, Klintschar M, Jaeger B, Schwerk N, Fuehner T, Salman J, Hoeper M, Haverich A, Ius F. Out of the Frying-Pan and into the Fire: Transplant Candidate Selection in Acute Lung Failure Due to SARS-CoV-2 Infection. J Heart Lung Transplant 2022. [PMCID: PMC8988482 DOI: 10.1016/j.healun.2022.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The COVID-19 pandemic led to unprecedented rates of acute lung failure (ALF), and a rise in lung transplantation (LTx) referrals. Data on LTx in ALF is limited to LTx outcomes, and the unpredictable course of SARS-CoV-2 makes candidate selection challenging. This study summarizes our experiences, in both patients transplanted and those we declined. Methods LTx referrals for ALF due to SARS-CoV-2 between 01Apr20-01Oct21 were reviewed. Set parameters were collected prospectively. Acceptance criteria reflected previous guidance. Cases were discussed at our multi-disciplinary meeting and suitable candidates evaluated at source before transfer for consent and listing. Internal follow-up and external data from declined patients were retrospectively analysed, with survival to discharge and length of hospital stay as end-points. Results 45 patients were referred (78% male). Median age was 55.8 [IQR 47.6-59.8] years. 36 (80%) required both mechanical ventilation and vvECMO, of median duration 46 [31-82] and 34 [24-72] days respectively. Consolidation was the commonest CT finding (47%). Bacterial colonisation (23/45, 51%), coagulopathy (21/45, 47%) and hepatic dysfunction (11/45, 24%) were common. Twenty-two patients were conscious, of whom 21 were evaluated. Five patients died during evaluation, from either sepsis or bleeding. One failed evaluation, and one withdrew consent. Six patients improved, making urgent LTx unnecessary, with 5 attending our review clinic. Of the 8 patients successfully evaluated, one died unexpectantly awaiting transfer, one improved at listing and a further patient died of sepsis after listing. Three patients underwent LTx, all being discharged home at 3 months post-LTx. Conclusion LTx candidate selection in critically ill SARS-CoV2 patients is challenging. Late recovery, particularly in non-fibrotic ALF is not unusual. Decision-making needs to include “acceptable morbidity” as a prelude to delayed evaluation and perhaps listing. More data is needed about declined candidates, particularly unweanable sedated patients with single-organ failure. Even successful awake recipients may experience significant psychological injury, underlining previous arguments in sedated patients. Equity to all candidates needs consideration, given the extraordinary demands on organ availability and care resources.
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Salman J, Aburahma K, Franz M, Schwerk N, Greer M, Falk C, Welte T, Haverich A, Kühn C, Warnecke G, Ius F. Risk Factors for the Development of Early Anti-HLA Donor Specific Antibodies After Lung Transplantation: The Role of Primary Graft Dysfunction. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hansmann G, Diekmann F, Chouvarine P, Ius F, Carlens J, Schwerk N, Warnecke G, Vogel-Claussen J, Hohmann D, Alten T, Jack T. Full Recovery of Right Ventricular Systolic Function in Children Undergoing Bilateral Lung Transplantation for Severe PAH. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G. Hansmann
- Pädiatrische kardiologie und intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F. Diekmann
- Pädiatrische kardiologie und intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - P. Chouvarine
- Pediatric Cardiology and Critical Care, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F. Ius
- Herz-, thorax-, transplantations- und gefäßchirurgie (httg), Medizinische Hochschule Hannover, Hannover, Deutschland
| | - J. Carlens
- Päd. Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - N. Schwerk
- Päd. Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - G. Warnecke
- Herzchirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - J. Vogel-Claussen
- Diagnostische und interventionelle radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - D. Hohmann
- Pädiatrische kardiologie und intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T. Alten
- Diagnostische und interventionelle radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T. Jack
- Pädiatrische kardiologie und intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
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Flöthmann K, Aburahma K, Franz M, Poyanmehr R, Iablonskii P, Saipbaev A, Greer M, Avsar M, Bobylev D, Schwerk N, Niehaus A, Sommer W, Warnecke G, Haverich A, Kühn C, Salman J, Ius F. Impact of Donor Quality on Recipient Outcomes in Lung Transplantation: 11-Year Single-Center Experience Using the Eurotransplant Lung Donor Score. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Flöthmann
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - K. Aburahma
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - M. Franz
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - R. Poyanmehr
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - P. Iablonskii
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - A. Saipbaev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - M. Greer
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Deutschland
| | - M. Avsar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - D. Bobylev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - N. Schwerk
- Department of Paediatrics, Hannover Medical School, Hannover, Deutschland
| | - A. Niehaus
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - W. Sommer
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - G. Warnecke
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - A. Haverich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - C. Kühn
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - J. Salman
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - F. Ius
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
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Aburahma K, Iablonskii P, Saipbaev A, Niehaus A, Avsar M, Bobylev D, Schwerk N, Sommer W, Greer M, Tudorache I, Warnecke G, Haverich A, Kühn C, Salman J, Ius F. Eight-Year Results of an IgA- and IgM-Enriched Human Immunoglobulin-Based Therapy for Possible Subclinical and Clinical Antibody-Mediated Rejection after Lung Transplantation. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Aburahma
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - P. Iablonskii
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - A. Saipbaev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - A. Niehaus
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - M. Avsar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - D. Bobylev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - N. Schwerk
- Department of Paediatrics, Hannover Medical School, Hannover, Deutschland
| | - W. Sommer
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - M. Greer
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Deutschland
| | - I. Tudorache
- Department of Cardiac Surgery, University Hospital Düsseldorf, Düsseldorf, Deutschland
| | - G. Warnecke
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - A. Haverich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - C. Kühn
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - J. Salman
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - F. Ius
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
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Franz M, Iablonskii P, Flöthmann K, Bobylev D, Saipbaev A, Schwerk N, Sommer W, Greer M, Avsar M, Warnecke G, Haverich A, Kühn C, Salman J, Ius F. Preformed Donor-Specific Antibodies in Lung Transplantation: Eight-Year Experience with Perioperative Desensitization Using IgA- and IgM-Enriched Human Immunoglobulins. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Franz
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - P. Iablonskii
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - K. Flöthmann
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - D. Bobylev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - A. Saipbaev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - N. Schwerk
- Department of Paediatrics, Hannover Medical School, Hannover, Deutschland
| | - W. Sommer
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - M. Greer
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Deutschland
| | - M. Avsar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - G. Warnecke
- Department of Cardiac Surgery, Heidelberg Medical School, Heidelberg, Deutschland
| | - A. Haverich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - C. Kühn
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - J. Salman
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
| | - F. Ius
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Deutschland
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Ius F, Salman J, Müller C, Carlens J, Aburahma K, Franz M, Niehaus A, Tudorache I, Sommer W, Greer M, Horke A, Kühn C, Haverich A, Avsar M, Bobylev D, Warnecke G, Schwerk N. Fifteen-Year Single Center Experience with Lung Transplantation in Pediatric Patients Younger Than 12 Years Old. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Flöthmann K, Salman J, Aburahma K, Siemeni T, Franz M, Greer M, Avsar M, Bobylev D, Müller C, Carlens J, Schwerk N, Niehaus A, Sommer W, Tudorache I, Warnecke G, Kühn C, Haverich A, Ius F. Impact of Donor Quality on Recipient Outcomes in Lung Transplantation: 10-year Single-Center Experience Using the Eurotransplant Lung Donor Score. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Salman J, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Sommer W, Greer M, Tudorache I, Falk C, Kühn C, Haverich A, Warnecke G, Ius F. Seven-Year Clinical Results of an IgA-and IgM-Enriched Human Immunoglobulin-Based Therapy for Antibody-Mediated Rejection after Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Mueller C, Sommer W, Boethig D, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Kuehn C, Salman J, Ius F. Influence of Donor-Recipient Age Mismatch in Young Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Müller C, Sommer W, Boethig D, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Salman J, Ius F. Influence of Donor-Recipient Age Mismatch in Young Lung Transplant Recipients. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Salman J, Aburahma K, Siemeni T, Kühn C, Avsar M, Bobylev D, Franz M, Schwerk N, Niehaus A, Sommer W, Greer M, Tudorache I, Warnecke G, Haverich A, Ius F. Seven-Year Clinical Results of AN IgA- and IgM-Enriched Human Immunoglobulin-Based Therapy for Antibody-Mediated Rejection in Lung Transplantation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Franz M, Aburahma K, Siemeni T, Avsar M, Bobylev D, Schwerk N, Müller C, Sommer W, Greer M, Tudorache I, Warnecke G, Hoeper M, Haverich A, Ius F, Salman J. 10-Year Experience with Postoperatively Extended Intraoperative Extracorporeal Membrane Oxygenation in Lung Transplantation for Patients with Severe Pulmonary Hypertension. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ius F, Salman J, Müller C, Carlens J, Aburahma K, Franz M, Niehaus A, Kühn C, Tudorache I, Warnecke G, Horke A, Avsar M, Haverich A, Schwerk N, Bobylev D. Lung Transplantation in Pediatric Patients Younger than 12 Years: 15-Year Single-Center Experience. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rose MA, Barker M, Liese J, Adams O, Ankermann T, Baumann U, Brinkmann F, Bruns R, Dahlheim M, Ewig S, Forster J, Hofmann G, Kemen C, Lück C, Nadal D, Nüßlein T, Regamey N, Riedler J, Schmidt S, Schwerk N, Seidenberg J, Tenenbaum T, Trapp S, van der Linden M. [Guidelines for the Management of Community Acquired Pneumonia in Children and Adolescents (Pediatric Community Acquired Pneumonia, pCAP) - Issued under the Responsibility of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Pulmonology (GPP)]. Pneumologie 2020; 74:515-544. [PMID: 32823360 DOI: 10.1055/a-1139-5132] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The present guideline aims to improve the evidence-based management of children and adolescents with pediatric community-acquired pneumonia (pCAP). Despite a prevalence of approx. 300 cases per 100 000 children per year in Central Europe, mortality is very low. Prevention includes infection control measures and comprehensive immunization. The diagnosis can and should be established clinically by history, physical examination and pulse oximetry, with fever and tachypnea as cardinal features. Additional signs or symptoms such as severely compromised general condition, poor feeding, dehydration, altered consciousness or seizures discriminate subjects with severe pCAP from those with non-severe pCAP. Within an age-dependent spectrum of infectious agents, bacterial etiology cannot be reliably differentiated from viral or mixed infections by currently available biomarkers. Most children and adolescents with non-severe pCAP and oxygen saturation > 92 % can be managed as outpatients without laboratory/microbiology workup or imaging. Anti-infective agents are not generally indicated and can be safely withheld especially in children of young age, with wheeze or other indices suggesting a viral origin. For calculated antibiotic therapy, aminopenicillins are the preferred drug class with comparable efficacy of oral (amoxicillin) and intravenous administration (ampicillin). Follow-up evaluation after 48 - 72 hours is mandatory for the assessment of clinical course, treatment success and potential complications such as parapneumonic pleural effusion or empyema, which may necessitate alternative or add-on therapy.
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Affiliation(s)
- M A Rose
- Fachbereich Medizin, Johann-Wolfgang-Goethe-Universität Frankfurt/Main und Zentrum für Kinder- und Jugendmedizin, Klinikum St. Georg Leipzig
| | - M Barker
- Klinik für Kinder- und Jugendmedizin, Helios Klinikum Emil von Behring, Berlin
| | - J Liese
- Kinderklinik und Poliklinik, Universitätsklinikum an der Julius-Maximilians-Universität Würzburg, Würzburg
| | - O Adams
- Institut für Virologie, Universitätsklinikum Düsseldorf
| | - T Ankermann
- Klinik für Kinder- und Jugendmedizin 1, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - U Baumann
- Pädiatrische Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover
| | - F Brinkmann
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ruhr-Universität Bochum
| | - R Bruns
- Zentrum für Kinder- und Jugendmedizin, Ernst-Moritz-Arndt-Universität Greifswald
| | - M Dahlheim
- Praxis für Kinderpneumologie und Allergologie, Mannheim
| | - S Ewig
- Kliniken für Pneumologie und Infektiologie, Thoraxzentrum Ruhrgebiet, Bochum/Herne
| | - J Forster
- Kinderabteilung St. Hedwig, St. Josefskrankenhaus , Freiburg und Merzhausen
| | | | - C Kemen
- Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg
| | - C Lück
- Institut für Medizinische Mikrobiologie und Hygiene, Technische Universität Dresden
| | - D Nadal
- Kinderspital Zürich, Schweiz
| | - T Nüßlein
- Klinik für Kinder- und Jugendmedizin, Gemeinschaftsklinikum Mittelrhein, Koblenz
| | - N Regamey
- Pädiatrische Pneumologie, Kinderspital Luzern, Schweiz
| | - J Riedler
- Kinder- und Jugendmedizin, Kardinal Schwarzenberg'sches Krankenhaus, Schwarzach, Österreich
| | - S Schmidt
- Zentrum für Kinder- und Jugendmedizin, Ernst-Moritz-Arndt-Universität Greifswald
| | - N Schwerk
- Pädiatrische Pneumologie, Allergologie und Neonatologie, Medizinische Hochschule Hannover
| | - J Seidenberg
- Klinik für pädiatrische Pneumologie und Allergologie, Neonatologie, Intensivmedizin und Kinderkardiologie, Klinikum Oldenburg
| | - T Tenenbaum
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Mannheim
| | | | - M van der Linden
- Institut für Medizinische Mikrobiologie, Universitätsklinikum Aachen
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24
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Ius F, Draeger H, Sommer W, Siemeni T, Kühn C, Avsar M, Bobylev D, Schwerk N, Greer M, Haverich A, Tudorache I, Warnecke G. Impact of Diaphragmatic Dysfunction on Postoperative Course after Bilateral Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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25
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Ius F, Sommer W, Salman J, Siemeni T, Kühn C, Avsar M, Schwerk N, Müller C, Falk C, Haverich A, Tudorache I, Warnecke G. Six-Year Results of an IgA- and IgM-Enriched Immunoglobulin-Based Therapy for Early Detectable Anti-HLA Donor Specific Antibodies in Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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26
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Ius F, Salman J, Sommer W, Poyanmehr R, Avsar M, Siemeni T, Bobylev D, Schwerk N, Müller C, Haverich A, Kühn C, Warnecke G, Tudorache I. Extracorporeal Membrane Oxygenation during Lung Transplantation and Long-Term Graft Function: Results from a 9-Year Single-Center Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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27
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Ius F, Sommer W, Salman J, Siemeni T, Kühn C, Avsar M, Schwerk N, Haverich A, Tudorache I, Warnecke G. Six-Year Clinical Results of an IgA-and IgM-Enriched Human Immunoglobulin-Based Therapy for Early Anti-HLA Donor Specific Antibodies after Lung Transplantation. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Ius F, Draeger H, Sommer W, Salman J, Schwerk N, Gottlieb J, Welte T, Haverich A, Tudorache I, Warnecke G. Impact of Unilateral Diaphragmatic Dysfunction on Postoperative Outcome after Bilateral Lung Transplantation. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Ius F, Verboom M, Sommer W, Müller C, Hallensleben M, Salman J, Siemeni T, Kühn C, Avsar M, Bobylev D, Schwerk N, Haverich A, Tudorache I, Warnecke G. Five-Year Results of an IgA and IgM-Enriched Human Immunoglobulin G-Based Therapy for Early Anti-HLA Donor Specific Antibodies in 158 Lung-Transplanted Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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30
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Ius F, Sommer W, Verboom M, Salman J, Siemeni T, Kühn C, Avsar M, Bobylev D, Hallensleben M, Schwerk N, Müller C, Haverich A, Tudorache I, Warnecke G. Five-Year Results of an IgA- and IgM-Enriched Human Immunoglobulin-Based Therapy for Early anti-HLA Donor-Specific Antibodies after Lung Transplantation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F. Ius
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - W. Sommer
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - M. Verboom
- Medizinische Hochschule Hannover, Transfusionsmedizin, Hannover, Germany
| | - J. Salman
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - T. Siemeni
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - C. Kühn
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - M. Avsar
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - D. Bobylev
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - M. Hallensleben
- Medizinische Hochschule Hannover, Transfusionsmedizin, Hannover, Germany
| | - N. Schwerk
- Medizinische Hochschule Hannover, Pädiatrische Pneumologie, Hannover, Germany
| | - C. Müller
- Medizinische Hochschule Hannover, Pädiatrische Pneumologie, Hannover, Germany
| | - A. Haverich
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - I. Tudorache
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
| | - G. Warnecke
- Medizinische Hochschule Hannover, Herz- Thorax- Transplantations- Gefäßchirurgie, Hannover, Germany
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31
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Seidl E, Carlens J, Reu S, Wetzke M, Ley-Zaporozhan J, Brasch F, Wesselak T, Schams A, Rauch D, Schuch L, Kappler M, Schelstraete P, Wolf M, Stehling F, Haarmann E, Borensztajn D, van de Loo M, Rubak S, Lex C, Hinrichs B, Reiter K, Schwerk N, Griese M. Pulmonary interstitial glycogenosis – A systematic analysis of new cases. Respir Med 2018; 140:11-20. [DOI: 10.1016/j.rmed.2018.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 05/13/2018] [Indexed: 11/16/2022]
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32
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Sommer W, Ius F, Schwerk N, Müller C, Bobylev D, Kühn C, Avsar M, Salman J, Siemeni T, Horke A, Haverich A, Tudorache I, Warnecke G. Non-standard Donor Organs in Pediatric Lung Transplantation Have No Negative Impact on Recipients Outcome. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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33
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Ius F, Sommer W, Verboom M, Hallensleben M, Salman J, Siemeni T, Kuehn C, Avsar M, Bobylev D, Poyanmehr R, Schwerk N, Mueller C, Haverich A, Tudorache I, Warnecke G. Long-term Results of an IgM-enriched Human Immunoglobulin-based Therapy for Early Donor Specific Antibodies After Lung Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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34
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Nyilas S, Carlens J, Price T, Singer F, Müller C, Hansen G, Warnecke G, Latzin P, Schwerk N. Multiple breath washout in pediatric patients after lung transplantation. Am J Transplant 2018; 18:145-153. [PMID: 28719135 DOI: 10.1111/ajt.14432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 01/25/2023]
Abstract
Forced expiratory volume in 1 second (FEV1 ) from spirometry is the most commonly used parameter to detect early allograft dysfunction after lung transplantation (LTx). There are concerns regarding its sensitivity. Nitrogen-multiple breath washout (N2 -MBW) is sensitive at detecting early global (lung clearance index [LCI]) and acinar (Sacin ) airway inhomogeneity. We investigated whether N2 -MBW indices indicate small airways pathology after LTx in children with stable spirometry. Thirty-seven children without bronchiolitis obliterans syndrome [BOS] at a median of 1.6 (0.6-3.0) years after LTx underwent N2 -MBW and spirometry, 28 of those on 2 occasions (≤6 months apart) during clinically stable periods. Additional longitudinal data (11 and 8 measurements, respectively) are provided from 2 patients with BOS. In patients without BOS, LCI and Sacin were significantly elevated compared with healthy controls. LCI was abnormal at the 2 test occasions in 81% and 71% of patients, respectively, compared with 30% and 39% of patients with abnormal FEV1 /forced vital capacity (FVC). Correlations of LCI with FEV1 /FVC (r = 0.1, P = .4) and FEV1 (r = -0.1, P = .6) were poor. N2 -MBW represents a sensitive and reproducible tool for the early detection of airways pathology in stable transplant recipients. Moreover, indices were highly elevated in both patients with BOS. Spirometry and LCI showed poor correlation, indicating distinct and complementary physiologic measures.
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Affiliation(s)
- S Nyilas
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - J Carlens
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
| | - T Price
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
| | - F Singer
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Division of Paediatric Pneumology, University Children's Hospital Zurich, Zurich, Switzerland
| | - C Müller
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
| | - G Hansen
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
| | - G Warnecke
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
| | - P Latzin
- Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - N Schwerk
- Department of Paediatric Pulmonology, Allergology and Neonatology, University Children`s Hospital Hannover, Hannover, Germany
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35
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Ius F, Sommer W, Verboom M, Hallensleben M, Salman J, Siemeni T, Kuehn C, Avsar M, Bobylev D, Erdfelder C, Schwerk N, Müller C, Haverich A, Tudorache I, Warnecke G. Long-term Results of an IgM-Enriched Human Immunoglobulin-Based Therapy for Early Donor-Specific Antibodies after Lung Transplantation. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F. Ius
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - W. Sommer
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - M. Verboom
- Department of Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - M. Hallensleben
- Department of Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - J. Salman
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - T. Siemeni
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - C. Kuehn
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - M. Avsar
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - D. Bobylev
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - C. Erdfelder
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - N. Schwerk
- Department of Paediatrics, Hannover Medical School, Hannover, Germany
| | - C. Müller
- Department of Paediatrics, Hannover Medical School, Hannover, Germany
| | - A. Haverich
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - I. Tudorache
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - G. Warnecke
- Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany
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36
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Sommer W, Ius F, Schwerk N, Müller C, Bobylev D, Kühn C, Avsar M, Salman J, Siemeni T, Horke A, Haverich A, Tudorache I, Warnecke G. Nonstandard Donor Organs in Pediatric Lung Transplantation have no Negative Impact on Recipients Outcome. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- W. Sommer
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - F. Ius
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - N. Schwerk
- Department for Pediatric Pneumology, Hannover Medical School, Hannover, Germany
| | - C. Müller
- Department for Pediatric Pneumology, Hannover Medical School, Hannover, Germany
| | - D. Bobylev
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - C. Kühn
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - M. Avsar
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - J. Salman
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - T. Siemeni
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - A. Horke
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - A. Haverich
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - I. Tudorache
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - G. Warnecke
- Medizinische Hochschule Hannover, Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
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Rademacher J, Buck A, Schwerk N, Price M, Fuge J, Welte T, Ringshausen F. Nasal Nitric Oxide Measurement and a Modified PICADAR Score for the Screening of Primary Ciliary Dyskinesia in Adults with Bronchiectasis. Pneumologie 2017; 71:543-548. [DOI: 10.1055/s-0043-111909] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background Determining the underlying diagnosis is essential for the targeted and specific treatment of bronchiectasis. Primary ciliary dyskinesia (PCD) is a rare genetic disease, which is characterized by abnormalities in ciliary structure and/or function and which may result in bronchiectasis. The disease is probably underestimated among adults with bronchiectasis due to the fact that extensive diagnostic testing is required and that the recognition of PCD is low.
Objective To evaluate a feasible screening algorithm for PCD among adults with bronchiectasis.
Methods Data from all patients who presented to our bronchiectasis outpatient clinic from June 2010 until July 2016 were retrospectively analysed from our database. Nasal NO (nNO) and a modified PICADAR score (PrImary CiliAry DyskinesiA Rule) were measured and compared in the two groups of PCD-bronchiectasis and non-PCD-bronchiectasis.
Results 185 of 365 patients (75 males, 110 females) had a sufficient measurement of nNO concentration and complete clinical data and were eligible for analysis. The mean (SD) nNO concentration in nL/ml was significant lower in the PCD group compared to the non-PCD group (25 [31] and 227 [112] nL/min, respectively; p < 0.001). A nNO level of 77 nL/min had the best discriminative value to differentiate between the two groups. Patients with PCD had a significant higher modified PIDACAR score than patients without PCD (5 2 and 1 1, respectively [p < 0.001]). Using ROC curve analysis, the modified PICADAR score of 2 had the best discriminative value with a sensitivity of 1.00 and a specificity of 0.89.
Conclusions Low nNO concentration and the modified PICADAR score are suitable and cheap screening tests for PCD in adults with bronchiectasis.
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Affiliation(s)
- J. Rademacher
- Department of Respiratory Medicine, Hannover Medical School
| | - A. Buck
- Department of Respiratory Medicine, Hannover Medical School
| | - N. Schwerk
- Clinic for Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School
| | - M. Price
- Clinic for Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School
| | - J. Fuge
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - T. Welte
- Department of Respiratory Medicine, Hannover Medical School
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - F. Ringshausen
- Department of Respiratory Medicine, Hannover Medical School
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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Schmidt F, Jack T, Sasse M, Mueller C, Schwerk N, Bobylev D, Beerbaum P, Koeditz H. Back to the roots? Dual cannulation strategy for ambulatory ECMO in adolescent lung transplant candidates: An alternative? Pediatr Transplant 2017; 21. [PMID: 28247591 DOI: 10.1111/petr.12907] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2017] [Indexed: 11/29/2022]
Abstract
Bridging critically ill pediatric patients to lung transplantation still remains a major challenge. Although still controversial, within the last 5 years, ECMO has been increasingly used as a bridge to lung transplantation concept in adult and pediatric patients with acceptable outcomes. The outstanding developments in the field of extracorporeal devices and the introduction of awake ECMO concepts with the avoidance of mechanical ventilation have led to a real paradigm shift in the ICU management of pretransplant candidates with severe respiratory failure. Therefore, ECMO is no longer seen as a contraindication for lung transplantation at least at our center. Nevertheless, how to bridge these patients on ECMO still remains controversial. Thus, we introduced an ambulatory ECMO approach in adolescent lung transplant candidates with acute respiratory failure using a dual cannulation strategy and hereby present first results from this procedure.
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Affiliation(s)
- F Schmidt
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - T Jack
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - M Sasse
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - C Mueller
- Department of Pediatric Pneumology and Neonatology, Medical School Hannover, Hannover, Germany
| | - N Schwerk
- Department of Pediatric Pneumology and Neonatology, Medical School Hannover, Hannover, Germany
| | - D Bobylev
- Department of Cardiothoracic Surgery, Transplantation and Vascular Surgery, Medical School Hannover, Hannover, Germany
| | - P Beerbaum
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
| | - H Koeditz
- Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany
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39
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Ius F, Sommer W, Verboom M, Kühn C, Avsar M, Knöfel A, Siemeni T, Salman J, Böthig D, Hallensleben M, Welte T, Schwerk N, Müller C, Haverich A, Tudorache I, Warnecke G. Three Years Experience with an IgM Enriched Human Intravenous Immunoglobulins Based Treatment for Patients with Early Donor Specific Antibodies After Lung Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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40
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Sommer W, Ius F, Kuehn C, Avsar M, Salman J, Siemeni T, Gottlieb J, Schwerk N, Haverich A, Tudorache I, Warnecke G. Technique and Outcomes of Less Invasive Lung Retransplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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41
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Falk C, Schwerk N, Mueller C, Sommer W, Daeman K, Keil J, Neudörfl C, Hansen G, Haverich A, Warnecke G, Tudorache I. Autotransplantation of the Left Lung for the Treatment of Recurrent Life Threatening Pulmonary Hemorrhage Related to Pulmonary Vascular Malformation: A Novel Treatment Approach & a Unique Chance to Study Ischemia/Reperfusion Injury. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Falk C, Schwerk N, Mueller C, Tudorache I, Sommer W, Daeman K, Keil J, Neudörfl C, Hansen G, Haverich A, Warnecke G. Immune Monitoring-Guided Treatment of a Pediatric Patient with Sequential GvHD, Acute Rejection and CMV Infection Following Lung Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ius F, Sommer W, Verboom M, Erdfelder C, Kühn C, Avsar M, Siemeni T, Salman J, Bobylev D, Hallensleben M, Greer M, Gottlieb J, Schwerk N, Müller C, Haverich A, Tudorache I, Warnecke G. Three Years of Experience with an IgM-Enriched Human Intravenous Immunoglobulin-Based Treatment for Patients with Early Donor-Specific Anti-HLA Antibodies after Lung Transplantation. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F. Ius
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - W. Sommer
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - M. Verboom
- Hannover Medical School, Department of Transfusion Medicine, Hannover, Germany
| | - C. Erdfelder
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - C. Kühn
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - M. Avsar
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - T. Siemeni
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - J. Salman
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - D. Bobylev
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - M. Hallensleben
- Hannover Medical School, Department of Transfusion Medicine, Hannover, Germany
| | - M. Greer
- Hannover Medical School, Department of Respiratory Medicine, Hannover, Germany
| | - J. Gottlieb
- Hannover Medical School, Department of Respiratory Medicine, Hannover, Germany
| | - N. Schwerk
- Hannover Medical School, Department of Paediatric Pneumology, Hannover, Germany
| | - C. Müller
- Hannover Medical School, Department of Paediatric Pneumology, Hannover, Germany
| | - A. Haverich
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - I. Tudorache
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
| | - G. Warnecke
- Hannover Medical School, Department of Cardiothoracic, Transplant and Vascular Surgery, Hannover, Germany
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Wert AF, Posa D, Tsilochristou O, Schwerk N. Treatment of allergic children - Where is the progress (for the practicing allergist)? Pediatr Allergy Immunol 2016; 27:671-681. [PMID: 27614100 DOI: 10.1111/pai.12653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 12/12/2022]
Abstract
For any kind of therapeutic intervention in allergic diseases such as environmental control, pharmacological, or immunomodulating treatment including educational programs, children are addressed separately from adults. Health authorities like the Food and Drug Administration in the United States of America or the European Medicine Agency in Europe request a specific 'Pediatric investigational plan' with studies addressing dose-response relationship, safety, and efficacy for infants, children, and adolescents. During the last 2 years, promising advances have been reported for the treatment of a variety of allergic and immunologic disorders. This review summarizes the progress in the treatment of pediatric asthma and allergic diseases, based on publications of approximately the last 2.5 years (end of 2013 until May 2016) in and beyond this journal. Meanwhile, it highlights areas with promising novel therapeutic approaches, which are likely to change treatment for allergic children in the near future.
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Affiliation(s)
- A F Wert
- Department of Paediatric Pneumology Allergy and Neonatology, Hannover Medical School, Hannover, Germany.
| | - D Posa
- Department of Paediatric Pneumology & Immunology, Charité Medical School, Berlin, Germany
| | - O Tsilochristou
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London & Guy's, St. Thomas'National Health Service Foundation Trust, London, UK
| | - N Schwerk
- Department of Paediatric Pneumology Allergy and Neonatology, Hannover Medical School, Hannover, Germany
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Aggarwal N, Martinez Delgado Delgado B, Salipalli S, Matamala N, Rademacher J, Schwerk N, Welte T, Janciauskiene S, Ringshausen FC. Why do some adults with PiMZ alpha1-antitrypin develop bronchiectasis? Pneumologie 2016. [DOI: 10.1055/s-0036-1592257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schultze-Florey RE, Tischer S, Schwerk N, Heim A, Eiz-Vesper B, Maecker-Kolhoff B. Monitoring of adenovirus (ADV)-specific T cells in a boy with ADV pneumonia and disseminated disease after lung transplantation. Transpl Infect Dis 2016; 18:756-760. [PMID: 27385198 DOI: 10.1111/tid.12569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/17/2016] [Accepted: 04/17/2016] [Indexed: 11/29/2022]
Abstract
Human adenovirus (ADV) infections are the cause of severe morbidity and mortality in transplant recipients. Cidofovir (CDV) is the current standard antiviral treatment. We report the case of a 3-year-old boy after lung transplantation with severe ADV sepsis, who was monitored for ADV-specific T cells during his disease and recovery. A strong increase in ADV-specific T cells was accompanied by resolution of ADV in blood and bronchoalveolar lavage fluid. Antiviral treatment with CDV was individually adapted according to anti-ADV immune responses, which provides a new method for tailoring antiviral treatment in lung transplant recipients.
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Affiliation(s)
- R E Schultze-Florey
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany.,Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - S Tischer
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.,Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - N Schwerk
- Pediatric Pneumology and Neonatology, Hannover Medical School, Hannover, Germany
| | - A Heim
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - B Eiz-Vesper
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.,Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - B Maecker-Kolhoff
- Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany. .,Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.
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Ius F, Sommer W, Poyanmehr R, Tudorache I, Kuehn C, Avsar M, Siemeni T, Salman J, Molitoris U, Greer M, Verboom M, Boethig D, Schwerk N, Welte T, Haverich A, Warnecke G, Gottlieb J. Risk Factors and Impact of Bronchial Stenoses after Lung Transplantation: Ten Year Single Center Experience with over 1,100 Patients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ius F, Sommer W, Verboom M, Erdfelder C, Tudorache I, Kuehn C, Avsar M, Salman J, Siemeni T, Molitoris U, Greer M, Blasczyk R, Hallensleben M, Schwerk N, Welte T, Haverich A, Gottlieb J, Warnecke G. IgM Enriched Human Immunoglobulins and Rituximab Nullify the Mortality Risk Associated with Early Donor Specific Antibodies After Lung Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Schmidt F, Schwerk N, Vogel-Claussen J, Brinkmann E, Koeditz H, Jack T, Sasse M, Bertram H, Horke A, Beerbaum P, Warnecke G, Hansmann G. Bilateral Lung Transplantation and Post-op VA-ECMO: A Novel Approach for Children with End-Stage Pulmonary Arterial Hypertension (PAH). Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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