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- ISBN: 9780849337178 | 0849337178
- Cover: Hardcover
- Copyright: 5/1/2006
Introduction | p. iii |
Preface | p. v |
Contributors | p. xi |
Clinical Aspects (Overview and Current Data) | |
Historical Overview of Lung and Heart-Lung Transplantation | p. 1 |
Introduction | p. 1 |
Heart-Lung Transplantation | p. 2 |
Unilateral Lung Transplantation | p. 4 |
Double-Lung Transplantation | p. 7 |
Single Sequential Lung Transplantation | p. 8 |
The ISHLT Registry | p. 10 |
Adult Lung Transplantation | p. 11 |
Adult Heart-Lung Transplantation | p. 14 |
Pediatric Lung Transplantation | p. 15 |
References | p. 16 |
Immunology of Transplantation-Basic Science | |
Basic Immunological Concepts in Lung Transplantation: The Role of Regulatory T Cells and Dendritic Cells | p. 21 |
Introduction | p. 21 |
Reprogramming the Immune System for Tolerance | p. 23 |
Nonoptimal T-Cell Signaling Induces Tolerance and Regulatory T Cells | p. 24 |
Heterogeneity of Regulatory T Cells | p. 26 |
Coreceptor Blockade for Transplantation Tolerance | p. 28 |
Costimulation Blockade for Tolerance Induction | p. 30 |
Monoclonal CD3 Antibodies | p. 31 |
Antigen Presenting Cells as Modulators of Immune Responses | p. 32 |
Immune Regulation and Induced Immune Privilege | p. 33 |
Conclusions | p. 35 |
References | p. 35 |
Allogeneic Recognition and Immune Tolerance in Lung Transplantation | p. 47 |
Introduction | p. 47 |
The Immune System and Self vs. Nonself | p. 48 |
Critical Events in Lung Transplantation and Lung Allograft Rejection | p. 49 |
Determinants of Graft Tolerance: Alloimmunity, Autoimmunity, and Regulation | p. 51 |
Summary | p. 55 |
References | p. 56 |
Clinical Aspects | |
Lung Transplantation for Chronic Obstructive Pulmonary Disease | p. 61 |
Introduction | p. 61 |
Natural History/Predictive Indices | p. 62 |
Medical Management | p. 67 |
Lung Volume Reduction as an Alternative or Bridge to Transplantation | p. 85 |
Timing of Referral and Listing for Lung Transplantation | p. 91 |
Choice of Procedure | p. 93 |
Outcomes | p. 96 |
Special Considerations Following Transplantation | p. 96 |
References | p. 99 |
Lung Transplant in Cystic Fibrosis | p. 121 |
Introduction | p. 121 |
Lung Transplant History and Current Challenges | p. 122 |
Referral Criteria for Lung Transplantation and Predictors of Short-Term Mortality in CF Patients | p. 123 |
A New Allocation Algorithm for Donor Lung Allocation in Potential Lung Transplant Candidates | p. 125 |
Infectious Contraindications | p. 126 |
Noninfectious Contraindications | p. 128 |
Posttransplant Complications and Management | p. 129 |
CF-Related Diabetes | p. 133 |
Summary | p. 138 |
References | p. 139 |
Pulmonary Arterial Hypertension and Lung Transplantation | p. 147 |
Introduction | p. 147 |
The Biology of Pulmonary Vascular Disease | p. 149 |
The Medical Management of PAH | p. 150 |
Conclusions | p. 157 |
References | p. 158 |
Lung Transplantation for Interstitial Lung Disorders | p. 165 |
Introduction | p. 165 |
Idiopathic Pulmonary Fibrosis | p. 166 |
Nonspecific Interstitial Pneumonia | p. 177 |
CVD-Associated PF | p. 180 |
Sarcoidosis | p. 183 |
References | p. 189 |
Pulmonary Langerhans Cell Histiocytosis and Lymphangioleiomyomatosis | p. 205 |
Pulmonary Langerhans Cell Histiocytosis | p. 205 |
Lymphangioleiomyomatosis | p. 213 |
References | p. 224 |
Pediatric Lung Transplantation | p. 233 |
Introduction | p. 233 |
Indications | p. 236 |
Contraindications and Psychosocial Considerations | p. 238 |
Anesthetic and Operative Considerations | p. 240 |
Postoperative Care | p. 241 |
Issues Particular to Pediatric Patients | p. 245 |
Gastrointestinal Function | p. 248 |
Survival | p. 250 |
Conclusion | p. 251 |
References | p. 251 |
Living Lobar Lung Transplantation | p. 255 |
Introduction | p. 255 |
Indications for Lobar Lung Transplantation and Donor Selection | p. 256 |
Operative Technique | p. 257 |
Results | p. 259 |
Recommendations and Future Directions | p. 264 |
References | p. 266 |
Heart-Lung Transplantation: Is It a Viable Option in the 21st Century? | p. 269 |
Introduction | p. 269 |
Historical Overview | p. 270 |
Indications for Heart-Lung Transplantation | p. 270 |
Alternatives to Heart-Lung Transplantation | p. 273 |
Postoperative Complications | p. 275 |
Economic Evaluation of Heart-Lung Transplantation | p. 276 |
Results of Heart-Lung Transplantation | p. 276 |
Conclusions | p. 279 |
References | p. 280 |
Organ Allocation and Donor Availability | |
Lung Allocation in the United States | p. 285 |
Introduction | p. 285 |
Current Algorithm | p. 286 |
Impetus for Change | p. 287 |
Initial Analyses | p. 288 |
Other Issues to Resolve | p. 290 |
The Lung Allocation Score: How the Algorithm Orders Candidates | p. 294 |
Determining the Lung Allocation Score | p. 297 |
Initial Feedback | p. 298 |
Lung Review Board | p. 299 |
Summary | p. 299 |
References | p. 299 |
Organ Allocation and Donor Availability-The European Experience | p. 301 |
Introduction | p. 301 |
Eurotransplant | p. 303 |
Listing and Delisting Policies | p. 305 |
Future European Cooperation Strategies | p. 306 |
Allocation of Donor Organs for Lung Transplantation: The Australian Experience | p. 307 |
Introduction | p. 307 |
The Australian Health Care System | p. 308 |
Organ Donation in Australia | p. 309 |
Multiorgan Donors in Australia | p. 311 |
Lung Transplantation in Australia | p. 312 |
Outcomes of Lung Transplantation in Australia | p. 318 |
Conclusion | p. 321 |
References | p. 322 |
Lung Preservation Techniques | p. 325 |
Introduction | p. 325 |
Preservation Solutions | p. 326 |
Conditions of Administration of the Flush Solution | p. 329 |
Storage of the Lung | p. 330 |
Non-Heart Beating Donor | p. 332 |
Therapies Under Investigation | p. 334 |
References | p. 339 |
Operative Techniques Utilized in Lung Transplantation and Strategies to Increase the Donor Pool | p. 349 |
Introduction | p. 349 |
Living Lobar Lung Transplantation | p. 350 |
Non-Heart Beating Donors | p. 351 |
Nonstandard Donor Lungs | p. 353 |
Criteria for Standard Donor Lungs | p. 353 |
Problems with Nonstandard Donor Lungs | p. 355 |
Primary Graft Dysfunction | p. 355 |
Infectious Complications | p. 356 |
Long-Term Allograft Function | p. 357 |
Experience with Nonstandard Lungs | p. 357 |
References | p. 359 |
Immunosuppression-Action, Efficacy, Drug Interactions, and Toxicities | |
Immunosuppressive Drugs: Cyclosporine, Tacrolimus, Sirolimus, Azathioprine, Mycophenolate Mofetil, and Corticosteroids | p. 363 |
Introduction | p. 363 |
Calcineurin Inhibitors | p. 363 |
Antimetabolites | p. 373 |
Other Drugs | p. 379 |
Conclusion | p. 384 |
References | p. 385 |
Lympholytic Agents (Polyclonal Antilymphocyte Antibodies, Anti-CD3 Monoclonal Antibodies, Anti-CD25 Monoclonal Antibodies) | p. 401 |
Introduction | p. 401 |
Polyclonal Antilymphocyte Antibodies | p. 403 |
Anti-CD3 Monoclonal Antibodies | p. 407 |
Anti-CD25 Monoclonal Antibodies | p. 409 |
Future Directions | p. 412 |
Conclusion | p. 413 |
References | p. 413 |
Novel and Future Approaches to Immunosuppression | p. 421 |
Introduction | p. 421 |
Inhalation Cyclosporine | p. 423 |
Use of Inhalation Cyclosporine in Humans | p. 424 |
Campath-1H | p. 427 |
Future Immunosuppression and Therapies | p. 432 |
References | p. 432 |
Complications in Lung Transplantation | |
Primary Graft Dysfunction Following Lung Transplantation: Pathogenesis and Impact on Early and Late Outcomes | p. 437 |
Introduction | p. 437 |
Definition and Diagnosis | p. 437 |
Scientific Principles | p. 439 |
Donor-Related Risk Factors | p. 444 |
Recipient-Related Factors | p. 447 |
Management of PGD | p. 452 |
Extracorporeal Membrane Oxygenation | p. 454 |
Outcomes of PGD | p. 455 |
References | p. 456 |
Airway Complications in Lung Transplantation | p. 465 |
Introduction | p. 465 |
Anatomic Considerations and Surgical Techniques | p. 465 |
Airway Complications | p. 468 |
Interventional Bronchoscopy for the Management of Airway Complications | p. 477 |
Conclusion | p. 481 |
References | p. 481 |
Infectious Complications | |
Viral Infections Complicating Lung and Solid Organ Transplantation | p. 485 |
Introduction | p. 485 |
The Herpesviruses | p. 486 |
Community-Acquired Respiratory Viruses | p. 506 |
Parvovirus B19 | p. 511 |
New and Emerging Viruses | p. 512 |
References | p. 514 |
Coccidioidomycosis After Solid Organ Transplantation | p. 527 |
Introduction | p. 527 |
Mycology | p. 528 |
Epidemiology and Geographic Occurrence | p. 530 |
Incidence | p. 530 |
Immunology | p. 532 |
Pretransplant Evaluation | p. 532 |
Clinical Disease | p. 534 |
Diagnosis | p. 536 |
Treatment of Coccidioidomycosis | p. 539 |
Prevention | p. 542 |
References | p. 543 |
Histoplasmosis and Blastomycosis After Solid Organ Transplantation | p. 549 |
Introduction | p. 549 |
Histoplasmosis | p. 549 |
Blastomycosis | p. 552 |
Conclusions | p. 553 |
References | p. 554 |
Invasive Fungal Infections Complicating Lung and Solid Organ Transplantation: Aspergillosis, Cryptococcosis, and Molds | p. 557 |
Aspergillus | p. 557 |
Cryptococcus | p. 570 |
Other Mold Infections | p. 572 |
References | p. 575 |
Bacterial Infections and Pneumocystis Infections | p. 587 |
Introduction | p. 587 |
Bacterial Infections | p. 588 |
Pneumocystis jirovecii | p. 599 |
References | p. 602 |
Legionella in Solid Organ Transplantation | p. 607 |
Introduction | p. 607 |
Microbiology and Pathogenesis | p. 608 |
Epidemiology | p. 609 |
Clinical Features | p. 610 |
Diagnosis | p. 611 |
Treatment and Outcomes | p. 612 |
Prevention | p. 613 |
Conclusions | p. 614 |
References | p. 614 |
Mycobacterial Infections Complicating Organ Transplantation | p. 623 |
Mycobacteriosis | p. 623 |
Mycobacterium tuberculosis | p. 624 |
Nontuberculosis Mycobacteriosis | p. 631 |
References | p. 642 |
Lung Allograft Rejection | |
Acute Allograft Rejection | p. 661 |
Introduction | p. 661 |
Incidence of ACR | p. 662 |
Diagnosis of ACR | p. 662 |
Noninvasive Markers of ACR | p. 669 |
References | p. 676 |
Pathology of the Lung Transplant | p. 683 |
Introduction | p. 683 |
Ischemia-Reperfusion Lung Injury | p. 687 |
Infection | p. 689 |
Rejection | p. 697 |
Tumors and Tumor-Like Conditions | p. 709 |
Recurrent Primary Disease | p. 712 |
Summary | p. 714 |
References | p. 714 |
Chronic Allograft Rejection | |
Obliterative Bronchiolitis | p. 723 |
Introduction | p. 723 |
Incidence and Prevalence of OB/BOS | p. 723 |
Clinical Presentation | p. 724 |
Histology of Chronic Rejection | p. 726 |
Risk Factors for Chronic Rejection | p. 727 |
Diagnosis | p. 731 |
Treatment of OB/BOS | p. 734 |
References | p. 742 |
The Role for Alloimmune and Nonalloimmune Injury and Cytokine Responses in the Pathogenesis of Bronchiolitis Obliterans Syndrome | p. 753 |
Introduction | p. 753 |
The Role of HLA Mismatches in the Pathogenesis of BOS | p. 754 |
The Role of Gastroesophageal Reflux in the Pathogenesis of BOS | p. 758 |
The Role of Cytokines During the Pathogenesis of BOS | p. 760 |
The Role of the IL-1 Cytokine Family During the Pathogenesis of BOS | p. 761 |
The Role of TNF-[alpha] During the Pathogenesis of BOS | p. 761 |
The Role of IL-12 During the Pathogenesis of BOS | p. 763 |
The Role of IFN-[gamma] in the Pathogenesis of BOS | p. 764 |
The Role of IL-10 During the Pathogenesis of BOS | p. 764 |
The Role of IL-6 During the Pathogenesis of BOS | p. 766 |
The Role of TGF-[beta] During the Pathogenesis of BOS | p. 766 |
The Role of Growth Factors During the Pathogenesis of BOS | p. 767 |
The Role of Chemokine Receptor/Chemokines During the Pathogenesis of BOS | p. 768 |
The Role of Receptor/CC Chemokines During the Pathogenesis of BOS | p. 769 |
The Role of Receptor/CXC Chemokines During the Pathogenesis of BOS | p. 772 |
Conclusion | p. 772 |
References | p. 773 |
Pulmonary Physiology Posttransplant | p. 789 |
Introduction | p. 789 |
Effects of Pulmonary Denervation | p. 790 |
Pulmonary Function and Gas Exchange | p. 793 |
Functional Imaging of the Graft | p. 800 |
Chest Wall and Respiratory Muscles | p. 800 |
Bronchial Hyperreactivity | p. 804 |
Exercise Physiology | p. 805 |
Limb Muscle Function | p. 806 |
Conclusion | p. 811 |
References | p. 811 |
Imaging of the Posttransplant Lung | p. 823 |
Introduction | p. 823 |
Immediate (Within 24 Hours) | p. 824 |
Early (24 Hours to 1 Week) | p. 830 |
Intermediate (First 2 Months) | p. 834 |
Primary Late (2-4 Months) | p. 841 |
Secondary Late (>4 Months) | p. 849 |
Any Stage | p. 861 |
Future Directions in Imaging | p. 865 |
Conclusion | p. 869 |
References | p. 869 |
Long-Term Complications of Lung Transplantation (and Immune Therapy) | |
Cardiac, Lipid, and Atherosclerotic Complications Among Lung and Heart-Lung Recipients | p. 881 |
Introduction | p. 881 |
Preoperative Cardiovascular Evaluation | p. 882 |
Early Posttransplant Cardiovascular Complications | p. 886 |
Lung Transplant vs. Heart-Lung Transplant | p. 886 |
Hyperlipidemia | p. 888 |
Hypertension | p. 889 |
Drugs and Transplant Vasculopathy | p. 890 |
Summary | p. 892 |
References | p. 892 |
Metabolic Bone Disease in Lung Transplant Recipients | p. 895 |
Introduction | p. 895 |
Risk Factors | p. 895 |
Management | p. 897 |
References | p. 898 |
Lymphoproliferative Disorders Complicating Solid Organ Transplantation | p. 901 |
Introduction | p. 901 |
Classification of PTLD | p. 902 |
Pathogenesis | p. 905 |
Risk Factors for PTLD | p. 906 |
Incidence of PTLD | p. 910 |
Clinical Manifestations of PTLD in Lung Transplantation | p. 911 |
Radiographic Imaging | p. 914 |
Diagnosis | p. 914 |
Risk Reduction or Prevention of PTLD | p. 916 |
Treatment of PTLD | p. 916 |
References | p. 921 |
Index | p. 935 |
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