Trends and outcomes of lung transplant listings for connective tissue disease-associated interstitial lung disease (CTD-ILD): A 20-Year analysis from the organ procurement and transplantation network database.

The ISHLT Consensus Statement on the Perioperative Use of ECLS in Lung Transplantation: Highlights and Perioperative Implications.

An ensemble learning approach for predicting hospital stay in transplant patients

Lung transplantation remains a vital treatment for patients with end-stage respiratory diseases, yet chronic lung allograft dysfunction (CLAD) continues to be a major complication. Identifying predictive biomarkers to optimize post-transplant management is essential. The tacrolimus concentration-to-dose ratio (CDR) serves as an indicator of a patient's metabolizer status and has been linked to transplant outcomes in kidney recipients. This study investigates the relationship between tacrolimus CDR and CLAD occurrence. We conducted a single-center retrospective study including adult lung transplant recipients treated with tacrolimus-based immunosuppression. Patients were stratified as rapid or slow metabolizers based on tacrolimus CDR at month 9 (M9). The primary endpoint was CLAD occurrence. Secondary objectives included assessing the impact of CDR variation over time on CLAD risk and identifying factors influencing CDR variability. Among 84 patients, 32 (38%) developed CLAD. No significant difference in CLAD incidence was found between rapid and slow metabolizers at M9 (p=0.267). However, increased CDR variability was significantly associated with a higher risk of CLAD (p<0.001). Factors contributing to CDR variability included variability in tacrolimus trough concentrations, hospitalization for infections, and prolonged azole antifungal therapy. Contrary to our hypothesis, tacrolimus metabolizer status at M9 was not predictive of CLAD. However, high intrapatient CDR variability was significantly associated with CLAD occurrence. Given the impact of infections and azole antifungal therapy on tacrolimus metabolism, these factors should be considered in post-transplant immunosuppressive management. Further studies are needed to confirm these findings and refine tacrolimus dosing strategies in lung transplant recipients.

Prognostic significance of 1-year pulmonary function changes in inflammatory myopathy-related interstitial lung disease.

Molecular detection of human herpesviruses in pleural effusions after lung transplantion

Valganciclovir therapeutic drug monitoring-guided dosing for cytomegalovirus prophylaxis in lung transplant patients.

Evodiamine protects against lung ischemia-reperfusion injury by attenuating SYK-associated TLR4/NLRP3 inflammasome activation and ferroptosis-related injury signatures.

Passenger lymphocyte syndrome after solid organ transplantation: Laboratory perspective.

Carbon monoxide (CO) has gained increasing attention as an endogenous gasotransmitter with potential therapeutic relevance. In preclinical studies, including acute lung injury, sepsis, transplantation, inflammatory bowel, and cardiovascular diseases, CO has shown anti-inflammatory, anti-apoptotic, vasodilatory, and cytoprotective properties, suggesting its application in treating a wide range of diseases associated with cellular stress. CO impairs blood oxygen transport when systemic exposure occurs, but it is safe when blood oxygen transport is not compromised. Consequently, treatment modalities benefit from local rather than systemic CO delivery to open the therapeutic window of this physiological gasotransmitter. This review, therefore, focuses on local drug delivery strategies for generating and delivering CO, and on solutions and perspectives for various applications that leverage CO's anti-inflammatory and cytoprotective effects with an enhanced safety profile. We present the use of CO-releasing molecules (CORMs) and their incorporation into advanced drug delivery devices to control local CO exposure. Special emphasis is placed on drug vehicles featuring controlled on-target delivery, dosing, and biocompatibility. Therefore, we identify key principles and remaining obstacles in CO delivery technologies, which confluences in strategies that reduce the risk for pharmaceutical development and clinical application for safe, controlled, and targeted therapies.

Non-ABO red blood cell antibodies in transplant patients.

Impact of immunosuppressive therapy on non-melanoma skin cancer after solid organ transplantation: A critical systematic review.

This review provides a summary of the evolving landscape of pediatric lung transplantation highlighting current trends, short and long-term outcomes, ongoing challenges in posttransplant survival, and unique considerations in pediatric populations. The annual volume of pediatric lung transplantation has declined over the past decade due to a decreased need among children with cystic fibrosis. Improvement in survival has paralleled advancements in bridge to transplant strategies, expanding what were once considered contraindications. Despite the ongoing shortage of donor organs, innovations in policy changes, surgical and immunologic strategies, and organ preservation technologies have expanded the donor lung pool. Chronic lung allograft dysfunction (CLAD) remains the primary limitation to long-term survival, with limited management strategies and emerging immunomodulatory therapies offering promise. As survival in pediatric lung transplantation improves, emphasis should shift to long-term outcomes including quality of life and equitable care, development of effective CLAD prevention strategies and pediatric-specific guidelines to optimize long-term survival.

OXCT1-induced succinylation at K81 shields HADH from HSPA8-Mediated degradation in alveolar epithelial cells to attenuate lung ischemia-reperfusion injury.

A 14-year-old girl underwent bilateral living-donor lobar lung transplants (LDLLT) from each parent for bronchiolitis obliterans following hematopoietic stem cell transplantation (HSCT). Pulmonary perfusion scintigraphy demonstrated a marked reduction in blood flow in the father-derived graft, which subsequently collapsed and was diagnosed as chronic lung allograft dysfunction (CLAD), whereas the mother-derived graft remained stable and functional. The HSCT was performed with the mother's stem cells, theoretically preventing rejection of the mother's graft. This case highlights the unique immunologic dynamics arising from donor selection in HSCT and LDLLT, and underscores the usefulness of scintigraphy in the early detection of CLAD.

The Contemporary Landscape of Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation.

This review aims to give an overview of recent advances in the clinical management of children <18 years of age with end-stage pulmonary hypertension refractory to conventional medical therapy. The increased awareness and characterization of pediatric pulmonary vascular disease has amounted more data toward creating an accurate, and comprehensive, risk prediction tool. This underscores the importance of serial outpatient re-assessment, as early consideration of advanced pharmaceutical and interventional therapies, as well as lung transplantation, improves outcomes in children. Despite the emergence and approval of new therapies against pulmonary hypertension in adults, pediatric-specific complications have not yet been adequately explored. It is, however, encouraging that several trials are ongoing to address this issue. Interventional strategies to unload the right ventricle are increasingly being utilized, although evidence remains scarce in this area. Extra-corporeal membrane oxygenation may, in addition to being a bridge to lung transplantation in well-selected patients, be considered as a bridge to catheter-based or surgical interventions. Management of pediatric right ventricular failure in the setting of advanced pulmonary hypertension is a truly complex clinical challenge at the intersection of cardiac, vascular and respiratory physiology and requires careful integration of invasive hemodynamic assessment, pulmonary vasodilator therapy, ventilatory strategy, and timely consideration of mechanical circulatory support.

First Healthy Live Birth Achieved Through Assisted Reproductive Technologies in Türkiye After Lung Transplantation: A Case Report.

Macrophage-mimetic photothermal nanotherapeutics regulate mitochondrial homeostasis and inflammatory cascades in lung ischemia-reperfusion injury.

When the risk of cardiopulmonary arrest during intubation is high, "awake" extracorporeal membrane oxygenation (ECMO) cannulation with sedation and a natural airway may provide hemodynamic stability and gas exchange to mitigate the hazards of intubation. This retrospective case series characterizes patient selection, clinical periprocedural management, and frequency of "awake" pediatric ECMO cannulations in nonintubated patients at a quaternary pediatric hospital. Between 2014 and 2024, 58 patients (7-18 years) with nonpostoperative cardiac indications underwent ECMO support, with six (10%) "awake" venoarterial ECMO cannulations. Of the "awake" cohort median age was 13 years, with pulmonary hypertension, myocarditis, dilated cardiomyopathy with arrhythmia, and severe mitral stenosis diagnoses. Five were emergent or urgent with cannulations performed after interdisciplinary discussions in the cardiac intensive care unit or catheterization lab. Access was via femoral cutdown with one patient requiring additional neck venous access. Postcannulation, five of six patients were intubated, with one later extubated, such that two were managed extubated while supported on ECMO. All survived to hospital discharge, one received a bilateral lung transplant, and none sustained neurological injuries. We describe ECMO cannulation in spontaneously breathing children with varied physiology who were considered at high risk for cardiopulmonary arrest during induction of anesthesia and intubation. Though rare in pediatric practice, this approach is feasible with appropriate preparation and team expertise.