Barron Holmgaard (dashshade37)

© 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.The first novel coronavirus (SARS-CoV-2) cases occurred in Germany after contact with a Chinese business delegate between January 19 and 22, 2020 near the city of Munich, Bavaria. Since then numerous additional cases have been reported and the dissemination of the infection does not only pose a major health challenge for the entire population, medical care facilities and the economy, but also for the medical training of future doctors and outpatient care of patients with skin disease. This article is protected by copyright. All rights reserved.BACKGROUND Outcomes after transplantation of lungs (LuTX) treated with Ex-Vivo Lung Perfusion (EVLP) are debated. METHODS In a single-center 8-years retrospective analysis we compared donors' and recipients' characteristics, gas exchange and lung mechanics at ICU admission, 3, 6 and 12 months, and patients survival of LuTX from Standard donors compared to EVLP treated grafts. RESULTS 193 LuTX were performed. Thirty-one LuTX, out of 50 EVLP procedures, were carried-out 7 from non-heart-beating and 24 from extended criteria brain-dead donors. Recipients' characteristics were similar. At ICU admission, compared to Standard donors, EVLP patients had worse PaO2 /FiO2 (276 [206;374] vs. 204 [133;245] mmHg, p less then 0.05), more frequent extracorporeal support (18 vs. Selleckchem SC144 32%, p=0.053) and longer mechanical ventilation duration (28-days ventilator-free days 27 [24; 28] vs. 26 [19;27], p less then 0.05). ICU length of stay (4 [2;9] vs. 6 [3;12] days, p=0.208), 28-days survival (99 vs. 97%, p=0.735) and 1-year respiratory function were similar between groups. Log-rank analysis (median follow-up 2.5 years) demonstrated similar patients survival (p=0.439) and time free of chronic lung allograft disease (p=0.484). CONCLUSIONS The EVLP program increased by 16% the number of LuTX. Compared to Standard donors, EVLP patients had worse respiratory function immediately after LuTX but similar early and mid-term outcomes. This article is protected by copyright. All rights reserved.INTRODUCTION Nonantigen-specific immunoadsorption (IA) has proven to be effective in acute antibody-mediated rejection (aAMR). However, there is a lack of solid studies evaluating the safety and efficacy of IA with antihuman Ig-columns in aAMR. For chronic-active AMR (cAMR), no studies have evaluated the efficacy of nonantingen-specific IA with antihuman Ig-columns. The purpose of this study was to evaluate the role of nonantigen-specific IA with antihuman Ig-columns in the treatment of both aAMR and cAMR in kidney transplantation. MATERIAL AND METHODS In retrospective and observational study, kidney graft and recipient survival rates were assessed after treatment of aAMR and cAMR with nonantigen-specific IA with Ig-Flex columns (Therasorb) between January 2012 and May 2018. Protocols included nonantigen-specific IA, rituximab, intravenous immunoglobulin, and rescue plasma exchange, if necessary. RESULTS The study included 14 patients with AMR (acute in 9, chronic active in 5). For aAMR, mean follow-up was 13 ± 6 months, and patient and graft survival were, respectively, of 100% and 83%, with a mean increase in estimated glomerular filtration rate (eGFR) of 7.98 ± 12.96, 10.18 ± 16.71, and 11.43 ± 13.85 mL/min/1.72 m2 (P > .05) at 3, 12 months after treatment, and at the end of follow-up, respectively. For cAMR, mean follow-up was 14 ± 8 months, and patient and graft survival were, respectively, of 100% and 60%, with an average increase in eGFR of 4.30 ± 7.86, 5.64 ± 10.47, and 14.5 ± 7.86 mL/min/m2 (P > .05) at 3, 12 months after IA treatment, and at the end of the follow-up, respectively, although 40% did not respond and required chronic hemodialysis. CONCLUSION Nonantigen-specific IA with Ig-Flex columns was safe and effective for aAMR treatment in kidney transplantation. In cAMR, IA with Ig-Flex columns was associated with a satisfactory kidney gra