Short‐Term liver transplant outcomes from SARS‐CoV‐2 lower respiratory tract NAT positive donors

2021 ◽  
Author(s):  
Ricardo M. La Hoz ◽  
Arjmand R. Mufti ◽  
Parsia A. Vagefi
Keyword(s):  
Respiratory Tract ◽  
Liver Transplant ◽  
Lower Respiratory Tract ◽  
Short Term ◽  
Transplant Outcomes

Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients

1995 ◽  
Vol 4 (2) ◽  
pp. 133-139 ◽  
Author(s):  
K Whiteman ◽  
L Nachtmann ◽  
D Kramer ◽  
S Sereika ◽  
M Bierman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Liver Transplant ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Continuous Lateral Rotation ◽  
Lateral Rotation

BACKGROUND: When liver transplant candidates and recipients suffer from pulmonary complications of immobility, the results can be life-threatening. Continuous lateral rotation therapy has been reported to decrease complications of immobility. OBJECTIVES: To determine whether continuous lateral rotation therapy decreases the duration of mechanical ventilation, intensive care unit length of stay, incidence or resolution of atelectasis, incidence or onset time of lower respiratory tract infection and pneumonia. METHODS: Sixty-nine subjects admitted to a liver transplant intensive care unit at a university teaching hospital were randomly assigned to continuous lateral rotation therapy or a stationary bed. All subjects were mechanically ventilated for 24 hours and had a Glasgow Coma Scale score of 11 or less upon admission to the study. Subjects were followed until out of bed, unable to rotate for 3 consecutive days, or transferred from the intensive care unit. Data and chest roentgenogram results were collected on admission and daily during the study. Sputum culture results were obtained if available as part of normal patient care. RESULTS: Incidence of lower respiratory tract infection was significantly lower and length of time to occurrence of lower respiratory tract infection was significantly longer in the continuous lateral rotation therapy group than in the stationary bed group. CONCLUSIONS: Although continuous lateral rotation therapy did not affect duration of mechanical ventilation, length of stay, or incidence of atelectasis, it was effective in decreasing the incidence of, and increasing onset time to, lower respiratory tract infection in the liver transplantation population.

Association of serum sphingomyelin profile with clinical outcomes in patients with lower respiratory tract infections: results of an observational, prospective 6-year follow-up study

2019 ◽  
Vol 57 (5) ◽  
pp. 679-689
Author(s):  
Thomas Baumgartner ◽  
Giedre Zurauskaite ◽  
Christian Steuer ◽  
Luca Bernasconi ◽  
Andreas Huber ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Short Term ◽  
Inflammatory Conditions ◽  
Tract Infections ◽  
The Impact

Abstract Background Sphingolipids – the structural cell membrane components – and their metabolites are involved in signal transduction and participate in the regulation of immunity. We investigated the prognostic implications of sphingolipid metabolic profiling on mortality in a large cohort of patients with lower respiratory tract infections (LRTIs). Methods We measured 15 different sphingomyelin (SM) types in patients with LRTIs from a previous Swiss multicenter trial that examined the impact of procalcitonin-guided antibiotic therapy on total antibiotic use and rates and duration of hospitalization. Primary and secondary end points were adverse outcomes – defined as death or intensive care unit admission within 30 days – and 6-year mortality. Results Of 360 patients, 8.9% experienced an adverse outcome within 30 days and 46% died within 6 years. Levels of all SM types were significantly lower in pneumonia patients vs. those with chronic obstructive pulmonary disease (COPD) exacerbation (p<0.0001 for all comparisons). Sphingomyelin subspecies SM (OH) C22:1 and SM (OH) C22:2 were associated with lower risk for short-term adverse outcomes (sex-, gender- and comorbidity-adjusted odds ratios [OR]: 0.036; 95% confidence interval [CI], 0.002–0.600; p=0.021 and 0.037; 95% CI, 0.001–0.848; p=0.039, respectively). We found no significant associations with 6-year mortality for any SM. Conclusions Circulating sphingolipid levels are lower in inflammatory conditions such as pneumonia and correlate with adverse short-term outcomes. Further characterization of the physiological, pathophysiological and metabolic roles of sphingolipids under inflammatory conditions may facilitate understanding of their roles in infectious disease.

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