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dc.contributor.authorLin, E-
dc.contributor.authorSnell, Gregory I-
dc.contributor.authorLevvey, Bronwyn J-
dc.contributor.authorMifsud, Nicole-
dc.contributor.authorPaul, Moumita-
dc.contributor.authorBuckland, MR-
dc.contributor.authorGooi, Julian-
dc.contributor.authorMarasco, Silvana-
dc.contributor.authorSharland, Alexandra F-
dc.contributor.authorMyles, PS-
dc.identifier.citationThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 2014-11; 33(11): 1139-48-
dc.description.abstractPrimary graft dysfunction (PGD) remains a significant problem after lung transplantation. Data from animal and clinical studies suggest that remote ischemic conditioning (RIC) may reduce ischemia-reperfusion injury in solid organ transplantation. A pilot randomized controlled trial of 60 patients undergoing bilateral sequential lung transplantation assessed the utility of RIC in attenuating PGD. Treated recipients underwent 3 cycles of lower limb ischemic conditioning before allograft reperfusion. The primary outcome measure was a comparison of the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (P/F ratio) between treatment groups. No adverse effects of tourniquet application were observed. The mean lowest P/F ratio during the first 24 hours after transplantation was 271.3 mm Hg in the treatment arm vs 256.1 mm Hg in the control arm (p = 0.46). PGD grade and severity and the rate of acute rejection also showed a tendency to favor the treatment arm. Sub-group analysis demonstrated a significant benefit of treatment in patients with a primary diagnosis of restrictive lung disease, a group at high risk for the development of PGD. RIC was not accompanied by systemic release of high-molecular-weight group box 1. Levels of cytokines, high-molecular-weight group box 1, and endogenous secretory receptor for advanced glycation end products peaked within 2 hours after reperfusion and likely reflected donor organ quality rather than an effect of RIC. RIC did not significantly improve P/F ratios or PGD in this randomized controlled trial. However, encouraging results in this small study warrant a large multicenter trial of RIC in lung transplantation.-
dc.subject.meshDouble-Blind Method-
dc.subject.meshFeasibility Studies-
dc.subject.meshIschemic Preconditioning-
dc.subject.meshLung Transplantation-
dc.subject.meshPilot Projects-
dc.subject.meshProspective Studies-
dc.titleSafety, feasibility, and effect of remote ischemic conditioning in patients undergoing lung transplantation.-
dc.typeJournal Article-
dc.typeRandomized Controlled Trial-
dc.typeResearch Support, Non-U.S. Gov't-
dc.identifier.journaltitleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation-
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairetypeRandomized Controlled Trial-
item.openairetypeResearch Support, Non-U.S. Gov't-
Appears in Collections:Scholarly and Clinical
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