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5 results on '"Dirk Van Raemdonck, MD, PhD"'

1. A multicenter analysis of lung transplantation outcomes comparing donation after circulatory death and donation after brain death

Author

Mohammed Abul Kashem, MD, PhD, Gabriel Loor, MD, Matthew Hartwig, MD, Dirk Van Raemdonck, MD, PhD, Mauricio Villavicencio, MD, Fabio Ius, MD, Kamrouz Ghadimi, MD, Jawad Salman, MD, Satish Chandrashekaran, MD, Tiago Machuca, MD, PhD, Pablo G. Sanchez, MD, PhD, Kathirvel Subramaniam, MD, Arne Neyrinck, MD, PhD, Hannah Calvelli, BA, Michael Warnick, BS, Huaqing Zhao, PhD, Stephen Huddleston, MD, PhD, Asishana Osho, MD, Ethan D'Silva, MD, Uma Ramamurthy, PhD, Andres Leon Pena, MD, Marcelo Salan-Gomez, MD, Andrew Shaffer, MD, Nathaniel Langer, MD, Amir Emtiazjoo, MD, and Yoshiya Toyoda, MD, PhD

Subjects
lung transplant, donation after circulatory death, donation after brain death, survival, outcomes, Surgery, RD1-811, Specialties of internal medicine, RC581-951
Abstract

Background: Donor organ shortage is a barrier to lung transplantation. Donation after circulatory death (DCD) may offer a solution, although it is underutilized. The objective of this study was to compare survival and other postoperative outcomes between DCD and donation after brain death (DBD). Methods: We performed a multicenter analysis of Multi-Institutional Extracorporeal Life Support (ECLS) Registry data from 11 lung transplant centers in the United States and Europe. Demographics and clinical parameters were compared using chi-square test and Fisher's exact test. Survival was assessed by Kaplan-Meier curves and compared by log-rank test with propensity score matching. Results: Of 1,585 patients included in the study, 135 (8.5%) received DCD lungs and 1,450 (91.5%) received DBD lungs. DCD recipients had higher rates of obstructive lung disease (p = 0.042), longer total ischemic time (p

Published
2024
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2. Sternal Elevation by Crane Technique During Double Lung Transplant for Patient With Pectus Excavatum

Author

Arizona Binst, MD, Yanina Jansen, MD, PhD, Laurens J. Ceulemans, MD, PhD, Dirk Van Raemdonck, MD, PhD, and Hans Van Veer, MD

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We present the case of a 28-year-old female patient who underwent a bilateral lung transplantation for underlying terminal bronchopulmonary dysplasia. The peroperative access to the hilum of the right lung was significantly compromised due to the presence of a pectus excavatum (Haller index 11). We used a wired sternal crane technique to elevate the sternum and gain exposure. Release of the crane after implantation went smoothly, as did the postoperative recovery. This report illustrates the feasibility of this technique during lung transplantation.

Published
2024
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3. Diagnosis and Management of Esophageal Fistulas After Lung Transplantation: A Case Series

Author

Stijn Vanstraelen, MD, Robin Vos, MD, PhD, Marie Dausy, MD, Jan Van Slambrouck, MD, Cedric Vanluyten, MD, Paul De Leyn, MD, PhD, Willy Coosemans, MD, PhD, Herbert Decaluwé, MD, PhD, Hans Van Veer, MD, Lieven Depypere, MD, PhD, Raf Bisschops, MD, PhD, Ingrid Demedts, MD, PhD, Michael P. Casaer, MD, PhD, Yves Debaveye, MD, PhD, Greet De Vlieger, MD, PhD, Laurent Godinas, MD, PhD, Geert Verleden, MD, PhD, Dirk Van Raemdonck, MD, PhD, Philippe Nafteux, MD, PhD, and Laurens J. Ceulemans, MD, PhD

Subjects
Surgery, RD1-811
Abstract

Background. Lung transplantations are highly complex procedures, often conducted in frail patients. Through the addition of immunosuppressants, healing can be compromised, primarily leading to the development of bronchopleural fistulas. Although esophageal fistulas (EFs) after lung transplantation remain rare, they are associated with significant morbidity. We aimed to investigate the clinical presentation, diagnostic approaches, and treatment strategies of EF after lung transplantation. Methods. All patients who developed EF after lung transplantation at the University Hospitals Leuven between January 2019 and March 2022 were retrospectively reviewed and the clinical presentations, diagnostic approaches, and treatment strategies were summarized. Results. Among 212 lung transplantation patients, 5 patients (2.4%) developed EF. Three patients were male and median age was 39 y (range, 34–63). Intraoperative circulatory support was required in 3 patients, with 2 needing continued support postoperatively. Bipolar energy devices were consistently used for mediastinal hemostasis. All EFs were right-sided. Median time to diagnosis was 28 d (range, 12–48) and 80% of EFs presented as recurrent respiratory infections or empyema. Diagnosis was made through computed tomography (n = 3) or esophagogastroscopy (n = 2). Surgical repair with muscle flap covering achieved an 80% success rate. All patients achieved complete resolution, with only 1 patient experiencing a fatal outcome during a complicated EF-related recovery. Conclusion. Although EF after lung transplantation remains rare, vigilance is crucial, particularly in cases of right-sided intrathoracic infection. Moreover, caution must be exercised when applying thermal energy in the mediastinal area to prevent EF development and mitigate the risk of major morbidity. Timely diagnosis and surgical intervention can yield favorable outcomes.

Published
2024
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