Search

Your search keyword '"Ethan D'Silva"' showing total 3 results
Start Over Author "Ethan D'Silva"
3 results on '"Ethan D'Silva"'

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
Full Text
View/download PDF

2. Risk Factors, Incidence, and Outcomes Associated With Clinically Significant Airway Ischemia

Author

Gloria Li, Zejian Liu, Marcelo Salan-Gomez, Emma Keeney, Ethan D’Silva, Babith Mankidy, Andres Leon, Aladdein Mattar, Abdusallam Elsennousi, Jennalee Coster, Anupam Kumar, Bruno Rodrigues, Meng Li, Alexis Shafii, Puneet Garcha, and Gabriel Loor

Subjects
lung transplant, airway stenosis, airway ischemia, airway anastomosis, airway dehiscence, Specialties of internal medicine, RC581-951
Abstract

Airway complications following lung transplantation remain an important cause of morbidity and mortality. We aimed to identify the incidence, risk factors and outcomes associated with clinically significant airway ischemia (CSAI) in our center. We reviewed 217 lung transplants (386 airway anastomoses) performed at our institution between February 2016 and December 2020. Airway images were graded using the 2018 ISHLT grading guidelines modified slightly for retrospective analysis. Airways were considered to have CSAI if they developed ischemia severity >B2, stenosis >50%, and/or any degree of dehiscence within 6-months of transplant. Regression analyses were used to evaluate outcomes and risk factors for CSAI. Eighty-two patients (37.8%) met criteria for CSAI. Of these, twenty-six (32%) developed stenosis and/or dehiscence, and 17 (21%) required interventions. Patients with CSAI had lower one-year (80.5% vs. 91.9%, p = 0.05) and three-year (67.1% vs. 77.8%, p = 0.08) survival than patients without CSAI. Factors associated with CSAI included younger recipient age, recipient diabetes, single running suture technique, performance of the left anastomosis first, lower venous oxygen saturation within 48-h, and takeback for major bleeding. Our single-center analysis suggests that airway ischemia remains a major obstacle in contemporary lung transplantation. Improving the local healing milieu of the airway anastomosis could potentially mitigate this risk.

Published
2024
Full Text
View/download PDF

3. Effect of intraoperative support mode on circulating inflammatory biomarkers after lung transplantation surgery

Author

Lourdes Chacon‐Alberty, Shengbin Ye, Abdussalam Elsenousi, Emma Hills, Madelyn King, Ethan D'Silva, Andres Pena Leon, Marcelo Salan‐Gomez, Meng Li, Camila Hochman‐Mendez, and Gabriel Loor

Subjects
Biomaterials, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, General Medicine
Abstract

Processes that activate the immune system during lung transplantation can lead to primary graft dysfunction (PGD) or allograft rejection.We analyzed cytokine expression profiles after reperfusion and allograft outcomes in a cohort of patients (n=59) who underwent lung transplantation off-pump (n=26), with cardiopulmonary bypass (CPB; n=18), or with extracorporeal membrane oxygenation (ECMO; n=15). Peripheral blood was collected from patients at baseline and at 6 and 72 hours after reperfusion. To adjust for clinical differences between groups, we utilized a linear mixed model with overlap weighting.PGD3 was present at 48 or 72 hours after reperfusion in 7.7% (2/26) of off-pump cases, 20.0% (3/15) of ECMO cases, and 38.9% (7/18) of CPB cases (p=0.04). The ECMO and CPB groups had greater reperfusion-induced increases in MIP-1B, IL-6, IL-8, IL-9, IL1-ra, TNF-alpha, RANTES, eotaxin, IP-10, and MCP-1 levels than did the off-pump group. Cytokine expression profiles after reperfusion were not significantly different between ECMO and CPB groups.Our data suggest that, compared with an off-pump approach, the intraoperative use of ECMO or CPB during lung transplantation is associated with greater reperfusion-induced cytokine release and graft injury.

Published
2022

Catalog

Books, media, physical & digital resources
See catalog results