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5. Identification and validation of a threshold for early posttransplant bronchoalveolar fluid hyaluronan that distinguishes lung recipients at risk for chronic lung allograft dysfunction

Author

Todd, Jamie L., Weber, Jeremy M., Kelly, Francine L., Nagler, Andrew, McArthur, Patrick, Eason, Lerin, Rim, Jeeyon G., Frankel, Courtney W., Belperio, John A., Budev, Marie, Martinu, Tereza, Patel, Kunal, Reynolds, John M., Shah, Pali D., Singer, Lianne G., Snyder, Laurie D., Tsuang, Wayne, Weigt, S. Sam, Neely, Megan L., and Palmer, Scott M.

Published
2024
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6. Frailty and aging‐associated syndromes in lung transplant candidates and recipients

Author

Schaenman, Joanna M, Diamond, Joshua M, Greenland, John R, Gries, Cynthia, Kennedy, Cassie C, Parulekar, Amit D, Rozenberg, Dmitry, Singer, Jonathan P, Singer, Lianne G, Snyder, Laurie D, and Bhorade, Sangeeta

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Aging, Organ Transplantation, Transplantation, Lung, Aged, Frail Elderly, Frailty, Humans, Lung Transplantation, Sarcopenia, Syndrome, clinical decision-making, clinical research / practice, complication: medical / metabolic, geriatrics, immunobiology, lung biology, lung transplantation / pulmonology, recipient selection, risk assessment / risk stratification, translational research / science, Medical and Health Sciences, Surgery, Clinical sciences, Immunology
Abstract

Many lung transplant candidates and recipients are older and frailer compared to previous eras. Older patients are at increased risk for pre- and posttransplant mortality, but this risk is not explained by numerical age alone. This manuscript represents the product of the American Society of Transplantation (AST) conference on frailty. Experts in the field reviewed the latest published research on assessment of elderly and frail lung transplant candidates. Physical frailty, often defined as slowness, weakness, low physical activity, shrinking, and exhaustion, and frailty evaluation is an important tool for evaluation of age-associated dysfunction. Another approach is assessment by cumulative deficits, and both types of frailty are common in lung transplant candidates. Frailty is associated with death or delisting before transplant, and may be associated with posttransplant mortality. Sarcopenia, cognitive dysfunction, depression, and nutrition are other important components for patient evaluation. Aging-associated inflammation, telomere dysfunction, and adaptive immune system senescence may also contribute to frailty. Developing tools for frailty assessment and interventions holds promise for improving patient outcomes before and after lung transplantation.

Published
2021

10. Early posttransplant reductions in club cell secretory protein associate with future risk for chronic allograft dysfunction in lung recipients: results from a multicenter study

Author

Todd, Jamie L., Weber, Jeremy M., Kelly, Francine L., Neely, Megan L., Nagler, Andrew, Carmack, Dylan, Frankel, Courtney W., Brass, David M., Belperio, John A., Budev, Marie M., Hartwig, Matthew G., Martinu, Tereza, Reynolds, John M., Shah, Pali D., Singer, Lianne G., Snyder, Laurie D., Weigt, S. Sam, and Palmer, Scott M.

Published
2023
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13. Usefulness of gene expression profiling of bronchoalveolar lavage cells in acute lung allograft rejection

Author

Weigt, S Samuel, Wang, Xiaoyan, Palchevskiy, Vyacheslav, Li, Xinmin, Patel, Naman, Ross, David J, Reynolds, John, Shah, Pali D, Danziger-Isakov, Lara A, Sweet, Stuart C, Singer, Lianne G, Budev, Marie, Palmer, Scott, and Belperio, John A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Transplantation, Lung, Biotechnology, Genetics, Acute Disease, Aged, Allografts, Bronchoalveolar Lavage Fluid, Cross-Sectional Studies, Female, Gene Expression Profiling, Graft Rejection, Humans, Lung Transplantation, Male, Middle Aged, Lung transplant, Acute cellular rejection, bronchoalveolar lavage, gene expression, transcriptome, genomic classifier, Cardiorespiratory Medicine and Haematology, Surgery, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundChronic lung allograft dysfunction (CLAD) is the main limitation to long-term survival after lung transplantation. Because effective therapies are lacking, early identification and mitigation of risk factors is a pragmatic approach to improve outcomes. Acute cellular rejection (ACR) is the most pervasive risk factor for CLAD, but diagnosis requires transbronchial biopsy, which carries risks. We hypothesized that gene expression in the bronchoalveolar lavage (BAL) cell pellet (CP) could replace biopsy and inform on mechanisms of CLAD.MethodsWe performed RNA sequencing on BAL CPs from 219 lung transplant recipients with A-grade ACR (n = 61), lymphocytic bronchiolitis (n = 58), infection (n = 41), or no rejection/infection (n = 59). Differential gene expression was based on absolute fold difference >2.0 and Benjamini-adjusted p-value ≤0.05. We used the Database for Annotation, Visualization and Integrated Discovery Bioinformatics Resource for pathway analyses. For classifier modeling, samples were randomly split into training (n = 154) and testing sets (n = 65). A logistic regression model using recursive feature elimination and 5-fold cross-validation was trained to optimize area under the curve (AUC).ResultsDifferential gene expression identified 72 genes. Enriched pathways included T-cell receptor signaling, natural killer cell-mediated cytotoxicity, and cytokine-cytokine receptor interaction. A 4-gene model (AUC = 0.72) and classification threshold defined in the training set exhibited fair performance in the testing set; accuracy was 76%, specificity 82%, and sensitivity 60%. In addition, classification as ACR was associated with worse CLAD-free survival (hazard ratio = 2.42; 95% confidence interval = 1.29-4.53).ConclusionsBAL CP gene expression during ACR is enriched for immune response pathways and shows promise as a diagnostic tool for ACR, especially ACR that is a precursor of CLAD.

Published
2019

14. Report from the American Society of Transplantation on frailty in solid organ transplantation.

Author

Kobashigawa, Jon, Dadhania, Darshana, Bhorade, Sangeeta, Adey, Deborah, Berger, Joseph, Bhat, Geetha, Budev, Marie, Duarte-Rojo, Andres, Dunn, Michael, Hall, Shelley, Harhay, Meera N, Johansen, Kirsten L, Joseph, Susan, Kennedy, Cassie C, Kransdorf, Evan, Lentine, Krista L, Lynch, Raymond J, McAdams-DeMarco, Mara, Nagai, Shunji, Olymbios, Michael, Patel, Jignesh, Pinney, Sean, Schaenman, Joanna, Segev, Dorry L, Shah, Palak, Singer, Lianne G, Singer, Jonathan P, Sonnenday, Christopher, Tandon, Puneeta, Tapper, Elliot, Tullius, Stefan G, Wilson, Michael, Zamora, Martin, and Lai, Jennifer C

Subjects
Humans, Organ Transplantation, Health Care Rationing, Societies, Medical, United States, Frailty, clinical research/practice, heart disease, immune regulation, kidney disease, kidney transplantation/nephrology, liver disease, liver transplantation/hepatology, lung disease, lung transplantation/pulmonology, Transplantation, Kidney Disease, clinical research, practice, kidney transplantation, nephrology, liver transplantation, hepatology, lung transplantation, pulmonology, Medical and Health Sciences, Surgery
Abstract

A consensus conference on frailty in kidney, liver, heart, and lung transplantation sponsored by the American Society of Transplantation (AST) and endorsed by the American Society of Nephrology (ASN), the American Society of Transplant Surgeons (ASTS), and the Canadian Society of Transplantation (CST) took place on February 11, 2018 in Phoenix, Arizona. Input from the transplant community through scheduled conference calls enabled wide discussion of current concepts in frailty, exploration of best practices for frailty risk assessment of transplant candidates and for management after transplant, and development of ideas for future research. A current understanding of frailty was compiled by each of the solid organ groups and is presented in this paper. Frailty is a common entity in patients with end-stage organ disease who are awaiting organ transplantation, and affects mortality on the waitlist and in the posttransplant period. The optimal methods by which frailty should be measured in each organ group are yet to be determined, but studies are underway. Interventions to reverse frailty vary among organ groups and appear promising. This conference achieved its intent to highlight the importance of frailty in organ transplantation and to plant the seeds for further discussion and research in this field.

Published
2019

15. Plasma CXCL9 and CXCL10 at allograft injury predict chronic lung allograft dysfunction

Author

Shino, Michael Y., Todd, Jamie L., Neely, Megan L., Kirchner, Jerry, Frankel, Courtney W., Snyder, Laurie D., Pavlisko, Elizabeth N., Fishbein, Gregory A., Schaenman, Joanna M., Mason, Kristen, Kesler, Karen, Martinu, Tereza, Singer, Lianne G., Tsuang, Wayne, Budev, Marie, Shah, Pali D., Reynolds, John M., Williams, Nikki, Robien, Mark A., Palmer, Scott M., Weigt, S. Sam, and Belperio, John A.

Published
2022
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16. Utility of bile acids in large airway bronchial wash versus bronchoalveolar lavage as biomarkers of microaspiration in lung transplant recipients: a retrospective cohort study

Author

Zhang, Chen Yang Kevin, Ahmed, Musawir, Huszti, Ella, Levy, Liran, Hunter, Sarah E., Boonstra, Kristen M., Moshkelgosha, Sajad, Sage, Andrew T., Azad, Sassan, Ghany, Rasheed, Yeung, Jonathan C., Crespin, Oscar M., Singer, Lianne G., Keshavjee, Shaf, and Martinu, Tereza

Published
2022
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17. Correlation between BAL CXCR3 chemokines and lung allograft histopathologies: A multicenter study

Author

Shino, Michael Y., Li, Ning, Todd, Jamie L., Neely, Megan L., Kirchner, Jerry, Kopetskie, Heather, Sever, Michelle L., Frankel, Courtney W., Snyder, Laurie D., Pavlisko, Elizabeth N., Martinu, Tereza, Singer, Lianne G., Tsuang, Wayne, Budev, Marie, Shah, Pali D., Reynolds, John M., Williams, Nikki, Robien, Mark A., Palmer, Scott M., Sam Weigt, Stephen, and Belperio, John A.

Published
2021
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21. Bronchoalveolar bile acid and inflammatory markers to identify high-risk lung transplant recipients with reflux and microaspiration

Author

Zhang, Chen Yang Kevin, Ahmed, Musawir, Huszti, Ella, Levy, Liran, Hunter, Sarah E., Boonstra, Kristen M., Moshkelgosha, Sajad, Sage, Andrew T., Azad, Sassan, Zamel, Ricardo, Ghany, Rasheed, Yeung, Jonathan C., Crespin, Oscar M., Frankel, Courtney, Budev, Marie, Shah, Pali, Reynolds, John M., Snyder, Laurie D., Belperio, John A., Singer, Lianne G., Weigt, S. Samuel, Todd, Jamie L., Palmer, Scott M., Keshavjee, Shaf, and Martinu, Tereza

Published
2020
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23. Short-course, direct-acting antivirals and ezetimibe to prevent HCV infection in recipients of organs from HCV-infected donors: a phase 3, single-centre, open-label study

Author

Feld, Jordan J, Cypel, Marcelo, Kumar, Deepali, Dahari, Harel, Pinto Ribeiro, Rafaela Vanin, Marks, Nikki, Kamkar, Nellie, Bahinskaya, Ilona, Onofrio, Fernanda Q, Zahoor, Mohamed A, Cerrochi, Orlando, Tinckam, Kathryn, Kim, S Joseph, Schiff, Jeffrey, Reichman, Trevor W, McDonald, Michael, Alba, Carolina, Waddell, Thomas K, Sapisochin, Gonzalo, Selzner, Markus, Keshavjee, Shaf, Janssen, Harry L A, Hansen, Bettina E, Singer, Lianne G, and Humar, Atul

Published
2020
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24. Lung transplantation for cystic fibrosis

Author

Yeung, Jonathan C., Machuca, Tiago N., Chaparro, Cecilia, Cypel, Marcelo, Stephenson, Anne L., Solomon, Melinda, Saito, Tomohito, Binnie, Matthew, Chow, Chung-Wai, Grasemann, Hartmut, Pierre, Andrew F., Yasufuku, Kazuhiro, de Perrot, Marc, Donahoe, Laura L., Tikkanen, Jussi, Martinu, Tereza, Waddell, Thomas K., Tullis, Elizabeth, Singer, Lianne G., and Keshavjee, Shaf

Published
2020
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26. Cystic Fibrosis Foundation consensus guidelines for the care of individuals with advanced cystic fibrosis lung disease

Author

Kapnadak, Siddhartha G., Dimango, Emily, Hadjiliadis, Denis, Hempstead, Sarah E., Tallarico, Erin, Pilewski, Joseph M., Faro, Albert, Albright, James, Benden, Christian, Blair, Shaina, Dellon, Elisabeth P., Gochenour, Daniel, Michelson, Peter, Moshiree, Baharak, Neuringer, Isabel, Riedy, Carl, Schindler, Teresa, Singer, Lianne G., Young, Dave, Vignola, Lauren, Zukosky, Joan, and Simon, Richard H.

Published
2020
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27. Prevention of viral transmission during lung transplantation with hepatitis C-viraemic donors: an open-label, single-centre, pilot trial

Author

Cypel, Marcelo, Feld, Jordan J, Galasso, Marcos, Pinto Ribeiro, Rafaela V, Marks, Nikki, Kuczynski, Magdalena, Kumar, Deepali, Bahinskaya, Ilona, Bagnato, Vanderlei S, Kurachi, Cristina, Slutsky, Arthur S, Yeung, Jonathan C, Donahoe, Laura, de Perrot, Marc, Yasufuku, Kazuhiro, Pierre, Andrew, Binnie, Matthew, Chaparro, Cecilia, Martinu, Tereza, Chen, Manyin, Tikkanen, Jussi, Chow, Chung-Wai, Sidhu, Aman, Waddell, Thomas K, Keshavjee, Shaf, Singer, Lianne G, and Humar, Atul

Published
2020
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31. Lack of association of Aspergillus colonization with the development of bronchiolitis obliterans syndrome in lung transplant recipients: An international cohort study

Author

Law, Nancy, Hamandi, Bassem, Fegbeutel, Christine, Silveira, Fernanda P., Verschuuren, Erik A., Ussetti, Piedad, Chin-Hong, Peter V., Sole, Amparo, Holmes-Liew, Chien-Li, Billaud, Eliane M., Grossi, Paolo A., Manuel, Oriol, Levine, Deborah J., Barbers, Richard G., Hadjiliadis, Denis, Younus, Muhammad, Aram, Jay, Chaparro, Cecilia, Singer, Lianne G., and Husain, Shahid

Published
2019
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33. In-Person Versus Remote 6-Minute Walk and Incremental Shuttle Walk Distances in Advanced Lung Disease.

Author

Wickerson, Lisa M., de Paula Ferreira, Manoela, Rozenberg, Dmitry, Mathur, Sunita, and Singer, Lianne G.

Subjects
CONTINUING education units, OXIMETERS, OXYGEN saturation, MUSCLE fatigue, PULMONARY function tests, PATIENT safety, LUNG transplantation, HEART rate monitoring, ACADEMIC medical centers, RESEARCH funding, BODY mass index, THERAPEUTICS, T-test (Statistics), PREHABILITATION, OXYGEN therapy, PILOT projects, PULMONARY artery, COOLDOWN, CLINICAL trials, HOME environment, TELEREHABILITATION, INTERSTITIAL lung diseases, MANN Whitney U Test, DESCRIPTIVE statistics, WALKING, LONGITUDINAL method, PRE-tests & post-tests, LUNG diseases, TREADMILLS, MEDICAL rehabilitation, EXERCISE tolerance, OBSTRUCTIVE lung diseases, EXERCISE tests, DYSPNEA, BLOOD pressure, DATA analysis software, HOME rehabilitation, COMPARATIVE studies, CONFIDENCE intervals, WALKING speed, REGRESSION analysis
Abstract

BACKGROUND: Field-based walk tests conducted remotely may provide an alternative method to a facility-based assessment of exercise capacity for people with advanced lung disease. This prospective study evaluated the level of agreement in the distance walked between a 6-min walk test (6MWT) and an incremental shuttle walk test performed by using standard in-person procedures and test variations and settings. METHODS: Adults with advanced lung disease underwent 4 study visits: (i) one in-person standard 6MWT (30-m corridor) and one in-person treadmill 6MWT, (ii) a remote 6MWT in a home setting (10-m corridor), (iii) 2 in-person standard incremental shuttle walk tests (10-m corridor), and (iv) a remote incremental shuttle walk test in a home setting (10-m corridor). A medical-grade oximeter measured heart rate and oxygen saturation before, during, and for 2 min after the tests. RESULTS: Twenty-eight participants were included (23 men [82%]; 64 (57--67) y old; 19 with interstitial lung disease [68%] and 9 with COPD [32%]; and 26 used supplemental oxygen (93%) [exertional Embedded Image of 0.46 ± 0.1]). There was no agreement between the tests. Greater walking distances were achieved with standard testing procedures: in-person 6MWT versus treadmill 6MWT (355 ± 68 vs 296 ± 97; P = .001; n = 28), in-person 6MWT versus remote 6MWT (349 ± 68 vs 293 ± 84; P = .001; n = 24), and in-person incremental shuttle walk test versus remote incremental shuttle walk test (216 ± 62 vs 195 ± 63; P = .03; n = 22). CONCLUSIONS: Differences in the distance walked may have resulted from different track lengths, widths, and walking surfaces. This should be considered in test interpretation if tests are repeated under different conditions. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Oesophageal stasis is a risk factor for chronic lung allograft dysfunction and allograft failure in lung transplant recipients

Author

Ramendra, Rayoun, primary, Fernández-Castillo, Juan C., additional, Huszti, Ella, additional, Ghany, Rasheed, additional, Aversa, Meghan, additional, Havlin, Jan, additional, Riddell, Peter, additional, Chaparro, Cecilia M., additional, Singer, Lianne G., additional, Liu, Louis, additional, Keshavjee, Shaf, additional, Yeung, Jonathan C., additional, and Martinu, Tereza, additional

Published
2023
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49. Prognostic implications of and clinical risk factors for acute lung injury and organizing pneumonia after lung transplantation: Data from a multicenter prospective cohort study

Author

Pavlisko, Elizabeth N., primary, Neely, Megan L., additional, Kopetskie, Heather, additional, Hwang, David M., additional, Farver, Carol F., additional, Wallace, W. Dean, additional, Arrossi, Andrea, additional, Illei, Peter, additional, Sever, Michelle L., additional, Kirchner, Jerry, additional, Frankel, Courtney W., additional, Snyder, Laurie D., additional, Martinu, Tereza, additional, Shino, Michael Y., additional, Zaffiri, Lorenzo, additional, Williams, Nikki, additional, Robien, Mark A., additional, Singer, Lianne G., additional, Budev, Marie, additional, Tsuang, Wayne, additional, Shah, Pali D., additional, Reynolds, John M., additional, Weigt, S. Sam, additional, Belperio, John A., additional, Palmer, Scott M., additional, and Todd, Jamie L., additional

Published
2022
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50. Supplemental Material - Experiences and perceptions of receiving and prescribing rehabilitation in adults with cystic fibrosis undergoing lung transplantation

Author

Wickerson, Lisa, Grewal, Rajan, Singer, Lianne G, and Chaparro, Cecilia

Subjects
110203 Respiratory Diseases, FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material for Experiences and perceptions of receiving and prescribing rehabilitation in adults with cystic fibrosis undergoing lung transplantation by Lisa Wickerson, Rajan Grewal, Lianne G Singer and Cecilia Chaparro in Chronic Respiratory Disease

Published
2023
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