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In Vitro/Ex Vivo Systems
Published in Anthony J. Hickey, Sandro R.P. da Rocha, Pharmaceutical Inhalation Aerosol Technology, 2019
Bethany M. Young, Alexandria Ritchie, Laleh Golshahi, Rebecca L. Heise
Tissue-engineered lungs are commonly designed as a strategy for lung transplantation, but they are also a promising alternative to in vivo models for drug testing. By using tissue from an animal or non-transplantable human sources, models for testing are more available. There are currently several naturally derived lung models for drug discovery and testing, including decellularized lung matrices, bioprinted lungs that offer natural signaling, and the complex lung anatomy, in a controlled system.
World Trade Center Health Program best practices for the diagnosis and treatment of fibrosing interstitial lung diseases
Published in Archives of Environmental & Occupational Health, 2023
Rafael E. de la Hoz, Kerri A. Johannson
Immunosuppressive medications are used for some fibrotic ILDs other than idiopathic pulmonary fibrosis (IPF), when there is underlying inflammation driving disease activity, particularly with CTD -ILDs and HP. As disease progresses, some patients may be eligible for lung transplantation.20 Optimal timing for referral varies, but a forced vital capacity < 80%, diffusion capacity < 40%, supplemental oxygen requirement, failure to respond to pharmacotherapy, or diagnoses of IPF or fibrotic nonspecific interstitial pneumonitis (NSIP) should lower the threshold for earlier referral and evaluation by lung transplant team.8 Advanced care planning, palliative and end-of-life care are important parts of comprehensive management of these often disabling and lethal diseases. Medicolegal issues, such as disability assessments, Workers’ Compensation claim filing, and registry reporting are important, but vary by individuals and jurisdictions.
Comparison of mechanical cardiopulmonary support strategies during lung transplantation
Published in Expert Review of Medical Devices, 2020
Noah Weingarten, Dean Schraufnagel, Gilman Plitt, Anthony Zaki, Kamal S. Ayyat, Haytham Elgharably
Lung transplantation (LT) is the definitive treatment for end-stage lung disease refractory to maximal therapy. Each year over 4000 LTs are performed across 170 centers worldwide [1]. Adult LT patients have a median survival of 6.5 years [1] and experience good functional outcomes [2]. After 5-years post-LT, 80% of survivors report minimal activity limitations and 40% are employed at least part-time [2]. Ongoing efforts to improve the long-term health of LT recipients must address primary graft dysfunction and chronic lung allograft dysfunction, the leading causes of death 30 days and one-year post-LT, respectively [3,4].