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“Purpose of AP26113 review
There are reasonably compelling data documenting the beneficial impact of lung transplantation on functional status, hemodynamics, and quality of life. Demonstration of a survival benefit has been more problematic, largely due to significant constraints on long-term survival. This article reviews the current literature addressing the question of whether transplantation is truly a life-extending procedure.
Recent findings
Because randomized trials are nonexistent, the question has been approached by comparing observed posttransplant survival to wait list survival, or by simulating
survival with and without transplantation by statistical modeling. Studies uniformly suggest that transplantation extends survival for patients with idiopathic pulmonary fibrosis. For patients with chronic obstructive pulmonary disease, studies are conflicting and suggest that survival benefit is largely restricted to a subset of patients with extremely severe airflow obstruction who undergo bilateral lung transplantation. Cystic fibrosis (CF) adults with a predicted 5-year survival of less than 50%, and without Burkholderia cepacia or arthropathy appear most likely to realize a survival benefit. Whether transplantation extends survival for pediatric CF patients remains controversial.
Summary
Questions about the survival benefit of lung transplantation linger. In the
absence of definitive answers, it may be most appropriate to view transplant as a procedure that enhances the quality but not necessarily the duration of life.”
“Aim: This study aimed to compare the differences in perioperative LY2157299 nmr outcome after endovascular repair of symptomatic abdominal aneurysms (S-AAAs) and elective non-symptomatic AAAs (E-AAAs). Data from the ENGAGE Registry were used for the analysis.
Methods: Between March 2009 and
December 2010, 1200 AAA patients were enrolled from 79 sites in 30 countries and treated with an Endurant Stent Graft. S-AAAs defined as AAAs accompanied by abdominal or back pain, without rupture, were present in 185 (15.4%) patients and E-AAAs in 1015 (84.6%) patients. Multivariate logistic regression was used to compare results.
Results: At baseline, E-AAA patients had larger aneurysms on average www.selleckchem.com/products/CX-6258.html (P = 0.006) and scored higher ASA classification more often (P = 0.001). Further analyses were corrected for baseline differences. Operation time and technical success were comparable, and S-AAAs were admitted to the Intensive Care Unit (ICU) as often as E-AAAs (35.7% vs. 33.4%, P = 0.479). Post-operative hospitalisation was similar (4.83 +/- 5.29 in E-AAAs and 4.37 +/- 3.49 in S-AAAs, P = 0.360). No differences in the occurrence of major adverse events, including mortality, within the 30-day post-implantation were seen between S-AAA and E-AAA patients, respectively, 3.2% and 4.2% (P = 0.572).