Patients with mechanical circulatory support bridged to a heart transplant (HTx) are at higher risk of postoperative graft dysfunction. In this subset, a mode of graft preservation that shortens graft ischaemia should be beneficial. The outcomes of 38 patients on mechanical circulatory support (extracorporeal life support, left ventricular assist device and biventricular assist device) who received a HTx between 2015 and 2020 were analysed according to the method of graft preservation: cold storage (CS) group, 24 (63%) or ex vivo perfusion (EVP) group, 14 (37%). The median age was 57 (range 30–73) vs 64 (35–75) years (P = 0.10); 88% were men (P = 0.28); extracorporeal life support was more frequent in the CS group (54% vs 36%; P = 0.27) versus left ventricular and biventricular assist devices in the EVP group (46% vs 64%; P = 0.27). Clamping time was shorter in the EVP group (P < 0.001) and ischaemic time >4 h was higher in the CS group (P = 0.01). Thirty-day mortality was 13% (0–27%) in the CS group and 0% (P = 0.28) in the EVP group. A significantly lower primary graft failure [7% (0–23%) vs 42% (20–63%); P = 0.03] was observed in the EVP group. Survival at 1 year was 79 ± 8% (63–95%) in the CS group and 84 ± 10% (64–104%) in the EVP group (P = 0.95). Our results support the use of ex vivo graft perfusion in patients on mechanical circulatory support as a bridge to a HTx. This technique, by shortening graft ischaemic time, seems to improve post-HTx outcomes.

This observational study aimed to: (i) assess the presence of periodontal disease among patients requiring aortic valve replacement; (ii) investigate the presence of oral pathogens in aortic valve specimens and compare them with the microorganisms detected in the oral cavity. Twenty-six patients (15 men and 11 women) were scheduled to be visited the day before the cardiac surgery: periodontal conditions were accurately registered through clinical and radiographic examinations; dental plaque or salivary samples were collected. Valve specimens were collected during surgical aortic valve replacement and analyzed for pathogens detection through microbiological 16SrRna gene sequencing. Bacteria found in plaque samples and valve specimens were assessed according to oral and periodontal conditions. A qualitative comparison between oral and cardiac profiles of the microorganisms detected was performed. The overall number of patients examined for soft tissues conditions was 19, as 7 patients were edentulous. Twelve and three individuals, respectively, presented moderate and severe periodontitis. Nine valves were found to be positive for the presence of oral and periodontopathic bacterial DNA. The microbial species found in valve samples of patients with periodontitis suggest that the presence of these microorganisms in valvular tissue seems to be not coincidental.

Pre-transplant allosensitization to human leukocyte antigens (HLA) increases the recipient waiting-list time and mortality in lung transplantation. Rather than waiting for crossmatch-negative donors, since 2013, recipients with preformed donor specific anti-HLA antibodies (pfDSA) have been managed with repeated IgA- and IgM-enriched intravenous immunoglobulin (IgGAM) infusions, usually in combination with plasmapheresis before IgGAM and a single dose of anti-CD20 antibody. This retrospective study presents our 9-year experience in patients transplanted with pfDSA. Records of patients transplanted between 02/2013 and 05/2022 were reviewed. Outcomes were compared between patients with pfDSA and those without any de-novo DSA. Median follow-up time was 50 months. Of the 1043 lung-transplanted patients, 758 (72.7%) did not develop any early DSA and 62 (5.9%) patients exhibited pfDSA. Among the 52 (84%) patients who completed treatment, pfDSA were cleared in 38 (73%) patients. In pfDSA vs. control patients and at 8-year follow-up, respectively, graft survival (%) was 75 vs. 65 (p=0.493) and freedom from chronic lung allograft dysfunction (CLAD, %) was 63 vs. 65 (p=0.525). In lung transplantation, crossing the preformed HLA-antibody barrier is safe using a treatment protocol based on IgGAM. Patients with pfDSA have a good 8-year graft survival and freedom from CLAD similar to control patients.

Plants belong to Euphorbiaceae family, bearing enormous Medicinal potential due to the presence of various pharmacologically important secondary metabolites. Now a days, with the help of various tools and techniques like FTIR, GCMS researchers are engaged to systematically find out various biologically active phytoconstituents. The present study investigated Acalypha indica L. and Euphorbia hirta L. leaf to establish the fact. Physico-chemical parameters of the experimental plants have been investigated. The result shows that Acalypha indica possesses maximum values on Swelling index, volatile matter, ash contents, fixed carbon, higher heat value, hydrogen content, oxygen content, carbon content, hemicellulose content, lignin content and extractive values. In contrast, the percentage composition of bulk density, carbon content, and nitrogen content is higher in Euphorbia hirta. In the present investigation, the FTIR analysis reveals that Acalypha indica L. possessed different chemical classes like Sulfoxide, Alkene, Carbon Dioxide, Alkane, Alcohol etc., whereas FTIR analysis reveals the presence Alkene, Secondary Alcohol, Conjugated Alkene, Carbon Dioxide, Alkene, Alcohol in Euphorbia hirta L. The methanolic leaf extracts of two different plants have been screened through GC-MS, revealing many important bioactive phytoconstituents. Acalypha indica L. possesses Cyclotrisiloxane, Hexamethyl-, cis-2,4-dimethylamine, S, S-dioxide, 1- nonadecanamine, n, n-dimethyl-, tridecane, 2,2,4,10,12,12-hexamethyl-7-(3,5,5-trimethylsilyl)-, dodecane, 1-fluoro-, whereas, Euphorbia hirta L. possesses myo- inositol, 4-c-methyl-, z,z-6,28-heptatriactontadien-2-one, phytylpalmitate, hexasiloxane, 1,1,3,3,5,5,7,7,9,9,11,11-dodecamethyl-, 4-tert-octylphenol, TMS derivative. Both these plants have chemical substances that have proven bioactivity in human welfare. The GC-MS of leaf methanolic extract reveals that the phytochemical cis-2,4-dimethylthiane, S, S-dioxide have Anticancer (stomach) activities, 1-nonadecanamine, N, N-dimethyl bears Antitumor (nasopharynx) activities, myo-inositol, 4-C- methyl bearing Myo-neuro-stimulant activities and Z, Z-6,28-heptatriactontadien-2-one having Increase zinc bioavailability activities. These activities of individual phytoconstituents have been proven through Dr. Duke's Phytochemical and Ethno-botanical Databases: U.S. Department of Agriculture. This information might be helpful to the pharmacologists, chemists, etc., for future novel drug discovery.

The physico-chemical and spectroscopic characterization of five selected medicinal plants viz., Acalypha indica, Senna tora, Euphorbia hirta, Physalis angulata and Ziziphus mauritina are the essence and has been carried out to assess bioactive potential and to establish traditional belief in the light of scientific interpretation. Fresh leaves were collected from Paschim Medinipur district of West Bengal, India, dried and powdered for Proximate analysis, ultimate analysis and compositional analysis, FTIR and GCMS. The study revealed that the highest concentration of Volatile matter (75.452%), Bulk density (0.256 %), Swelling index (1.456 %), Cellulose content (61.727 %), Hemicellulose content (4.372 %) and Tannins (0.635 g/ 100g) was observed to occur in Acalypha indica leaf than other experimental plants. In Physalis angulata the percentage composition of fixed carbon (15.251%) and extractive content (1.974 %) was higher than others. Ash content (12.327 %), hemicellulose content (4.372 %), and lignin content (5.531 %) were observed to be higher in the Senna tora leaf than others. Total carbohydrate concentrations (9.619 gm/100 gm) and nitrogen content (2.050 %) were observed to be higher in Euphorbia hirta than others. Total protein (2.321 gm/100 gm), total fat (0.655 gm/100 gm), oxygen content (34.222 %) and Higher heat value (HHV) (16.546 %) were higher in Ziziphus mauritina than others. The existence of functional groups and the relevance of the presence of a specific bioactive component were determined using FTIR (Fourier Transform Infrared Spectroscopy) of the leaves of five plant samples. According to GCMS (Gas Chromatography Mass Spectroscopy), five different medicinal plants contain significant bioactive chemicals. By using GC-MS analysis, a total of 10 bioactive compounds (Acalypha indica, Senna tora) and 8 bioactive compounds (Ziziphus mauritina, Euphorbia hirta, Physalis Angulata) were found in the peaks of methanolic extracts of five potential medicinal plants. The bioactive compounds like Cyclotrisiloxane, Hexamethyl-, Dodecane, 1-Fluoro-, Myo-Inositol, 4-C-Methyl obtained from Acalypha indica leaf extract, Palmitic Acid, Phthalic Acid, Cyclopentadecanol obtained from Senna tora leaf extract and 4-Tert-Octylphenol, TMS Derivative obtained from Euphorbia hirta leaf extract has no records of individual bioactivity as per Dr. Duke’s ethnobotanical and pharmaceutical database and are considered as novel bioactive compounds. Isolation of these compounds and successive bioactivity studies should be the thrust area for future researchers. Also, the current study confirms that specific plant leaves are a great source of important phytochemicals and can be used to make herbal formulations, practical medications, and complementary medicines.

Survival after lung transplantation has significantly improved during the last two decades. The refinement of the already existing extracorporeal life support (ECLS) systems, such as extracorporeal membrane oxygenation (ECMO), and the introduction of new techniques for donor lung optimization, such as ex vivo lung perfusion (EVLP), have allowed the extension of transplant indication to patients with end-stage lung failure after acute respiratory distress syndrome (ARDS) and the expansion of the donor organ pool, due to the better evaluation and optimization of extended-criteria donor (ECD) lungs and of donors after circulatory death (DCD). The close monitoring of anti-HLA donor-specific antibodies (DSAs) has allowed the early recognition of pulmonary antibody-mediated rejection (AMR), which requires a completely different treatment and has a worse prognosis than acute cellular rejection (ACR). As such, the standardization of patient selection and post-transplant management has significantly contributed to this positive trend, especially at high-volume centers. This review focuses on lung transplantation after ARDS, on the role of EVLP in lung donor expansion, on ECMO as a principal cardiopulmonary support system in lung transplantation, and on the diagnosis and therapy of pulmonary AMR.