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  1. Article: Survival after lipiodol escape at embolization for lung transplant chylothorax.

    Buzacott, Hugh / Vazirani, Jaideep / Snell, Gregory Ian

    Respirology case reports

    2023  Volume 11, Issue 3, Page(s) e01108

    Abstract: We present imaging of lipiodil escape after thoracic duct embolization for transplant associated chylothorax leading to transient impairment, then resolution. ...

    Abstract We present imaging of lipiodil escape after thoracic duct embolization for transplant associated chylothorax leading to transient impairment, then resolution.
    Language English
    Publishing date 2023-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2750180-2
    ISSN 2051-3380
    ISSN 2051-3380
    DOI 10.1002/rcr2.1108
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Case Report: Bilateral Lung Transplantation for Rapidly Progressive Undifferentiated Interstitial Lung Disease-A Cautionary Tale.

    Koshy, Kavya / Prasad, Jyotika / Vazirani, Jaideep / Snell, Gregory

    Transplantation proceedings

    2023  Volume 55, Issue 3, Page(s) 703–705

    Abstract: Interstitial lung disease is fast becoming one of the most common indications for lung transplantation (LTx); however, LTx for Goodpasture's syndrome with pulmonary involvement has not been previously described in the literature. In this report, we ... ...

    Abstract Interstitial lung disease is fast becoming one of the most common indications for lung transplantation (LTx); however, LTx for Goodpasture's syndrome with pulmonary involvement has not been previously described in the literature. In this report, we outline the case of a young male with undifferentiated rapidly progressive interstitial lung disease who ultimately received a bilateral sequential LTx after deterioration requiring extracorporeal membrane oxygenation. The original disease soon recurred in the graft, and unfortunately, the patient did not survive. The diagnosis of Goodpasture's syndrome was made postmortem and was not clearly evident on examination of the native explanted tissue, nor was there an elevated titer of antiglomerular basement membrane antibodies during his initial work-up. We hypothesize that the donor and recipient's HLA profile made him more susceptible to aggressive disease. In hindsight, active Goodpasture's disease would have been a contraindication to proceed to transplantation. This case is a cautionary reminder of the high stakes of performing LTx without a certain diagnosis.
    MeSH term(s) Humans ; Male ; Anti-Glomerular Basement Membrane Disease/surgery ; Anti-Glomerular Basement Membrane Disease/diagnosis ; Lung Diseases, Interstitial/surgery ; Lung Transplantation/adverse effects ; Autopsy
    Language English
    Publishing date 2023-03-28
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2023.02.039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Prolonged survival after lung transplantation in the absence of conventional immunosuppression.

    Vazirani, Jaideep / Snell, Gregory I / Westall, Glen P

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2020  Volume 39, Issue 10, Page(s) 1159–1162

    MeSH term(s) Adolescent ; Graft Survival ; Humans ; Immunosuppression ; Lung Transplantation/methods ; Male
    Language English
    Publishing date 2020-06-27
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2020.06.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Management of Multidrug Resistant Infections in Lung Transplant Recipients with Cystic Fibrosis.

    Vazirani, Jaideep / Crowhurst, Thomas / Morrissey, C Orla / Snell, Gregory I

    Infection and drug resistance

    2021  Volume 14, Page(s) 5293–5301

    Abstract: Cystic fibrosis (CF) is an inherited multisystem disease characterised by bronchiectasis and chronic respiratory infections which eventually cause end stage lung disease. Lung transplantation (LTx) is a well-established treatment option for patients with ...

    Abstract Cystic fibrosis (CF) is an inherited multisystem disease characterised by bronchiectasis and chronic respiratory infections which eventually cause end stage lung disease. Lung transplantation (LTx) is a well-established treatment option for patients with CF-associated lung disease, improving survival and quality of life. Navigating recurrent infections in the setting of LTx is often difficult, where immune suppression must be balanced against the constant threat of infection. Sepsis/infections are one of the major contributors to post-LTx mortality and multiresistant organisms (eg,
    Language English
    Publishing date 2021-12-10
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2494856-1
    ISSN 1178-6973
    ISSN 1178-6973
    DOI 10.2147/IDR.S301153
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  5. Article ; Online: Airway oscillometry parameters in baseline lung allograft dysfunction: Associations from a multicenter study.

    Darley, David Ross / Nilsen, Kris / Vazirani, Jaideep / Borg, Brigitte M / Levvey, Bronwyn / Snell, G / Plit, Marshall Lawrence / Tonga, Katrina O

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2023  Volume 42, Issue 6, Page(s) 767–777

    Abstract: Background: Baseline lung allograft dysfunction (BLAD), the failure to achieve ≥80%-predicted spirometry after lung transplant (LTx), is associated with impaired survival. Physiologic abnormalities in BLAD are poorly understood. Airway oscillometry ... ...

    Abstract Background: Baseline lung allograft dysfunction (BLAD), the failure to achieve ≥80%-predicted spirometry after lung transplant (LTx), is associated with impaired survival. Physiologic abnormalities in BLAD are poorly understood. Airway oscillometry measures respiratory system mechanics and may provide insight into understanding the mechanisms of BLAD.
    Objectives: This study aims to describe and measure the association between airway oscillometry parameters [Reactance (X
    Methods: A multi-center cross-sectional study was performed including bilateral LTx between January 2020 and June 2021. Participants performed concurrent airway oscillometry and spirometry. Multivariable logistic regression was performed to measure the association between oscillometry parameters and BLAD.
    Results: A total of 404 LTx recipients performed oscillometry and 253 were included for analysis. Stable allograft function was confirmed in 149 (50.2%) recipients (92 (61.7%) achieving normal spirometry and 57 (38.3%) with BLAD). Among stable LTx recipients, lower X
    Conclusions: Oscillometry provides novel physiologic insights into mechanisms of BLAD. The independent association between X
    MeSH term(s) Humans ; Oscillometry ; Cross-Sectional Studies ; Lung ; Respiratory Function Tests ; Lung Transplantation ; Spirometry ; Allografts
    Language English
    Publishing date 2023-01-06
    Publishing country United States
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2022.12.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Scedosporium apiospermum and Lomentospora prolificans in lung transplant patients - A single center experience over 24 years.

    Vazirani, Jaideep / Westall, Glen P / Snell, Gregory I / Morrissey, C Orla

    Transplant infectious disease : an official journal of the Transplantation Society

    2021  Volume 23, Issue 3, Page(s) e13546

    Abstract: Introduction: Scedosporium apiospermum and Lomentospora prolificans (Scedosporium/Lomentospora) species are emerging, multi-resistant pathogens that cause life-threatening illnesses among lung transplant (LTx) recipients. The current epidemiology and ... ...

    Abstract Introduction: Scedosporium apiospermum and Lomentospora prolificans (Scedosporium/Lomentospora) species are emerging, multi-resistant pathogens that cause life-threatening illnesses among lung transplant (LTx) recipients. The current epidemiology and management in LTx are unknown.
    Methods: We performed a retrospective single center audit of all sputum/bronchoscopy samples for Scedosporium/Lomentospora species in LTx patients over a 24-year period (1995-2019). Patients were diagnosed as colonized or with invasive fungal disease.
    Results: From a cohort of 962 LTx recipients, 30 patients (3.1%) cultured Scedosporium/Lomentospora (1.2%, 1.9%, respectively). There were no isolates from 1995 to 2013, with multiple yearly isolates thereafter. Nineteen (63%) cases were classified as IFD, and 11 (37%) as colonization. The median time to first culture from transplantation was 929 days (Interquartile-range [IQR] 263-2960). Most patients (63%) had received antifungals prior to the first positive culture of Scedosporium/Lomentospora for other fungal infection. The most common antifungal used for treatment of Scedosporium/Lomentospora was posaconazole (n = 16; 53%). Median duration of therapy was 364 days (IQR 164-616). Treatment was associated with improved lung function over 6 months (median FEV1 increased from 1.3L[IQR 0.9-1.8L] to 1.8L[IQR 1.1-2.3] P = .05). Six patients cultured Scedosporium/Lomentospora prior to transplantation, and no survival disadvantage was seen as compared to our whole LTx cohort (P = .8).
    Conclusion: Our single center 24-year experience suggests that the incidence of Scedosporium/Lomentospora is increasing. Scedosporium/Lomentospora is typically isolated several years after LTx, and requires prolonged anti-fungal treatment that is usually associated with improved in lung function. Culture of Scedosporium/Lomentospora prior to LTx did not pose a survival disadvantage. Further surveillance is required to fully characterize implications of these organisms for LTx recipients.
    MeSH term(s) Antifungal Agents/therapeutic use ; Humans ; Lung Transplantation ; Mycoses/drug therapy ; Retrospective Studies ; Scedosporium
    Chemical Substances Antifungal Agents
    Language English
    Publishing date 2021-01-03
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 1476094-0
    ISSN 1399-3062 ; 1398-2273
    ISSN (online) 1399-3062
    ISSN 1398-2273
    DOI 10.1111/tid.13546
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  7. Article ; Online: Oscillometry in Stable Single and Double Lung Allograft Recipients Transplanted for Interstitial Lung Disease: Results of a Multi-Center Australian Study.

    Sim, Joan P Y / Nilsen, Kristopher / Borg, Brigitte M / Levvey, Bronwyn / Vazirani, Jaideep / Ennis, Samantha / Plit, Marshall / Snell, Gregory I / Darley, David R / Tonga, Katrina O

    Transplant international : official journal of the European Society for Organ Transplantation

    2023  Volume 36, Page(s) 11758

    Abstract: Peak spirometry after single lung transplantation (SLTx) for interstitial lung disease (ILD) is lower than after double lung transplantation (DLTx), however the pathophysiologic mechanisms are unclear. We aim to assess respiratory mechanics in SLTx and ... ...

    Abstract Peak spirometry after single lung transplantation (SLTx) for interstitial lung disease (ILD) is lower than after double lung transplantation (DLTx), however the pathophysiologic mechanisms are unclear. We aim to assess respiratory mechanics in SLTx and DLTx for ILD using oscillometry. Spirometry and oscillometry (tremoflo
    MeSH term(s) Male ; Humans ; Middle Aged ; Oscillometry/methods ; Forced Expiratory Volume/physiology ; Australia ; Lung ; Lung Diseases, Interstitial/surgery ; Allografts
    Language English
    Publishing date 2023-12-05
    Publishing country Switzerland
    Document type Multicenter Study ; Journal Article
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.3389/ti.2023.11758
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  8. Article: A complicated cockroach-ectomy.

    Vazirani, Jaideep / Yu, Christiaan / Stirling, Robert

    Respirology case reports

    2018  Volume 6, Issue 6, Page(s) e00332

    Abstract: The exact incidence of foreign body aspiration among adults is unknown, and its clinical presentation is vastly divergent. We report the previously undescribed occurrence of cockroach aspiration in an adult, presenting with a "crawling sensation" in his ... ...

    Abstract The exact incidence of foreign body aspiration among adults is unknown, and its clinical presentation is vastly divergent. We report the previously undescribed occurrence of cockroach aspiration in an adult, presenting with a "crawling sensation" in his chest. Flexible endobronchial examination revealed a foreign body impacted in the lingula, resembling the Australian cockroach Periplaneta australasiae. Partial extraction via biopsy forceps was performed and complicated by acute hypoxia on disimpaction, requiring a brief period of bag/mask ventilation. Following the offset of procedural sedation, the remaining foreign body was manually expectorated. A total of 24 h post-procedure, the patient was febrile with positive blood cultures (Micrococcus luteus). We highlight the importance of definitive airway support during endobronchial interventions and raise the question regarding the significance of transient bacteraemia following bronchoscopic manipulation.
    Language English
    Publishing date 2018-05-17
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2750180-2
    ISSN 2051-3380
    ISSN 2051-3380
    DOI 10.1002/rcr2.332
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  9. Article ; Online: Outcomes Following Extracorporeal Photopheresis for Chronic Lung Allograft Dysfunction Following Lung Transplantation: A Single-Center Experience.

    Vazirani, Jaideep / Routledge, David / Snell, Greg I / Watson, Doug / Paraskeva, Miranda / Westall, Glen P / Harrison, Simon J

    Transplantation proceedings

    2020  Volume 53, Issue 1, Page(s) 296–302

    Abstract: Introduction: Survival following lung transplantation (LTx) is limited by the development of chronic lung allograft dysfunction (CLAD), for which there are few effective therapies and no standardized management. Several small studies have demonstrated ... ...

    Abstract Introduction: Survival following lung transplantation (LTx) is limited by the development of chronic lung allograft dysfunction (CLAD), for which there are few effective therapies and no standardized management. Several small studies have demonstrated the effectiveness of extracorporeal photopheresis (ECP) as a therapeutic option for CLAD.
    Methods: A retrospective descriptive audit of 12 LTx recipients who received rescue ECP for CLAD over 5 years (2013-2018) at the Alfred Hospital, Melbourne, Australia, was completed. Nonresponders to ECP were defined as patients who experienced a 20% decrease in forced expiratory volume (FEV
    Results: Mean time since LTx was 849 days and mean time since diagnosis of CLAD was 131 days. Fifty-eight percent of patients were male (n = 7) and 67% responded to ECP therapy (n = 8). Among responders, the mean (95% confidence interval) decline in FEV
    Conclusion: Rescue ECP arrested the decline of lung function in 67% of patients with CLAD. Sex, pre-ECP neutrophil count, and exposure to anti-thymocyte globulin may help determine response to ECP. Future clinical trials are needed to confirm this effect, help predict response to therapy, and ultimately guide the placement of ECP in the treatment algorithm for CLAD.
    MeSH term(s) Adult ; Australia ; Female ; Humans ; Lung Transplantation/adverse effects ; Male ; Middle Aged ; Photopheresis/methods ; Primary Graft Dysfunction/therapy ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2020-10-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2020.09.003
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  10. Article ; Online: Mandatory pain scoring at triage reduces time to analgesia.

    Vazirani, Jaideep / Knott, Jonathan C

    Annals of emergency medicine

    2012  Volume 59, Issue 2, Page(s) 134–8.e2

    Abstract: Study objective: We study whether mandatory triage pain scoring and an educational program reduces the time to initial analgesic treatment.: Methods: We performed a prospective interventional study in the emergency department (ED) of an adult ... ...

    Abstract Study objective: We study whether mandatory triage pain scoring and an educational program reduces the time to initial analgesic treatment.
    Methods: We performed a prospective interventional study in the emergency department (ED) of an adult tertiary referral hospital and major trauma center. After an observational assessment of baseline time to analgesic administration, we mandated the recording of triage pain scores through our computerized information system. In a second separate phase, we administered a staff educational package on the importance of timely analgesia. We measured time to initial analgesia after each phase and at 12-month follow-up.
    Results: We studied 35,628 patients (8,743 baseline, 8,462 after mandating pain scoring, 9,043 after the educational program, and 9,380 at follow-up), with 12,925 patients (36.3%) overall receiving analgesics. At baseline, the median time to analgesia was 123 minutes (interquartile range [IQR] 58 to 231 minutes), which reduced with pain scoring (95 minutes; IQR 45 to 194 minutes) but no further with the educational package (98 minutes; IQR 45 to 191 minutes). At 12-month follow-up, the median time to analgesia was 78 minutes (IQR 45 to 143 minutes), 45 minutes (36.4%) faster than at baseline.
    Conclusion: The simple act of altering our ED computerized information system to require pain scoring at triage led to substantially faster provision of initial analgesia, with the effect sustained at 12 months.
    MeSH term(s) Adult ; Aged ; Analgesia/methods ; Analgesia/standards ; Analgesia/statistics & numerical data ; Analgesics/therapeutic use ; Education/methods ; Emergency Service, Hospital/standards ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Male ; Mandatory Programs/standards ; Mandatory Programs/statistics & numerical data ; Middle Aged ; Pain Measurement/methods ; Pain Measurement/standards ; Pain Measurement/statistics & numerical data ; Prospective Studies ; Time Factors ; Triage/methods
    Chemical Substances Analgesics
    Language English
    Publishing date 2012-02
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2011.08.007
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