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Article ; Online: Bleeding risks in preoperative plasmapheresis.

Fessler, Julien / Le Guen, Morgan / Pascreau, Tiffany

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

2024 Volume 43, Issue 4, Page(s) 693–694

MeSH term(s)	Humans ; Plasmapheresis ; Preoperative Care
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Letter
ZDB-ID	1062522-7
ISSN	1557-3117 ; 1053-2498
ISSN (online)	1557-3117
ISSN	1053-2498
DOI	10.1016/j.healun.2024.01.007
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Article ; Online: From a good idea to the best practice!

Fessler, Julien / Fischler, Marc / Le Guen, Morgan

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

2023 Volume 42, Issue 12, Page(s) 1768–1769

Language	English
Publishing date	2023-07-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1062522-7
ISSN	1557-3117 ; 1053-2498
ISSN (online)	1557-3117
ISSN	1053-2498
DOI	10.1016/j.healun.2023.07.016
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Article ; Online: Examining Bleeding Risk, Transfusion-related Complications, and Strategies to Reduce Transfusions in Lung Transplantation.

Bottiger, Brandi / Klapper, Jacob / Fessler, Julien / Shaz, Beth H / Levy, Jerrold H

Anesthesiology

2024 Volume 140, Issue 4, Page(s) 808–816

MeSH term(s)	Humans ; Blood Transfusion ; Hemorrhage/etiology ; Hemorrhage/therapy ; Lung Transplantation/adverse effects ; Platelet Transfusion
Language	English
Publishing date	2024-02-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000004829
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Article ; Online: How We Would Treat Our Own Lung Transplantation: A Multidisciplinary and International Perspective.

Martin, Archer Kilbourne / Reed, Anna Katja / Hoetzenecker, Konrad / Fessler, Julien

Journal of cardiothoracic and vascular anesthesia

2023 Volume 37, Issue 11, Page(s) 2207–2214

Abstract: Lung transplantation is the ultimate treatment for end-stage lung disease (ESLD) arising from various etiologies. This manuscript will focus on selected aspects of a theoretical perioperative lung transplantation plan, highlighting data-driven and ... ...

Abstract	Lung transplantation is the ultimate treatment for end-stage lung disease (ESLD) arising from various etiologies. This manuscript will focus on selected aspects of a theoretical perioperative lung transplantation plan, highlighting data-driven and theoretical techniques the authors would employ if they were the index patient undergoing surgery. Beginning with looking for a transplant center using an Internet search, patient advocacy organizations, and artificial intelligence guidance, the authors lay out a course for multidisciplinary care throughout the entire patient journey, ending with ideal approaches to recovery 6 months posttransplantation. Although the index case will focus on a theoretical patient with pulmonary fibrosis, the general management principles will be applicable across the entire spectrum of patients with ESLD presenting for lung transplantation.
MeSH term(s)	Humans ; Artificial Intelligence ; Lung Transplantation ; Pulmonary Fibrosis ; Internationality ; Lung Diseases/surgery
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2023.07.042
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Article: New Aspects of Lung Transplantation: A Narrative Overview Covering Important Aspects of Perioperative Management.

Fessler, Julien / Finet, Michaël / Fischler, Marc / Le Guen, Morgan

Life (Basel, Switzerland)

2022 Volume 13, Issue 1

Abstract: The management of lung transplant patients has continued to evolve in recent years. The year 2021 was marked by the publication of the International Consensus Recommendations for Anesthetic and Intensive Care Management of Lung Transplantation. There ... ...

Abstract	The management of lung transplant patients has continued to evolve in recent years. The year 2021 was marked by the publication of the International Consensus Recommendations for Anesthetic and Intensive Care Management of Lung Transplantation. There have been major changes in lung transplant programs over the last few years. This review will summarize the knowledge in anesthesia management of lung transplantation with the most recent data. It will highlight the following aspects which concern anesthesiologists more specifically: (1) impact of COVID-19, (2) future of transplantation for cystic fibrosis patients, (3) hemostasis management, (4) extracorporeal membrane oxygenation management, (5) early prediction of primary graft dysfunction, and (6) pain management.
Language	English
Publishing date	2022-12-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13010092
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Article ; Online: Interest in the new thromboelastometry device, Clot Pro®, for predicting thrombocytopenia and hypofibrinogenemia during lung transplantation.

Pascreau, Tiffany / Gougeon, Marine / Fessler, Julien / Zia Chahabi, Sara / Le Guen, Morgan / Vasse, Marc

Thrombosis research

2023 Volume 233, Page(s) 203–211

Abstract: Introduction: Lung transplantation is associated with high proportion of transfusion. Monitoring of coagulopathy using viscoelastic tests could aid in the perioperative management of bleeding. The aim of the study was to assess the predictive cut-off ... ...

Abstract	Introduction: Lung transplantation is associated with high proportion of transfusion. Monitoring of coagulopathy using viscoelastic tests could aid in the perioperative management of bleeding. The aim of the study was to assess the predictive cut-off values for thrombocytopenia and hypofibrinogenemia using the new thromboelastography analyzer, ClotPro. Methods: We retrospectively enrolled 65 patients who underwent lung transplantation and were sampled for both viscoelastic assays and conventional coagulation assays simultaneously during the procedure. We characterized the correlation between the EX-test (extrinsic pathway) and platelet count as well as between the FIB-test (extrinsic pathway after platelet inhibition) and fibrinogen concentration. Then, we used ROC curve analysis to determine the optimal EX-test and FIB-test values for predicting thrombocytopenia and hypofibrinogenemia. Results: All the amplitude values of the EX-test (A5, A10, A20, MCF) showed correlation with platelets count (Spearman's rank correlation coefficient ranging from 0.75 to 0.77, all p < 0.0001). We also observed a strong correlation between the amplitude values of the FIB-test (A5, A10, A20 and MCF) and the fibrinogen concentration (Spearman's rank correlation coefficient ranging from 0.68 to 0.71, all p < 0.0001). The AUCs of the EX-test values for thrombocytopenia <100 G/L and <80 G/L ranged from 0.80 to 0.93. Similarly, the AUCs of the FIB-test values for hypofibrinogenemia <1.5 g/L and <2 g/L ranged from 0.74 to 0.83. These results indicate that only the five-minute parameter of thromboelastometry is sufficient for detecting thrombocytopenia and hypofibrinogenemia in patients undergoing lung transplantation. The proposed cut off values for the EX-test to predict thrombocytopenia <80 G/L showed high sensitivity (>86 %), high specificity (>89 %) and high negative predictive value (>95 %). FIB-test cut off values predictive of fibrinogen below 1.5 g/L showed sensitivity (>78 %), specificity (>55 %) and negative predictive value (>88 %). Conclusions: Our study provided preliminary results that are useful for developing a ClotPro-based algorithm to guide transfusion in lung transplantation. Future interventional studies will be necessary to validate these cut-off values of ClotPro for guiding transfusion.
MeSH term(s)	Humans ; Thrombelastography/methods ; Afibrinogenemia/diagnosis ; Afibrinogenemia/complications ; Retrospective Studies ; Thrombocytopenia/diagnosis ; Thrombocytopenia/etiology ; Fibrinogen/metabolism ; Thrombosis/complications ; Lung Transplantation/adverse effects
Chemical Substances	antineoplaston A10 (16VY3TM7ZO) ; Fibrinogen (9001-32-5)
Language	English
Publishing date	2023-11-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2023.11.029
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Article ; Online: Pulmonary Artery Pressure Without Simultaneously Measured Cardiac Output: A Serious Omission?

Fessler, Julien / Fischler, Marc

Journal of cardiothoracic and vascular anesthesia

2019 Volume 33, Issue 6, Page(s) 1796–1797

MeSH term(s)	Cardiac Output ; Extracorporeal Circulation ; Feasibility Studies ; Lung Transplantation ; Pulmonary Artery ; Thermodilution
Language	English
Publishing date	2019-02-10
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2019.02.001
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Article: Complementary Therapy Learning in the Setting of Lung Transplantation: A Single-Center Observational Study of Appropriation and Efficacy.

Michel-Cherqui, Mireille / Fessler, Julien / Szekely, Barbara / Glorion, Matthieu / Sage, Edouard / Fischler, Marc / Vallée, Alexandre / Le Guen, Morgan

Journal of clinical medicine

2023 Volume 12, Issue 5

Abstract: Transplanted patients could benefit from complementary techniques. This prospective single-center, open study, performed in a tertiary university hospital, evaluates the appropriation and efficacy of a toolbox-kit of complementary techniques. Self- ... ...

Abstract	Transplanted patients could benefit from complementary techniques. This prospective single-center, open study, performed in a tertiary university hospital, evaluates the appropriation and efficacy of a toolbox-kit of complementary techniques. Self-hypnosis, sophrology, relaxation, holistic gymnastics, and transcutaneous electric nerve stimulation (TENS) were taught to adult patients scheduled for double-lung transplantation. Patients were asked to use them before and after transplantation, as needed. The primary outcome was appropriation of each technique within the first three postoperative months. Secondary outcomes included efficacy on pain, anxiety, stress, sleep, and quality-of-life. Among the 80 patients included from May 2017 to September 2020, 59 were evaluated at the 4th postoperative month. Over the 4359 sessions performed, the most frequent technique used before surgery was relaxation. After transplantation, the techniques most frequently used were relaxation and TENS. TENS was the best technique in terms of autonomy, usability, adaptation, and compliance. Self-appropriation of relaxation was the easiest, while self-appropriation of holistic gymnastics was difficult but appreciated by patients. In conclusion: the appropriation by patients of complementary therapies such as mind-body therapies, TENS and holistic gymnastics is feasible in lung transplantation. Even after a short training session, patients regularly practiced these therapies, mainly TENS and relaxation.
Language	English
Publishing date	2023-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12051722
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Article ; Online: Feasibility and Usefulness of Self-Hypnosis in Patients Undergoing Double-Lung Transplantation During the Pre- and Postoperative Periods: A Randomized Study.

Michel-Cherqui, Mireille / Szekely, Barbara / Fessler, Julien / Glorion, Matthieu / Sage, Edouard / Le Guen, Morgan / Trichereau, Julie / Vallée, Alexandre / Fischler, Marc

Journal of cardiothoracic and vascular anesthesia

2022 Volume 36, Issue 8 Pt A, Page(s) 2490–2499

Abstract: Objective: Hypnosis can reduce pain and anxiety in surgical patients. This study aimed to demonstrate that implementing self-hypnosis in the setting of lung transplantation could improve patients' pain and quality of life.: Design: A randomized, ... ...

Abstract	Objective: Hypnosis can reduce pain and anxiety in surgical patients. This study aimed to demonstrate that implementing self-hypnosis in the setting of lung transplantation could improve patients' pain and quality of life. Design: A randomized, single-center study. Setting: Foch University Hospital, Suresnes, France. Participants: The participants were patients aged 15 years or older who needed a double-lung transplant. Patients were excluded if they participated in only 1 learning self-hypnosis session before transplantation. Interventions: Patients were included at the time of their final evaluation before inscription on the waiting list. They were taught self-hypnosis at this time and were asked to perform it by themselves before and after transplantation, as frequently as possible. Measurements and main results: The main outcome of the study was self-reported pain 1 month after lung transplantation. Secondary outcomes were self-reported pain, anxiety, coping, catastrophism, and self-reported quality of life evaluated at their registration, 7 days and 1 and 4 months after the transplantation. Seventy-eight patients were included, but only 28 patients in the control group and 33 in the self-hypnosis group were evaluated at the fourth postoperative month. Practice of self-hypnosis was high before transplantation (76.6%), lower after, from 32.3% in the intensive care unit to 51.6% during the last 3 months of the study. Group-time interactions were not statistically significant whatever the concerned outcome, especially pain score at 1 month (p = 0.16). Conclusion: Implementation of self-hypnosis is possible, but the study failed to demonstrate an improvement in patients' experience, perhaps due to the variable compliance with the technique.
MeSH term(s)	Adolescent ; Adult ; Feasibility Studies ; Humans ; Hypnosis/methods ; Lung Transplantation/adverse effects ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Quality of Life
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2022.01.027
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Article ; Online: Protocol for venoarterial ExtraCorporeal Membrane Oxygenation to reduce morbidity and mortality following bilateral lung TransPlantation: the ECMOToP randomised controlled trial.

Messika, Jonathan / Eloy, Philippine / Boulate, David / Charvet, Aude / Fessler, Julien / Jougon, Jacques / Lacoste, Philippe / Mercier, Olaf / Portran, Philippe / Roze, Hadrien / Sage, Edouard / Thes, Jacques / Tronc, Francois / Vourc'h, Mickael / Montravers, Philippe / Castier, Yves / Mal, Herve / Mordant, Pierre

BMJ open

2024 Volume 14, Issue 3, Page(s) e077770

Abstract: Introduction: Lung transplantation (LTx) aims at improving survival and quality of life for patients with end-stage lung diseases. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used as intraoperative support for LTx, despite no precise ... ...

Abstract	Introduction: Lung transplantation (LTx) aims at improving survival and quality of life for patients with end-stage lung diseases. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used as intraoperative support for LTx, despite no precise guidelines for its initiation. We aim to evaluate two strategies of VA-ECMO initiation in the perioperative period in patients with obstructive or restrictive lung disease requiring bilateral LTx. In the control 'on-demand' arm, high haemodynamic and respiratory needs will dictate VA-ECMO initiation; in the experimental 'systematic' arm, VA-ECMO will be pre-emptively initiated. We hypothesise a 'systematic' strategy will increase the number of ventilatory-free days at day 28. Methods and analysis: We designed a multicentre randomised controlled trial in parallel groups. Adult patients with obstructive or restrictive lung disease requiring bilateral LTx, without a formal indication for pre-emptive VA-ECMO before LTx, will be included. Patients with preoperative pulmonary hypertension with haemodynamic collapse, ECMO as a bridge to transplantation, severe hypoxaemia or hypercarbia will be secondarily excluded. In the systematic group, VA-ECMO will be systematically implanted before the first pulmonary artery cross-clamp. In the on-demand group, VA-ECMO will be implanted intraoperatively if haemodynamic or respiratory indices meet preplanned criteria. Non-inclusion, secondary exclusion and VA-ECMO initiation criteria were validated by a Delphi process among investigators. Postoperative weaning of ECMO and mechanical ventilation will be managed according to best practice guidelines. The number of ventilator-free days at 28 days (primary endpoint) will be compared between the two groups in the intention-to-treat population. Secondary endpoints encompass organ failure occurrence, day 28, day 90 and year 1 vital status, and adverse events. Ethics and dissemination: The sponsor is the Assistance Publique-Hôpitaux de Paris. The ECMOToP protocol version 2.1 was approved by Comité de Protection des Personnes Ile de France VIII. Results will be published in international peer-reviewed medical journals. Trial registration number: NCT05664204.
MeSH term(s)	Adult ; Humans ; Extracorporeal Membrane Oxygenation ; Quality of Life ; Lung Transplantation ; Morbidity ; Hypertension, Pulmonary/therapy ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
Language	English
Publishing date	2024-03-05
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-077770
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