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Drugs to suppress the immune system after lung transplantation in patients with cystic fibrosis

Lung transplantation is an available and realistic treatment option for patients with cystic fibrosis whose lungs are severely damaged. However, as a natural defence mechanism, the body recognises a transplanted lung as foreign and activates the immune system to reject it. This is known as graft rejection. To prevent this, drugs are needed to suppress the immune system after lung transplantation. There are several different types of such drugs that act by suppressing different components of the immune system. Much of the research on such drugs has focused on all patients after lung transplantation, and not specifically on patients with cystic fibrosis. Currently, clinicians do not all agree on a common way of using such drugs in patients with cystic fibrosis after lung transplantation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Can antibody induction therapy help to reduce organ rejection for lung transplant recipients?

People who receive transplanted lungs are at significant risk of organ rejection. To help reduce the risk of organ rejection, antibodies against T‐cells (a type of white blood cell that plays a central role in immunity) are given to patients within the first two weeks after transplantation. Several types of antibodies have been used, but their benefits and harms are unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Which drug to prevent lung transplant rejection provides best results with fewest adverse effects?

Almost everyone who receives a lung transplant is treated with the drugs tacrolimus or cyclosporin to prevent transplanted organ rejection. Both drugs have serious and common adverse effects. We aimed to compare the use of tacrolimus with cyclosporin to prevent organ rejection after lung transplantation to assess which drug worked best and had fewest adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Cyclosporin (the drug for preventing organ rejection after transplant) as an oral corticosteroid sparing agent in stable asthma

Some people with asthma need to rely on corticosteroid drugs to control their asthma. Corticosteroids help reduce the inflammation (swelling) of the airways (passages to the lungs) associated with asthma. Long‐term use of these drugs may have serious adverse effects, so other ways to try and cut down on the need for corticosteroids are sometimes tried. Cyclosporin is the drug used to prevent organ rejections after transplants, and it can be used for other conditions involving inflammation (such as arthritis). The review of trials found that cyclosporin has a small impact on asthma symptoms, but it has major serious adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Antifungal drugs used for prevention can significantly reduce the number of invasive fungal infections in liver transplant patients

Invasive fungal infections ‐ infections of the bloodstream and organs within the body (e.g. meningitis, pneumonia, peritonitis) ‐ are important causes of morbidity and mortality in liver, pancreas, heart, kidney and lung (i.e. solid organ) transplant recipients. This review found that fluconazole, used as a preventive drug, significantly reduced the number of invasive fungal infections in liver transplant patients. More studies are needed to determine how effective antifungal drugs are for pancreas, heart, kidney and lung transplant patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antiviral drugs used as protective and preventive therapy reduce CMV disease and CMV‐associated deaths in solid organ transplant recipients

Cytomegalovirus (CMV; a herpes virus) is the most common type of virus detected in people who have received solid organ transplants (kidney, heart, liver, lung and pancreas). CMV disease is a major cause of illness and death during the first six to 12 months after transplantation. Two main strategies to prevent CMV disease have been adopted: protection and prevention (prophylaxis) of viral infections for all organ recipients using antiviral drugs, or 'pre‐emptive therapy' of organ recipients, who develop evidence of CMV infection during routine screening.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Prophylaxis with Immunoglobulin G (IgG), anti CMV vaccine or interferon do not significantly reduce CMV disease and CMV‐associated mortality in solid organ transplant recipients

Cytomegalovirus (CMV) is the most common virus causing disease and death in solid organ transplant recipients (kidney, heart, liver, lung and pancreas) during the first six months after transplantation. This review looked at the benefits and harms of IgG, anti CMV vaccines and interferon to prevent CMV disease in solid organ transplant recipients. Thirty seven studies (2185 participants) were identified. This review shows that IgG did not reduce the risk of CMV disease or all‐cause mortality compared with placebo or no treatment. The combination of IgG with antiviral medications (aciclovir or ganciclovir) were not more effective than antiviral medications alone in reducing the risk of CMV disease or all‐cause mortality. Anti CMV vaccines and interferon did not reduce the risk of CMV disease compared with placebo or no treatment. Currently there are no indications for IgG in the prevention of CMV disease in recipients of solid organ transplants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Which drugs are most effective to prevent tuberculosis in organ transplant recipients?

Organ transplantation is often the best treatment option for patients with end‐stage kidney, pancreas, heart, liver and lung disease. A major risk for transplant recipients is organ rejection. Although anti‐rejection drugs improve survival, they weaken the immune system and increase the risk of infection, cancer, and cardiovascular disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

High‐dose chemotherapy and stem cell transplant compared to conventional therapy for children with high‐risk neuroblastoma

Despite the development of new treatment options, the prognosis of high‐risk neuroblastoma patients still remains poor; in more than half of patients the disease returns. High‐dose chemotherapy and haematopoietic stem cell rescue, also known as myeloablative therapy, might improve the survival of these patients. A well‐informed decision on the use of myeloablative therapy in the treatment of children with high‐risk neuroblastoma should be based on high quality evidence of effectiveness for treating tumours and side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Chemicals for sticking the outer lung surface to surrounding membranes compared to surgery to stop air persistently collecting in the chest

Cystic fibrosis is an inherited disease which irreversibly damages the lungs. People with cystic fibrosis are prone to getting a pneumothorax. A pneumothorax is defined as the presence of air in the space between the two linings of the lungs. It can potentially kill people with cystic fibrosis because of the added stress on the heart and lungs. It can be treated by surgical and non‐surgical interventions. However, although these treatments are generally effective, they are far from perfect. Certain treatments work in some people but not others. Also, the treatments do have side effects and can be dangerous for people with cystic fibrosis. Currently, physicians do not know the safest and most effective way of treating pneumothorax in people with cystic fibrosis. We did not find any randomised controlled trials that compared the surgical and non‐surgical treatments for pneumothorax in people with cystic fibrosis. Therefore, more research is needed in this field. Future studies should compare the safety and efficacy of surgical and non‐surgical interventions for pneumothorax in people with cystic fibrosis. There is currently no research being undertaken in this area. We will continue to search for evidence, but will not be updating the review until we find new evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Treating Chronic Hepatitis C: A Review of the Research for Adults

This summary will discuss treatment options for chronic hepatitis C. It will tell you about research on how well medicines for chronic hepatitis C work. It will also tell you about research on the side effects of these medicines. It does not discuss screening and diagnosis of hepatitis C. This summary can help you talk with your doctor about which treatment might be best for you.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: November 27, 2012

Bone Marrow or Blood Stem Cell Transplants in Children With Certain Rare Inherited Metabolic Diseases: A Review of the Research for Parents and Caregivers

This summary will cover: Information about each rare inherited metabolic disease Possible benefits of an HSCT What researchers have found about treating children who have one of these diseases with an HSCT using stem cells from a donor What an HSCT is and how it is done Possible risks of an HSCT

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: September 25, 2013

Bisphosphonates for osteoporosis in people with cystic fibrosis

Cystic fibrosis is a serious genetic disorder that affects many organs (e.g. lung and pancreas). It commonly leads to reduced bone mineral density, known as osteoporosis, which increases the likelihood of fractures. The short‐term and long‐term effects of fractures (e.g. rib and vertebral) may make lung disease worse. Bisphosphonates are drugs that increase bone mineral density by slowing down bone resorption. They are used to treat osteoporosis caused by menopause or the use of corticosteroid drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Psychological treatments to help individuals with cystic fibrosis and their caregivers manage the disease

Cystic fibrosis is a genetic disorder that damages many of the body's organs and can shorten a person's life span. The disease is progressive, stressful to manage, and needs complex and time‐consuming treatments, leaving patients and caregivers stressed due to the challenges of the treatment. Thus, individuals with cystic fibrosis and their family members often need help to cope better and to deal with their thoughts and feelings. They also need assistance in managing the demands of the prescribed treatment schedules. In addition, infection control guidelines recommend the isolation of people with cystic fibrosis from others with the same disease, leading to a lack of peer support and potential social isolation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Prostacyclin for pulmonary hypertension in adults

Prostacyclin may benefit patients with pulmonary hypertension (raised blood pressure in the lungs) in the short term but studies longer in duration are required. Pulmonary hypertension occurs when blood is pumped through arteries in the lungs at an increased pressure. The condition can lead to heart failure and death. Once the diagnosis is made, life expectancy ranges from a few months to a few years. Most current treatments apart from lung transplantation do not improve survival. Over an 8‐12 week period prostacyclin improved exercise capacity and some measures of blood flow when given intravenously or via injection to patients with pulmonary hypertension. However, with intravenous administration there can be serious side effects as the drug has to be given continuously via a pump into a catheter placed into a central vein. It is not clear how long the drug continues to confer benefit without serious side effects. Prostacyclin can also be given by mouth, under the skin or through an inhaler. These forms of administration may be safer than intravenous prostacyclin and there is evidence that these may be effective in the short term.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Pre‐emptive treatment with antiviral agents can help to reduce the risk of cytomegalovirus disease

Cytomegalovirus (CMV) is the most common cause of viral disease in people who have received kidney, heart, liver, lung or pancreas transplants (solid organ transplants). CMV is a major cause of illness and death during the first six months after transplantation. Characteristics of CMV include fever, very low white blood cell counts (leucopenia) and very low numbers of platelets (thrombocytopenia) with or without specific organ involvement.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Langerhans Cell Histiocytosis Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood Langerhans Cell Histiocytosis.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 8, 2014

Childhood Hodgkin Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood Hodgkin lymphoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 22, 2014

Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood non-Hodgkin lymphoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 21, 2014

AIDS-Related Lymphoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of AIDS-Related Lymphoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 21, 2014

Medical Encyclopedia

  • Lung transplant
    Lung transplant is surgery to replace one or both diseased lungs with healthy lungs from a human donor.
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