Lung and Heart Lung Transplantation for Scleroderma Lung Disease: Indications, Survival and Prognosis

37th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation (ISHLT), San Diego, CA, APR 05-08, 2017International audienceno abstrac

Ultrathin InAlN/AlN Barrier HEMT With High Performance in Normally Off Operation

We present GaN-based high electron mobility transistors (HEMTs) with a 2-nm-thin InAlN/AlN barrier capped with highly doped n(++) GaN. Selective etching of the cap layer results in a well-controllable ultrathin barrier enhancement-mode device with a threshold voltage of +0.7 V. The n(++) GaN layer provides a 290-Omega/square sheet resistance in the HEMT access region and eliminates current dispersion measured by pulsed IV without requiring additional surface passivation. Devices with a gate length of 0.5-mu m exhibit maximum drain current of 800 mA/mm, maximum transconductance of 400 mS/mm, and current cutoff frequency f(T) of 33.7 GHz. In addition, we demonstrate depletion-mode devices on the same wafer, opening up perspectives for reproducible high-performance InAlN-based digital integrated circuits

Cardiopulmonary exercise testing provides prognostic information in advanced cystic fibrosis lung disease

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordWorkshop at the 46th European Cystic Fibrosis Conference, 7 - 10 June 2023, Vienna, Austri

Cardiopulmonary exercise testing provides prognostic information in advanced cystic fibrosis lung disease

This is the author accepted manuscript. The final version is available from the American Thoracic Society via the DOI in this record Rationale: Cardiopulmonary exercise testing (CPET) provides prognostic information in cystic fibrosis (CF); however, its prognostic value for patients with advanced CF lung disease (ACFLD) is unknown. Objectives: To determine the prognostic value of CPET on the risk of death or lung transplant (LTX) within 2-years. Methods: We retrospectively collected data from 20 CF centers in Asia, Australia, Europe, and North America on patients with a forced expiratory volume in 1s (FEV1) 40% predicted who performed a cycle ergometer CPET between January 2008 and December 2017. Time to death/LTX was analyzed using mixed Cox proportional hazards regression. Conditional inference trees were modelled to identify subgroups with increased risk of death/LTX. Results: In total, 174 patients (FEV1 30.9±5.8% predicted) were included. Forty-four patients (25.5%) died or underwent LTX. Cox regression analysis adjusted for age, sex and FEV1, revealed percent predicted peak oxygen uptake ( OV 2peak) and peak work rate (Wpeak) as significant predictors of death/LTX: adjusted hazard ratios per each additional ten percent predicted were 0.60 (95% confidence interval, 0.43–0.90, P=0.008) and 0.60 (0.48–0.82, P<0.001). Tree-structured regression models, including a set of twelve prognostic factors for survival, identified Wpeak to be most strongly associated with 2-year risk of death/LTX. Probability of death/LTX was 45.2% for those with a Wpeak 49.2% predicted versus 10.9% for those with a Wpeak >49.2% predicted, P<0.001. Conclusions: CPET provides prognostic information in ACFLD and Wpeak appears to be a promising marker for LTX referral and candidate selection.LUNGE ZURIC

Blood Gene Expression Predicts Bronchiolitis Obliterans Syndrome

Bronchiolitis obliterans syndrome (BOS), the main manifestation of chronic lung allograft dysfunction, leads to poor long-term survival after lung transplantation. Identifying predictors of BOS is essential to prevent the progression of dysfunction before irreversible damage occurs. By using a large set of 107 samples from lung recipients, we performed microarray gene expression profiling of whole blood to identify early biomarkers of BOS, including samples from 49 patients with stable function for at least 3 years, 32 samples collected at least 6 months before BOS diagnosis (prediction group), and 26 samples at or after BOS diagnosis (diagnosis group). An independent set from 25 lung recipients was used for validation by quantitative PCR (13 stables, 11 in the prediction group, and 8 in the diagnosis group). We identified 50 transcripts differentially expressed between stable and BOS recipients. Three genes, namely POU class 2 associating factor 1 (POU2AF1), T-cell leukemia/lymphoma protein 1A (TCL1A), and B cell lymphocyte kinase, were validated as predictive biomarkers of BOS more than 6 months before diagnosis, with areas under the curve of 0.83, 0.77, and 0.78 respectively. These genes allow stratification based on BOS risk (log-rank test p &lt; 0.01) and are not associated with time posttransplantation. This is the first published large-scale gene expression analysis of blood after lung transplantation. The three-gene blood signature could provide clinicians with new tools to improve follow-up and adapt treatment of patients likely to develop BOS