Ex-vivo recruitment and x-ray assessment of donor lungs in a challenging retrieval from a donor supported by lvad using the portable normothermic perfusion system: A case report

Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval. CASE PRESENTATION: Our case presents a successful procurement and bilateral lung transplantation from a donor supported by a left ventricular assist device (LVAD) who experienced an intraoperatively haemodynamic complication. The use of portable normothermic perfusion device let us to reduce ischemic injury and assess these marginal donor lungs helping us to determine the clinical suitability for transplantation. Given our extensive experience with the device instrumentation and management, the EVLP process was uneventful with excellent post-transplant course. CONCLUSIONS: This case report demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system using the portable normothermic perfusion platform to assess and preserve these donor lungs

Modelling the outburst profile of X-ray powered millisecond pulsars

The outbursts of low mass X-ray binaries are prolonged relative to those of dwarf nova cataclysmic variables as a consequence of X-ray irradiation of the disc. We show that the time-scale of the decay light curve and its luminosity at a characteristic time are linked to the radius of the accretion disc. Hence a good X-ray light curve permits two independent estimates of the disc radius. In the case of the millisecond pulsars SAX J1808.4-3658 and XTE J0929-314 the agreement between these estimates is very strong. Our analysis allows new determinations of distances and accretion disc radii. Our analysis will allow determination of accretion disc radii for sources in external galaxies, and hence constrain system parameters where other observational techniques are not possible. We also use the X-ray light curves to estimate the mass transfer rate. The broken exponential decay observed in the 2002 outburst of SAX J1808.4-3658 may be caused by the changing self-shadowing of the disc.Comment: To be published in the proceedings of the workshop 'A Decade of Accreting Millisecond X-ray pulsars' (Amsterdam 14-18 April 2008; Eds. Wijnands et al.

Timing the accretion flow around accreting millisecond pulsars

At present, ten years after they were first discovered, ten accreting millisecond pulsars are known. I present a study of the aperiodic X-ray variability in three of these systems, which led to the discovery of simultaneous kHz quasi periodic oscillations in XTE J1807-294 and extremely strong broadband noise at unusually low variability frequencies in IGR J00291+5934. Furthermore, we classified SWIFT J1756.9-2508 as an atoll source and measured in its 2007 outburst spectral and variability properties typical of the extreme island state. I also give detailed estimates of the total fluence during the studied outbursts.Comment: To be published in the proceedings of the workshop 'A Decade of Accreting Millisecond X-ray pulsars' (Amsterdam 14-18 April 2008; Eds. Wijnands et al.

Modeling pulse profiles of accreting millisecond pulsars

I review the basic observational properties of accreting millisecond pulsars that are important for understanding the physics involved in formation of their pulse profiles. I then discuss main effects responsible for shaping these profiles. Some analytical results that help to understand the results of simulations are presented. Constraints on the pulsar geometry and the neutron star equation of state obtained from the analysis of the pulse profiles are discussed.Comment: Invited review, to appear in the proceedings of the workshop 'A Decade of Accreting Millisecond X-ray Pulsars' (Amsterdam, April 2008

The Spin Distribution of Millisecond X-ray Pulsars

The spin frequency distribution of accreting millisecond X-ray pulsars cuts off sharply above 730 Hz, well below the breakup spin rate for most neutron star equations of state. I review several different ideas for explaining this cutoff. There is currently considerable interest in the idea that gravitational radiation from rapidly rotating pulsars might act to limit spin up by accretion, possibly allowing eventual direct detection with gravitational wave interferometers. I describe how long-term X-ray timing of fast accreting millisecond pulsars like the 599 Hz source IGR J00291+5934 can test the gravitational wave model for the spin frequency limit.Comment: 8 pages with 2 figures, to appear in the proceedings of "A Decade of Accreting Millisecond X-ray Pulsars", Amsterdam, April 2008, eds. R. Wijnands et al. (AIP Conf. Proc.

Multiwavelength study of RX J2015.6+3711: a magnetic cataclysmic variable with a 2-hr spin period

The X-ray source RX J2015.6+3711 was discovered by ROSAT in 1996 and recently proposed to be a cataclysmic variable (CV). Here we report on an XMM-Newton observation of RX J2015.6+3711 performed in 2014, where we detected a coherent X-ray modulation at a period of 7196+/-11 s, and discovered other significant (>6sigma) small-amplitude periodicities which we interpret as the CV spin period and the sidebands of a possible ~12 hr periodicity, respectively. The 0.3-10 keV spectrum can be described by a power law (Gamma = 1.15+/-0.04) with a complex absorption pattern, a broad emission feature at 6.60+/-0.01 keV, and an unabsorbed flux of (3.16+/-0.05)x10^{-12} erg/s/cm^2. We observed a significant spectral variability along the spin phase, which can be ascribed mainly to changes in the density of a partial absorber and the power law normalization. Archival X-ray observations carried out by the Chandra satellite, and two simultaneous X-ray and UV/optical pointings with Swift, revealed a gradual fading of the source in the soft X-rays over the last 13 years, and a rather stable X-ray-to-optical flux ratio (F_X/F_V ~1.4-1.7). Based on all these properties, we identify this source with a magnetic CV, most probably of the intermediate polar type. The 2 hr spin period makes RX J2015.6+3711 the second slowest rotator of the class, after RX J0524+4244 ("Paloma", P_spin~2.3 hr). Although we cannot unambiguously establish the true orbital period with these observations, RX J2015.6+3711 appears to be a key system in the evolution of magnetic CVs.Comment: 11 pages, 8 figures, accepted for publication on MNRA

Lighthouses with two lights: burst oscillations from the accretion-powered millisecond pulsars

The key contribution of the discovery of nuclear-powered pulsations from the accretion-powered millisecond pulsars (AMPs) has been the establishment of burst oscillation frequency as a reliable proxy for stellar spin rate. This has doubled the sample of rapidly-rotating accreting neutron stars and revealed the unexpected absence of any stars rotating near the break-up limit. The resulting `braking problem' is now a major concern for theorists, particularly given the possible role of gravitational wave emission in limiting spin. This, however, is not the only area where burst oscillations from the AMPs are having an impact. Burst oscillation timing is developing into a promising technique for verifying the level of spin variability in the AMPs (a topic of considerable debate). These sources also provide unique input to our efforts to understand the still-elusive burst oscillation mechanism. This is because they are the only stars where we can reliably gauge the role of uneven fuel deposition and, of course, the magnetic field.Comment: Invited review, to appear in the proceedings of the workshop 'A decade of accreting millisecond x-ray pulsars' (Amsterdam, April 2008

Motion of the hot spot and spin torque in accreting millisecond pulsars

The primary concern of this contribution is that accreting millisecond pulsars (AMXPs) show a much larger amount of information than is commonly believed. The three questions to be addressed are: 1. Is the apparent spin torque observed in AMXPs real ? 2. Why do we see correlations and anti-correlations between fractional amplitudes and timing residuals in some AMXPs ? 3. Why the timing residuals, the lightcurve and the 1Hz QPO in SAX J1808.4$-$3658 are related ?Comment: To be published in the proceedings of the workshop 'A Decade of Accreting Millisecond X-ray pulsars' (Amsterdam 14-18 April 2008; Eds. Wijnands et al.

Intermittent accreting millisecond pulsars: light houses with broken lamps?

Intermittent accreting millisecond X-ray pulsars are an exciting new type of sources. Their pulsations appear and disappear either on timescales of hundreds of seconds or on timescales of days. The study of these sources add new observational constraints to present models that explain the presence or not of pulsations in neutron star LMXBs. In this paper we present preliminary results on spectral and aperiodic variability studies of all intermittent AMSPs, with a particular focus on the comparison between pulsating and non pulsating periods.Comment: 4 pages, 2 figures; to appear in the proceedings of the workshop "A Decade of Accreting Millisecond X-ray Pulsars", Amsterdam, April 2008, eds. R. Wijnands et al. (AIP Conf. Proc.