Browsing by Author "Morton, John"

Now showing 1 - 4 of 4
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    Acute respiratory distress syndrome in the cardiothoracic patient: State of the art and use of veno-venous extracorporeal membrane oxygenation
    (Elsevier, 2021-12) Copeland, Hannah; Levine, Deborah; Morton, John; Hayanga, J.W. Awori; Surgery, School of Medicine
    Central Message: Acute respiratory distress syndrome after cardiopulmonary bypass can be managed with veno-venous extracorporeal membrane oxygenation.
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    ERAS Including Minimal Narcotic Pain Management is Successful After Heart Transplant and LVAD Implantation: A Single Center Review
    (Elsevier, 2025-04-08) Elder, Joseph; McComb, Jennifer; Blitzer, David; Lirette, Seth; Lytal, Kristin; Morton, John; Mohammed, Asim; Copeland, Hannah; Surgery, School of Medicine
    Objective: To assess the outcomes of an enhanced recovery after surgery (ERAS) protocol for heart failure patients receiving heart transplant or left ventricular assist device (LVAD) surgery. Methods: A single center, retrospective IRB study reviewed consecutive heart transplant and LVAD implantation patients from May 2020 to May 2022. Patients received an organized ERAS protocol. The following data points were evaluated: demographics, medication history, date of surgery, acute medication use, nutrition and bowel function assessment, time to liberate from mechanical ventilation, delirium screening, pain scores, functional status, time from implant to hospital discharge, and pain medications at both discharge and 30-day follow-up. Results: Thirty-two patients received ERAS: 18 heart transplants and 14 LVAD implants. One heart transplant was excluded from ERAS protocol due to delayed sternal closure for 72 hours after surgery. For a seven-day postoperative observation period, three patients (9%) had a positive delirium score. Pain scores were acceptable. The mean morphine milligram equivalent (MME) was 26.25 mg per day. No patient developed gastrointestinal complications. The average length of stay after surgery was 25 days for heart transplant, and 19 days for LVAD implant. No patients were prescribed opioids at discharge, and no patients reported opioid use over baseline at 30-days. Conclusion: For heart transplant and LVAD surgery, ERAS reduced opioid consumption, preserved mechanical ventilation time, and limited acute delirium. ERAS limited postoperative opioid induced gastroparesis while preserving acceptable pain scores, maintained the length of hospitalization, and prevented unnecessary opioid prescribing at discharge up to and including 30 days thereafter.
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    Transcriptional and functional profiling of human intestinal dendritic cells reveals conserved specialization and a role for Bcl-6 and Blimp-1 in terminal subset differentiation
    (Springer Nature, 2014) Watchmaker, Payal B.; Lahl, Katharina; Lee, Mike; Baumjohann, Dirk; Morton, John; Kim, Sun Jung; Zeng, Ruizhu; Dent, Alexander; Ansel, K. Mark; Diamond, Betty; Hadeiba, Husein; Butcher, Eugene C.; Microbiology and Immunology, School of Medicine
    Dendritic cells (DCs) that orchestrate mucosal immunity have been studied in mice. Here we characterized human gut DC populations and defined their relationship to previously studied human and mouse DCs. CD103(+)Sirpα(-) DCs were related to human blood CD141(+) DCs and to mouse intestinal CD103(+)CD11b(-) DCs and expressed markers of cross-presenting DCs. CD103(+)Sirpα(+) DCs aligned with human blood CD1c(+) DCs and mouse intestinal CD103(+)CD11b(+) DCs and supported the induction of regulatory T cells. Both CD103(+) DC subsets induced the TH17 subset of helper T cells, while CD103(-)Sirpα(+) DCs induced the TH1 subset of helper T cells. Comparative analysis of transcriptomes revealed conserved transcriptional programs among CD103(+) DC subsets and identified a selective role for the transcriptional repressors Bcl-6 and Blimp-1 in the specification of CD103(+)CD11b(-) DCs and intestinal CD103(+)CD11b(+) DCs, respectively. Our results highlight evolutionarily conserved and divergent programming of intestinal DCs.
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    Veno-venous ECLS rescue for a heart transplant recipient with COVID-19, a case report
    (Sage, 2023) Copeland, Hannah; Baran, David A.; Morton, John; Rodriguez, Vicente; Fernandes, Eustace; Mohammed, Asim; Surgery, School of Medicine
    The potential for increased rates of morbidity of SARS-CoV-2 within immunocompromised populations has been of concern since the pandemic’s onset. Transplant providers and patients can face particularly challenging situations, in the current settings as data continues to emerge for the prevention and treatment of the immunocompromised subpopulation. This case report details a patient 9-months post orthotopic heart transplant that developed SARS-CoV-2 infection despite two prior doses of the Pfizer-BioNtech COVID-19 vaccine, and had successful rescue from refractory hypoxemia with veno-venous extracorporeal membrane oxygenation (VV ECLS).