Nancy Blumenthal

Nancy Blumenthal
University of Pennsylvania | UP · Penn Medicine Transplant Institute

DNP, ACNP-BC

About

59
Publications
3,003
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2,781
Citations

Publications

Publications (59)
Article
Purpose Symptoms experienced by lung transplant candidates are heterogenous and may not reflect objective measures of illness severity. Both may contribute to healthcare use. We aimed to identify distinct profiles using integrated data on symptoms and illness severity and examine differences in healthcare use among observed profiles. Methods This...
Article
Context : Caring for people with advanced illness has an impact on caregivers’ physical, psychological, and emotional health. Patients being evaluated for lung transplantation or those on the transplant waitlist are required to have identified social support. However, little is known about the caregivers’ specific supportive care needs. Objective...
Article
Background: Little is known about the palliative care needs of patients awaiting lung transplantation. The aim of this study was to describe these needs in patients undergoing evaluation for or awaiting lung transplantation. Methods: Cross-sectional survey using an adapted version of the Needs at the End-of-life Screening Tool (NEST-13) at a US-...
Article
Background Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and...
Article
Purpose Palliative care (PC) has been shown to improve outcomes for seriously ill patients but has not been fully integrated into the care of lung transplant patients. Little is known about the palliative care needs for this population. Our goal was to describe adult lung transplant candidates’ perspectives of their PC needs. Methods Prospective,...
Article
Frailty is associated with increased mortality among lung transplant candidates. We sought to determine the association between frailty, as measured by the Short Physical Performance Battery (SPPB) and mortality after lung transplantation. In a multicenter prospective cohort study of adults who underwent lung transplantation, pre‐operative frailty...
Article
Background: Although there is consensus regarding disease-specific indications for lung transplant, ambiguity remains regarding how patient-specific attributes should influence lung transplant candidacy. This study had 3 aims (1) to establish the missing domains of the interdisciplinary assessment of the lung transplant candidate, (2) to have thes...
Article
Frailty is associated with morbidity and mortality in abdominal organ transplantation but has not been examined in lung transplantation. To examine the construct and predictive validity of frailty phenotypes in lung transplant candidates. In a multicenter prospective cohort we measured frailty with the Fried Frailty Phenotype (FFP) and Short Physic...
Article
The question is not, as Drs Pastis and Strange¹ have suggested, about the best interest of the medical profession; rather, it is about what is in the best interest of the patients. A decade ago, Barber and colleagues² published their experience in developing the first nurse-led bronchoscopy practice in the United Kingdom. Inspiration to establish t...
Article
The role of nurses in cardiothoracic transplantation has evolved over the last 25 years. Transplant nurses work in a variety of roles in collaboration with multidisciplinary teams to manage complex pre- and post-transplantation. There is lack of clarity and consistency regarding required qualifications to practice transplant nursing, delineation of...
Article
Lung transplantation through controlled donation after circulatory death (cDCD) has slowly gained universal acceptance with reports of equivalent outcomes to those through donation after brain death. In contrast, uncontrolled DCD (uDCD) lung use is controversial and requires ethical, legal and medical complexities to be addressed in a limited time....
Article
Full-text available
Rationale: Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited. Objectives: Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated wit...
Article
The University of Pennsylvania is committed to providing the highest level of longitudinal care to patients with end stage lung disease who pursue and undergo lung transplantation. Since 1991, the Penn Lung Transplant Program has performed over 800 lung, heart/lung, lung/liver, and redo lung transplants. As a result of this experience, we believe i...
Article
Mr. F. is a fifty-year-old father of two school-aged daughters. Six years ago, he received a double lung transplant because he was suffering from interstitial lung disease, a fatal illness that causes suffocation by progressive scarring of the lungs. He is now experiencing chronic rejection of the transplant and is being considered to receive anoth...
Article
Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation. The risk of developing PTLD varies depending on a number of factors, including the organ transplanted and the degree of immunosuppression used. We report a retrospective analysis of 35 patients with PTLD treated at our center after lung transplantation....
Article
Full-text available
Background: Venous thromboembolism (VTE) is common after lung transplantation. We aimed to review our experience with VTE in lung transplant recipients, while paying attention to the use of sirolimus, a novel immunosuppressive agent that may have prothrombotic effects. Methods: A retrospective review of lung transplant recipients at the University...
Article
The effects of lung transplant recipient race on post-transplant outcomes have not been adequately evaluated. This cohort study seeks to determine the characteristics of African American lung transplant recipients and the effects of African American race on post-transplant outcomes, particularly acute and chronic rejection, compared with white reci...
Article
PURPOSE: Clinical lung transplantation was initiated at our institution in 1991. Since then, 512 transplants have been performed in 502 patients. The indications, procedures and outcomes were analyzed. METHODS: All patients undergoing lung transplantation at our institution since the inception of the program were retrospectively analyzed. Diagnoses...
Article
The effect of the new lung allocation score on ranking of patients on the waiting list and the number of transplants performed is not known. We assessed this effect on our lung transplant program and conducted a simulation of lung transplants for the first few months of the new system, using the old waiting lists. Patients with idiopathic pulmonary...
Article
A fundamental goal of lung transplantation is the regaining of functional capacity, yet little is known about what factors are associated with the achievement of this goal. The aim of this study is to test the association of clinical risk factors with functional status 1 year following lung transplantation. We conducted a cohort study of 321 lung t...
Article
A few publications have reported on the role of variables affecting blood component usage during lung transplantation. Transfusion records for lung transplantation patients at the Hospital of the University of Pennsylvania (November 1991 to July 2004) were reviewed. Bivariate analyses and regression models were used to correlate usage of packed red...
Article
Primary graft failure (PGF) is a severe acute lung injury syndrome that occurs following lung transplantation. We compared the clinical outcomes of patients who developed PGF with those who did not. We conducted a retrospective cohort study including 255 consecutive lung transplant procedures. PGF was defined as (1) diffuse alveolar opacities devel...
Article
Pulmonary fibrosis and atherosclerosis have many similarities at the histopathologic level. Moreover, fibrotic lung diseases exhibit systemic effects and have the potential to affect the vasculature beyond the lung. The existence of a relationship between the two, however, has not been studied. To investigate whether fibrotic lung disorders may pre...
Article
Full-text available
Doppler echocardiography is commonly used to estimate systolic pulmonary artery pressure and to diagnose pulmonary hypertension, but data relating to its utility in patients with advanced lung disease are limited. In a cohort study of 374 lung transplant candidates, the performance characteristics of echocardiography compared with right heart cathe...
Conference Paper
Doppler echocardiography is commonly used to estimate systolic pulmonary artery pressure and to diagnose pulmonary hypertension, but data relating to its utility in patients with advanced lung disease are limited. In a cohort study of 374 lung transplant candidates, the performance characteristics of echocardiography compared with right heart cathe...
Article
The use of cardiopulmonary bypass in lung transplantation remains controversial. Previous studies have concluded that cardiopulmonary bypass is deleterious, but these studies were confounded by the inclusion of patients with different diagnoses undergoing single- and double-lung transplantation with elective or emergency use of bypass. The goal of...
Article
Antithymocyte globulin is frequently used as a component of induction therapy in thoracic organ transplantation. This study evaluates the utility of monitoring peripheral CD3 lymphocytes to rationally adjust antithymocyte globulin therapy in this patient population. A total of 17 heart and 19 lung transplant recipients received antithymocyte globul...
Article
Malignancy is a well-recognized complication of solid-organ transplantation. Although a variety of malignancies have been reported in lung transplant recipients, a paucity of information exists regarding the incidence and clinical course of bronchogenic carcinoma in this patient population. We conducted a retrospective cohort study of our lung tran...
Article
To characterize the course of patients with advanced sarcoidosis who have been listed for lung transplantation and to identify prognostic factors for death while they are on the waiting list. Retrospective cohort study. Tertiary-care university hospital. Forty-three patients with sarcoidosis who have been listed for lung transplantation at the Univ...
Article
A 50-year-old woman underwent single lung transplantation for advanced chronic obstructive pulmonary disease. Shortly after the procedure, it was discovered that the donor suffered from both a renal cell carcinoma and a spindle-cell sarcoma of the ascending aorta, which had metastasized to the spleen. The patient was emergently listed for a retrans...
Article
This study was undertaken to evaluate the efficacy of high resolution computed tomography (HRCT) in predicting the development of bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. Fifty lung transplant patients who were clinically stable and without evidence of BOS were evaluated for the presence of four HRCT features reported...
Article
There is controversy regarding the transplant procedure of choice in chronic obstructive pulmonary disease. We reviewed our intermediate-term outcomes with single lung transplantation (SLT) versus bilateral lung transplantation (BLT). We retrospectively reviewed 130 patients with chronic obstructive pulmonary disease: 84 underwent SLT, 46 BLT. The...
Article
We studied lung mechanics and small airways function in 15 patients after double-lung (DL) transplantation. Patients were classified as stable (DL-S, n = 11), or having obliterative bronchiolitis syndrome (DL-OBS, n = 4). We performed pulmonary function tests (PFT), measured slope of phase 3 of the single-breath nitrogen test (N2SP3), and obtained...
Article
Full-text available
To determine the incidence of primary graft failure (PGF) following lung transplantation, assess possible risk factors, and characterize its effect on outcomes. Retrospective review of 100 consecutive patients undergoing lung transplantation at the University of Pennsylvania Medical Center. Fifteen patients meeting diagnostic criteria for PGF (PGF+...
Article
The finding of a pulmonary infiltrate on chest radiograph may represent a spectrum of pathologic entities in the acutely ill hospitalized adult. Timely intervention depends on the advanced practice nurse's ability to devise a differential diagnosis based on the characteristics of the infiltrate and the clinical setting. Pulmonary infiltrates are de...
Article
Traditionally, despite ventilation/perfusion mismatch, single lung transplantation has been the mainstay for end-stage chronic obstructive pulmonary disease. We tested the hypothesis that bilateral sequential lung transplantation has better short- and intermediate-term results than single lung transplantation for chronic obstructive pulmonary disea...
Article
Interpleural analgesia offers effective postoperative pain control and can enhance patient participation in pulmonary care regimens. Nurses play a vital role in the management of these patients by assisting with interpleural analgesia administration and monitoring patient outcomes.

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