Lung Transplantation for Acute Respiratory Distress Syndrome Patients: A Single Center Experience.

Acute respiratory distress syndrome (ARDS) is a rapidly progressive lung disease with a high mortality rate. Although lung transplantation (LTx) remains the only lifesaving option for certain end-stage pulmonary diseases, ARDS as indication for LTx is discussed controversially and only limited data are available. For example, in the Eurotransplant region, only 17 patients transplanted for ARDS are documented. Since we have followed a liberal approach of accepting ARDS patients for LTx, we reviewed retrospectively the outcome of this particular patient cohort in our center. From 08/98 to 03/19 a total of 10 patients transplanted for ARDS were identified in our center. Demographic and clinical data of these patients were collected and analyzed. Eight/10 patients were listed and transplanted while on extracorporeal membrane oxygenation (ECMO). The remaining 2 patients could be initially weaned from ECMO but were respirator dependent at the time of referral for LTx. The median mechanical ventilation time and median length of ECMO was 33.5 (IQR: 3.5-62.3) and 29.5 (28-38) days before LTx. Length of ICU and length of hospital stay was 38 (24.5-52) and 57 (43.5-94) days. The 30-day mortality was 10% and 1-year survival rate was calculated as 55.5% (Figure 1). One patient developed chronic lung allograft dysfunction (CLAD) and received re-transplantation 12 years after the primary procedure. The median follow up time was 82 (49.9-1065) days. Lung transplantation is feasible in carefully selected ARDS patients. Given the lack of alternative treatment options it provides acceptable long-term results. [ABSTRACT FROM AUTHOR]