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Extracorporeal membrane oxygenation as a bridge to lung transplant: midterm outcomes.
- Source :
-
The Annals of thoracic surgery [Ann Thorac Surg] 2011 Oct; Vol. 92 (4), pp. 1226-31; discussion 1231-2. Date of Electronic Publication: 2011 Aug 26. - Publication Year :
- 2011
-
Abstract
- Background: Extracorporeal membrane oxygenation (ECMO) is used occasionally as a bridge to lung transplantation. The impact on mid-term survival is unknown. We analyzed outcomes after lung transplant over a 19-year period in patients who received ECMO support.<br />Methods: From March 1991 to October 2010, 1,305 lung transplants were performed at our institution. Seventeen patients (1.3%) were supported with ECMO before lung transplant. Diagnoses included retransplantation (n = 6), pulmonary fibrosis (n = 6), cystic fibrosis (n = 4), and chronic obstructive pulmonary disease (n = 1). Fifteen patients underwent double lung transplant, one patient had single left lung transplant and one patient had a heart-lung transplant. Venovenous and venoarterial ECMO were implanted in eight and nine cases, respectively. Median duration of support was 3.2 days (range, 1 to 49 days). Mean patient follow-up was 2.3 years.<br />Results: Thirty-day, 1-year, and 3-year survivals were 81%, 74%, and 65%, respectively, for the supported patients and 93%, 78%, and 62% in the control group (p = 0.56). Two-year survival was not affected by ECMO type, with survival of five out of nine patients supported by venoarterial ECMO vs seven out of eight patients supported by venovenous ECMO (p = 0.17). At 1- year follow-up, allograft function for the ECMO-supported patients did not differ from the control group (forced expiratory volume in one second, 2.35 L vs 2.09 L, p = 0.39) (forced vital capacity, 3.06 L vs 2.71 L, p = 0.34).<br />Conclusions: Extracorporeal membrane oxygenation as a bridge to lung transplantation is associated with higher perioperative mortality but acceptable mid-term survival in carefully selected patients. Late allograft function did not differ in patients who received ECMO support before lung transplant from those who did not receive ECMO.<br /> (Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Follow-Up Studies
Graft Survival
Heart-Lung Transplantation methods
Heart-Lung Transplantation mortality
Humans
Lung Transplantation mortality
Middle Aged
Pennsylvania epidemiology
Respiratory Insufficiency mortality
Retrospective Studies
Survival Rate trends
Time Factors
Transplantation, Homologous
Treatment Outcome
Extracorporeal Membrane Oxygenation methods
Lung Transplantation methods
Preoperative Care methods
Respiratory Insufficiency therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1552-6259
- Volume :
- 92
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Annals of thoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 21872213
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2011.04.122