A Study for Bridge to Lung Transplant with Extracorporeal Membrane Oxygenation

Yoshizumi, Tomo; Sunagawa, Gengo; Brann, Stacey; Keshavamurthy, Suresh; Dulam, Vipin; Gomez-Abraham, J.; Kashem, Mohammed A.; Minakata, Kenji; Shigemura, Norihisa; Toyoda, Yoshiya

doi:10.1016/j.healun.2018.01.631

Cited by 1 publication

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“…Optimal early outcomes are dependent on a well-coordinated, multidisciplinary approach. Factors that have contributed to improved outcomes include advancements in perioperative critical care, surgical and anesthetic techniques, improved immunosuppression and understanding of transplant immunobiology, stringent posttransplant surveillance for infection, rejection, and the perioperative use of extracorporeal membrane oxygenation (ECMO) [1] used to bridge decompensating patients to lung transplantation and ex vivo lung perfusion (EVLP) to facilitate optimization and transplantation of marginal donor lungs with outcomes considered equivalent to those from lungs transplanted using standard criteria [2,3]. Given the aging population, older patients with a higher comorbid burden are being referred for lung transplant evaluation.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Care for Lung Transplant Recipients: A Multidisciplinary Approach

Brann¹,

Geier²,

Timofeeva³

et al. 2019

Perioperative Care for Organ Transplant Recipient

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Lung transplantation has evolved as the gold standard for selective patients with end-stage lung disease since the first clinical lung transplant was performed in 1983 in the United States. Over the last few decades, lung transplantation volume has increased worldwide with steadily improving outcomes; however, access to lung transplantation remains limited due to the critical shortage of donor organs. Factors that have contributed to improved outcomes include a multidisciplinary management approach supported by advancements in surgical and anesthetic techniques, nursing and critical care, immunosuppressive therapy, transplant immunobiology, and the perioperative use of extracorporeal membrane oxygenation (ECMO) and ex vivo lung perfusion (EVLP). Excellent outcomes have been achieved in selective patients with high-risk comorbidities such as age over 65 years, concomitant severe coronary artery disease (CAD), and preexisting sensitization with donor-specific antibodies (DSAs). Such comorbidities are no longer considered absolute contraindications to lung transplantation. This chapter provides an overview of perioperative care of lung transplant recipients with focus on a multidisciplinary approach and highlights management strategies for patients with concomitant severe coronary artery disease and end-stage lung disease as well as those with preexisting sensitization with DSAs.

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Section: Introductionmentioning

confidence: 99%