Early Gait Function After Lung Transplantation in Patients With and Without Pretransplant Extracorporeal Membrane Oxygenation Support

Outcomes of Lung Transplantation in Patients With Right Ventricular Dysfunction: A Single-Center Retrospective Analysis Comparing ECMO Configurations in a Bridge-to-Transplant Setting

“…The complication rate was the lowest (37.1%) in the V-V ECMO group and the highest (78.6%) in the V-A/V-AV or Oxy-RVAD group (p = 0.029). Preoperative ECMO duration was similar between the V-A/V-AV ECMO or Oxy-RVAD and configuration change groups (16 [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs. 17 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]). The median duration from starting ECMO to changing the configuration was 7 days [4.3-62.0 days] in the configuration change group.…”

“…This suggests a likelihood of accompanying issues, such as DIC or acute kidney injury due to cardiogenic shock. The choice between Oxy-RVAD and V-A ECMO for patients with hemodynamic decompensated RV dysfunction is currently dependent on hospital or physician preference, although the application of Oxy-RVAD is increasing [ 16 ]. Oxy-RVAD, requiring left anterior thoracotomy for the placement of the reinfusion cannula in the pulmonary artery, is technically more complex than peripheral V-A ECMO, but it offers several advantages over V-A ECMO, such as enabling systemic circulation with oxygenated blood and showing fewer thromboembolic complications [ 6 , 9 ].…”

“…A bolus of unfractionated heparin (50–70 units/kg) was infused at the start of ECMO support, and heparin was continuously infused to achieve an activated partial thromboplastin time of 40–60 s during V-V ECMO support and 50–75 s during V-A ECMO support. Once patients achieve hemodynamic stabilization, preoperative rehabilitation begins with both mechanical ventilation with early tracheostomy and ECMO support [ 16 ]. A few patients underwent lung transplantation as awakening ECMO.…”