Extracorporeal Life Support as a Bridge to Lung Transplantation in Patients With Acute Respiratory Failure

Yeo, Hye Ju; Lee, S.; Yoon, Seong Hoon; Lee, S.E.; Cho, W.H.; Jeon, Doo Soo; Kim, Y.S.; Kim, D.

doi:10.1016/j.transproceed.2017.02.064

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…Biscotti et al [ 29 ] reported the lowest percentage of successfully bridged patients; on the other hand, two studies[ 27 , 30 ] had a 100% success rate with the ECMO bridge to transplantation. Various authors, as expected, reported post-operative bleeding as the most frequent complication[ 28 , 29 , 32 , 34 , 35 ] in the bridged patients. The reported in-hospital mortality was acceptable in the majority of the studies, except for Yeo et al [ 28 ] who had an in-hospital mortality rate of 42%, but it has to be taken in consideration that the clinical conditions of patients supported with pre-transplant ECMO are usually more critical than those of the general population waiting for a LTx not supported by ECMO.…”

Section: Ecmo As a Bridge To Ltxsupporting

confidence: 62%

“…We decided to collect the most recent studies (published from 2017 to 2020) to provide updated evidence. As reported in Table 2 , the median duration of ECMO bridge ranged from 2 d[ 27 ] to 17 d[ 28 ], the most frequently used configuration was VV ECMO[ 26 - 34 ] and the majority of patients were successfully bridged to transplantation. Biscotti et al [ 29 ] reported the lowest percentage of successfully bridged patients; on the other hand, two studies[ 27 , 30 ] had a 100% success rate with the ECMO bridge to transplantation.…”

Section: Ecmo As a Bridge To Ltxmentioning

confidence: 99%

See 1 more Smart Citation

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Faccioli¹,

Terzi²,

Pangoni³

et al. 2021

WJT

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The use of extracorporeal membrane oxygenation (ECMO) in the field of lung transplantation has rapidly expanded over the past 30 years. It has become an important tool in an increasing number of specialized centers as a bridge to transplantation and in the intra-operative and/or post-operative setting. ECMO is an extremely versatile tool in the field of lung transplantation as it can be used and adapted in different configurations with several potential cannulation sites according to the specific need of the recipient. For example, patients who need to be bridged to lung transplantation often have hypercapnic respiratory failure that may preferably benefit from veno-venous (VV) ECMO or peripheral veno-arterial (VA) ECMO in the case of hemodynamic instability. Moreover, in an intra-operative setting, VV ECMO can be maintained or switched to a VA ECMO. The routine use of intra-operative ECMO and its eventual prolongation in the post-operative period has been widely investigated in recent years by several important lung transplantation centers in order to assess the graft function and its potential protective role on primary graft dysfunction and on ischemia-reperfusion injury. This review will assess the current evidence on the role of ECMO in the different phases of lung transplantation, while analyzing different studies on pre, intra- and post-operative utilization of this extracorporeal support.

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Section: Ecmo As a Bridge To Ltxsupporting

confidence: 62%

Section: Ecmo As a Bridge To Ltxmentioning

confidence: 99%

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Faccioli¹,

Terzi²,

Pangoni³

et al. 2021

WJT

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“…Table 1 reports the most recent case series on ECMO as BTT. These case series show that survival results have been steadily improving over the last years and that (I) a careful patient selection, (II) the implementation of awake ECMO protocols and (III) center transplant volume and experience were fundamental to this improvement (3)(4)(5)(6)(7)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49).…”

Section: Ecmo As a Bridge To Transplantationmentioning

confidence: 96%

Extracorporeal support, during and after lung transplantation: the history of an idea

Ius¹,

Tudorache²,

Warnecke³

2018

J. Thorac. Dis.

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During recent years, continuous technological innovation has provoked an increase of extracorporeal life support (ECLS) use for perioperative cardiopulmonary support in lung transplantation. Initial results were disappointing, due to ECLS-specific complications and high surgical risk of the supported patients. However, the combination of improved patient management, multidisciplinary team work and standardization of ECLS protocols has recently yielded excellent results in several case series from high-volume transplant centres. Therein, it was demonstrated that, although the prevalence of complications remains higher in supported patients, there may be no difference in long-term graft function between supported and non-supported patients. These results are important, because most of the patients who require ECLS support in lung transplantation are young and have no other chance to survive, but to be transplanted. Moreover, there is no device for "bridging to destination" therapy in lung transplantation. Of note, the evidence in favour of ECLS support in lung transplantation was never validated by randomized controlled trials, but by everyday experience at the patient bed-side. Here, we review the state-of-the-art ECLS evidence for intraoperative and postoperative cardiopulmonary support in lung transplantation.

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“… 27‐36 Nowadays, ECLS is being considered for awake and nonintubated patients to improve oxygenation and carbon dioxide (CO 2 ) removal, facilitate ambulation, and improve physical conditioning before transplant 37‐47 . Several programs have developed ambulatory capability for ECLS, which is now referred to as an “artificial lung.” Recent outcomes with ECLS bridging to lung transplant at experienced centers are equivalent to outcomes in high‐risk nonbridged patients 28,32‐35,48‐53 …”

Section: Existing Mechanical Devicesmentioning

confidence: 99%

Artificial lungs––Where are we going with the lung replacement therapy?

et al. 2020

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Lung transplantation may be a final destination therapy in lung failure, but limited donor organ availability creates a need for alternative management, including artificial lung technology. This invited review discusses ongoing developments and future research pathways for respiratory assist devices and tissue engineering to treat advanced and refractory lung disease. An overview is also given on the aftermath of the coronavirus disease 2019 pandemic and lessons learned as the world comes out of this situation. The first order of business in the future of lung support is solving the problems with existing mechanical devices. Interestingly, challenges identified during the early days of development persist today. These challenges include device‐related infection, bleeding, thrombosis, cost, and patient quality of life. The main approaches of the future directions are to repair, restore, replace, or regenerate the lungs. Engineering improvements to hollow fiber membrane gas exchangers are enabling longer term wearable systems and can be used to bridge lung failure patients to transplantation. Progress in the development of microchannel‐based devices has provided the concept of biomimetic devices that may even enable intracorporeal implantation. Tissue engineering and cell‐based technologies have provided the concept of bioartificial lungs with properties similar to the native organ. Recent progress in artificial lung technologies includes continued advances in both engineering and biology. The final goal is to achieve a truly implantable and durable artificial lung that is applicable to destination therapy.

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Extracorporeal Life Support as a Bridge to Lung Transplantation in Patients With Acute Respiratory Failure

Cited by 17 publications

References 21 publications

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Extracorporeal support, during and after lung transplantation: the history of an idea

Artificial lungs––Where are we going with the lung replacement therapy?

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