Extracorporeal membrane oxygenation as a bridge to lung transplantation: a long-term study†

Dellgren, Göran; Riise, Gerdt C.; Swärd, Kristina; Gilljam, M.; Rexius, Helena; Lidén, Hans; Silverborn, Martin

doi:10.1093/ejcts/ezu112

Cited by 48 publications

(33 citation statements)

References 12 publications

(16 reference statements)

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“…function, disease severity, or APACHE score [11,14,15]. The use of MV as a bridge to lung transplantation in select IPF patients has been proposed [11,23]. Indeed, the potential extension of life offered by MV should be weighed against the risks associated with invasive critical care, particularly in patients with a life-limiting disease such as IPF.…”

Section: Discussionmentioning

confidence: 99%

The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

Rush

Wiskar

Berger

et al. 2016

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

Rush

Wiskar

Berger

et al. 2016

Respiratory Medicine

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“…Ilhan Inci, 1 Stephanie Klinzing, 2 Didier Schneiter, 1 Reto A. Schuepbach, 3 Peter Kestenholz, 1 Sven Hillinger, 1 Christian Benden, 4 Marco Maggiorini, 2 and Walter Weder 1 Background. Extracorporeal life support (ECLS) as a bridge to lung transplantation (LuTx) is a promising option for patients with end-stage lung disease on the transplant waiting list.…”

Section: Outcome Of Extracorporeal Membrane Oxygenation As a Bridge Tmentioning

confidence: 99%

Outcome of Extracorporeal Membrane Oxygenation as a Bridge To Lung Transplantation

et al. 2015

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“…ECLS was previously considered a relative contraindication to transplant. Improvements in membranes/circuitry, lower anticoagulation targets, greater center experience, lower complication rates, and earlier institution have resulted in more favorable survival to LT. [33][34][35][36][37][38][39] Although appropriate patient selection is crucial, 34 data pertaining specifically to PAH remains scarce. Veno-arterial (VA) cannulation is generally required to bypass the high resistance native pulmonary circulation, offload the RV, and deliver oxygenated blood directly to the systemic circulation to aid end-organ function.…”

Section: Extracorporeal Life Supportmentioning

confidence: 99%

Lung Transplantation for Pulmonary Hypertension and Strategies to Bridge to Transplant

Baillie

Granton

2017

Semin Respir Crit Care Med

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Despite an expanded armamentarium of medical therapies, pulmonary arterial hypertension (PAH) remains a progressive disease associated with significant morbidity and premature mortality. Lung transplantation (LT) is the last safety net for patients failing medical therapy, providing excellent overall long-term survival and health-related quality-of-life outcomes in line with more common parenchymal lung disease indications. Waitlist mortality remains disproportionally elevated, however, reflecting an inability of the lung allocation score to completely capture PAH disease severity, and a propensity for PAH to deteriorate rapidly without warning, even in patients who appear externally “well.” Early referral to a LT center can mitigate these risks and facilitate rapid listing if necessary. Several bridging therapies are available to support severely unwell patients to LT, such as extracorporeal life support (ECLS) and atrial septostomy. Unique perioperative considerations include higher rates of primary graft dysfunction and dynamic right ventricular outflow obstruction which may, at least in part, reflect rapid afterload reduction in the face of a conditioned right ventricle. Extending ECLS into the perioperative period may ameliorate these risks by allowing more gradual adaptation of both ventricles to their new loading conditions. Chronic lung allograft dysfunction, particularly bronchiolitis obliterans syndrome, remains a major cause of long-term morbidity and mortality, and complications from corticosteroid and immunosuppressive therapy are common. Nevertheless, the morbidity, mortality, and burden of disease management after LT continue to improve and compare favorably to that of refractory PAH in carefully selected patients.

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Extracorporeal membrane oxygenation as a bridge to lung transplantation: a long-term study†

Abstract: ECMO used as a bridge to LTx results in acceptable survival in selected patients with end-stage pulmonary disease.

Cited by 48 publications

References 12 publications

The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis

Outcome of Extracorporeal Membrane Oxygenation as a Bridge To Lung Transplantation

Lung Transplantation for Pulmonary Hypertension and Strategies to Bridge to Transplant

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