Five-year experience with intraoperative extracorporeal membrane oxygenation in lung transplantation: Indications and midterm results

Ius, F.; Sommer, W.; Tudorache, I.; Avşar, M.; Siemeni, T.; Salman, J.; Molitoris, Ulrich; Gras, C; Juettner, Bjoern; Puntigam, J.; Optenhoefel, Joerg; Greer, Mark; Schwerk, Nicolaus; Gottlieb, Jens; Welte, Tobias; Hoeper, Marius M.; Haverich, Axel; Kuehn, C.; Warnecke, G.

doi:10.1016/j.healun.2015.08.016

Cited by 97 publications

(105 citation statements)

References 25 publications

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“…Extracorporeal membrane oxygenation (ECMO) is a life-support technology device that performs gas exchange external to the body by providing cardiorespiratory support in patients with severe respiratory and cardiac failure [4]. Since the introduction of intraoperative ECMO to replace cardiopulmonary bypass (CPB) in 2001, most centers have switched to the routine use of ECMO intraoperative from 2008 on with favorable results [5][6][7][8]. Intraoperative ECMO is generally used in patients with pulmonary hypertension, hemodynamic instability, inability to tolerate single-lung ventilation, or hyper perfusion due to the reduced lung size during lung transplantation [3].…”

Section: Introductionmentioning

confidence: 99%

“…Intraoperative ECMO is generally used in patients with pulmonary hypertension, hemodynamic instability, inability to tolerate single-lung ventilation, or hyper perfusion due to the reduced lung size during lung transplantation [3]. However, preoperative factors of this procedure in lung transplantation patients have not yet been characterized, and the decision to employ ECMO during lung transplantation depends largely on individual institutional practices [7][8][9][10]. Nevertheless, ECMO implantations without any a priori indication or inappropriate patient selection may increase resource utilization and hospital costs and may even be associated with significant morbidity and mortality [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation

Zhang

Sang

et al. 2020

Respir Res

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Background: Intraoperative Extracorporeal membrane oxygenation (ECMO) is increasingly being applied as lifesupport for lung transplantation patients. However, factors associated with this procedure in lung transplantation patients have not yet been characterized. The aim of this study was to identify preoperative factors of intraoperative ECMO support during lung transplantation and to evaluated the outcome of lung transplantation patients supported with ECMO. Methods: Patients underwent lung transplantation treated with and without ECMO in Guangzhou Institute of Respiratory Diseases between January 2015 to August 2018 were retrospectively reviewed. Patient demographics and clinical variables were collected and analyzed. Multivariate logistic regression was performed to identify factors independently associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation. Results: During the study period, 138 patients underwent lung transplantation at our institution, the mean LAS was (56.63 ± 18.39) (range, 32.79 to 88.70). Fourty four patients were treated with veno-venous/veno-arterial ECMO. Among the patients, 32 patients wean successfully ECMO after operation, 12 patients remain ECMO after operation, and 32 patients (62.74%) survived to hospital discharge. In multiple analysis, the following factors were associated with intraoperative ECMO support: advanced age, high PAP before operation, duration of mechanical ventilation before operation, a higher APACHE II and primary diagnosis for transplantation. The overall survival rates at 1, 3, and 12 months were 90. 91, 72.73, and 56.81% in the ECMO group, and 95.40, 82.76, and 73.56% in the non-ECMO group, respectively (log-rank P = 0.081). Patients who underwent single lung transplant had a lower survival rates in ECMO group as compared with non-ECMO group at 1, 3, and 12 months (90.47% vs 98.25, 71.43% vs 84.21, and 52.38% vs 75.44%) (log-rank P = 0.048). Conclusions: The preoperative factors of intraoperative ECMO support during lung transplantation included age, high PAP before operation, preoperative mechanical ventilation, a higher APACHE II and primary diagnosis for transplantation based on multivariate analysis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation

Zhang

Sang

et al. 2020

Respir Res

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“…Ayrıca 595 akciğer naklinin incelendiği bir başka çalışmada ECMO gereken hastalar ile gerekmeyenler arasında mortalite açısından fark olmadığı saptanmıştır. [26] Sonuç olarak, akciğer naklinde diğer organ nakillerine göre tüm dünyada daha yavaş bir ilerleme olduğu gibi ülkemizde de yavaş bir ilerleme vardır. Ancak hem doğru hasta hem de doğru donör seçimleri ile beraber iyi organize olunduğunda başarının geleceği ve de yıllar geçtikçe akciğer nakli sayısı ve başarısının artması ile ülkemizdeki akciğer nakli sayısında artış olacağı kesindir.…”

Section: Discussionunclassified

Early period lung transplantation results of Yedikule Organ Transplantation Center: our three-year experience

Büyükkale¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada akciğer nakli merkezimizin erken dönem akciğer nakli sonuçları sunuldu. Bul gu lar: Nakil endikasyonu hastaların dokuzunda bronşiektazi, sekizinde amfizem, altısında interstisyel pulmoner hastalık, ikisinde sarkoidoz, ikisinde akciğer nakli sonrası yaygın bronş darlığı ve dördünde diğer akciğer hastalıkları (alfa-1 antitripsin eksikliği, alveoler mikrolitiazis, tüberküloza ikincil haraplanmış akciğer, slikozis) idi. Hastaların nakil listesinde bekleme süresi ortalama 6.3±4.8 ay idi (dağılım 1-19 ay). Ameliyat sırası ekstrakorporeal membran oksijenizasyonu gereksinimi oranı %45.1 idi (n=14). İskemi süresi tek akciğer nakli için 342±79 dakika, çift akciğer nakli için 535±85.9 dakika idi. Ameliyat sırası mortalite görülmedi. Erken mortalite oranı %25.8 (n=8) idi. Erken mortaliteyi etkileyen tek faktör ameliyat sırası ekstrakorporeal membran oksijenizasyonu gereksinimi idi (göreceli olasılıklar oranı=16, %95 güven aralığı: 1.6-155, p= 0.004). İskemi süresi hem tek hem çift akciğer nakilleri için erken mortalite görülenlerde daha uzun idi, ancak farklılık istatistiksel olarak anlamlı değildi (sırasıyla, p= 0.318 ve p= 0.931). Medyan 16.1±11.9 aydır (dağılım 3-43 ay) takipte olan hastaların 18'i halen yaşamaktadır (%62). Bir yıllık genel sağkalım %59.2±9.6 iken erken mortaliteler çıkarıldıktan sonraki bir yıllık sağkalım %78.2±9.6 idi. Ça lış ma pla nı:So nuç: Akciğer nakli seçilmiş hastalarda önemli sağkalım oranları sağlamaktadır.Anah tar söz cük ler: Erken dönem sonuçlar; son evre akciğer hastalığı; akciğer nakli; morbidite; mortalite. ABSTRACTBackground: This study aims to present the early period lung transplantation results of our lung transplantation center.

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“…However, they use ECMO on a selective basis and more than 50% of patients were performed LTx without cardiopulmonary support with excellent outcomes (17,18). However, our institute has limited experience and lower annual volume.…”

Section: Discussionmentioning

confidence: 99%

Transition to routine use of venoarterial extracorporeal oxygenation during lung transplantation could improve early outcomes

Paik

Haam

et al. 2016

J. Thorac. Dis.

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Five-year experience with intraoperative extracorporeal membrane oxygenation in lung transplantation: Indications and midterm results

Abstract: Intraoperative ECMO filled the gap between pre-operative and post-operative ECMO in lung transplantation. Although complications and in-hospital mortality were higher in patients who received ECMO, survival was similar among patients who underwent transplantation with or without ECMO.

Cited by 97 publications

References 25 publications

Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation

Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation

Early period lung transplantation results of Yedikule Organ Transplantation Center: our three-year experience

Transition to routine use of venoarterial extracorporeal oxygenation during lung transplantation could improve early outcomes

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