Lung Transplantation for Acute Respiratory Distress Syndrome

Bharat, Ankit; Höetzenecker, Konrad

doi:10.1016/j.thorsurg.2022.01.005

Cited by 3 publications

(1 citation statement)

References 57 publications

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“…Regarding our other impressive lessons, the acute syndrome “AFOP” resulting in respiratory failure can be classified as a form of acute respiratory distress syndrome (ARDS). Urgent transplantation for ARDS has been identified ( 12 - 14 ). ARDS during the coronavirus disease 2019 (COVID-19) pandemic became even more a new indication for transplantation in well-selected patients.…”

Section: Discussionmentioning

confidence: 99%

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

Ye,

Chen,

Huang

et al. 2023

AME Case Rep

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Background Acute fibrinous and organizing pneumonia (AFOP) is one of acute expiratory diseases, which occurs rarely with a difficult diagnosis. AFOP is related to an idiopathic cause or autoimmune disease, drug use, infection, cancer, or transplantation. Variation of treatment depends on different institutions. To date, no evidence shows that lobar lung transplantation is applied in an urgent situation such as AFOP. Case Description A 33-year-old female patient experienced fever, cough, and dyspnea four days prior to admission. She had no underlying health conditions. Initially, she received oxygen therapy and empiric antimicrobial treatment, but later developed pulmonary consolidation. Pathological examination confirmed the diagnosis of AFOP. Despite receiving standardized treatment involving extracorporeal membrane oxygenation (ECMO) and mechanical ventilation, the patient’s respiratory function remained compromised. Consequently, an urgent lobar lung transplantation was performed. However, the patient encountered several challenges including carbapenem-resistant Pseudomonas aeruginosa pneumonia, exophytic granulation tissue, anastomotic stenosis, bronchopleural fistulae, anastomotic infections, septic shock, bacteremia, reperfusion syndrome, primary graft dysfunction, severe renal failure, and critical illness myopathy. Although the patient ultimately recovered and had a favorable survival outcome over 1-year post-discharge through multidisciplinary care, there are several key points to consider. Based on the findings from a systematic review, urgent transplantation may be a potential alternative treatment for AFOP. However, peri-transplantation programs should be enhanced, particularly regarding criteria selection, ECMO management, and the role of enhanced recovery after transplantation. Conclusions The case demonstrates the feasibility of bilateral lobar lung transplantation in patients with AFOP, especially in an urgent situation.

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Section: Discussionmentioning

confidence: 99%

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

Ye,

Chen,

Huang

et al. 2023

AME Case Rep

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Akutes Lungenversagen (ARDS)

Larsen¹,

Mathes

2023

Beatmung

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Outcome of Veno-Pulmonary Extracorporeal Life Support in Lung Transplantation Using ProtekDuo Cannula: A Systematic Review and Description of Configurations

Capoccia,

Brewer,

Rackauskas

et al. 2024

JCM

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Background: Refractory end-stage pulmonary failure may benefit from extracorporeal life support (ECLS) as a bridge to lung transplantation. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) has been recommended for patients who have failed conventional medical therapy and mechanical ventilation. Veno-arterial (VA) ECMO may be used in patients with acute right ventricular (RV) failure, haemodynamic instability, or refractory respiratory failure. Peripheral percutaneous approaches, either dual-site single-lumen cannulation for veno-pulmonary (VP) ECMO or single-site dual-lumen (dl)VP ECMO, using the ProtekDuo right ventricular assist device (RVAD) cannula, has made this configuration a desirable option as a bridge to transplantation. These configurations support the right ventricle, prevent recirculation by placing the tricuspid and pulmonary valve between the drainage and return cannulas, provide the direct introduction of oxygenated blood into the pulmonary artery, and have been shown to decrease the incidence of acute kidney injury (AKI), requiring continuous renal replacement therapy (CRRT) in certain disease states. This promotes haemodynamic stability, potential sedation-weaning trials, extubation, mobilisation, and pre-transplant rehabilitation. Methods: A web-based literature search in PubMed and EMBASE was undertaken based on a combination of keywords. The PICOS and PRISMA approaches were used. Results: Four case series were identified out of 323 articles, with a total of 34 patients placed on VP ECMO as a bridge to lung transplantation. All relevant data are reviewed and integrated into the Discussion. Conclusions: Despite the limited available evidence, the use of ProtekDuo has become very promising for the management of end-stage lung disease as a bridge to lung transplantation.

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Lung Transplantation for Acute Respiratory Distress Syndrome

Cited by 3 publications

References 57 publications

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

Akutes Lungenversagen (ARDS)

Outcome of Veno-Pulmonary Extracorporeal Life Support in Lung Transplantation Using ProtekDuo Cannula: A Systematic Review and Description of Configurations

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