Long-term outcome and bridging success of patients evaluated and bridged to lung transplantation on the ICU.

Autor:	Gan CT; Department of Respiratory Diseases, Tuberculosis and Lung Transplantation, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: c.t.gan@umcg.nl., Hoek RAS; Department of Pulmonary Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., van der Bij W; Department of Respiratory Diseases, Tuberculosis and Lung Transplantation, University Medical Center Groningen, Groningen, The Netherlands., Van De Wauwer C; Department of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, The Netherlands., Erasmus ME; Department of Cardiothoracic Surgery, University Medical Center Groningen, Groningen, The Netherlands., Oude Lansink-Hartgring A; Department of Critical Care, University Medical Center Groningen, Groningen, The Netherlands., Droogh JM; Department of Critical Care, University Medical Center Groningen, Groningen, The Netherlands., Seghers L; Department of Pulmonary Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., Mathot BJ; Department of Pulmonary Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., Mahtab EAF; Department of Cardiothoracic Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., Bekkers JA; Department of Cardiothoracic Surgery, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands., Dos Reis Miranda D; Department of Intensive Care Medicine, University Medical Center Rotterdam, Rotterdam, The Netherlands., Verschuuren EAM; Department of Respiratory Diseases, Tuberculosis and Lung Transplantation, University Medical Center Groningen, Groningen, The Netherlands., Hellemons ME; Department of Pulmonary Medicine, Erasmus MC Transplant Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2022 May; Vol. 41 (5), pp. 589-598. Date of Electronic Publication: 2022 Jan 24.
DOI:	10.1016/j.healun.2022.01.017
Abstrakt:	Background: Evaluating and bridging patients to lung transplantation (LTx) on the intensive care unit (ICU) remains controversial, especially without a previous waitlist status. Long term outcome data after LTx from ICU remains scarce. We compared long-term survival and development of chronic lung allograft dysfunction (CLAD) in elective and LTx from ICU, with or without previous waitlist status. Methods: Patients transplanted between 2004 and 2018 in 2 large academic Dutch institutes were included. Long-term survival and development of CLAD was compared in patients who received an elective LTx (ELTx), those bridged and transplanted from the ICU with a previous listing status (BTT), and in patients urgently evaluated and bridged on ICU (EBTT). Results: A total of 582 patients underwent a LTx, 70 (12%) from ICU, 39 BTT and 31 EBTT. Patients transplanted from ICU were younger than ELTx (46 vs 51 years) and were bridged with mechanical ventilation (n = 42 (60%)), extra corporeal membrane oxygenation (n = 28 (40%)), or both (n = 21/28). Bridging success was 48% in the BTT group and 72% in the EBTT group. Patients bridged to LTx on ICU had similar 1 and 5 year survival (86.8% and 78.4%) compared to elective LTx (86.8% and 71.9%). This was not different between the BTT and EBTT group. 5 year CLAD free survival was not different in patients transplanted from ICU vs ELTx. Conclusion: Patients bridged to LTx on the ICU with and without prior listing status had excellent short and long-term patient and graft outcomes, and was similar to patients electively transplanted. Competing Interests: Disclosure statement The authors have no conflicts of interest to declare. (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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