Five-year experience with intraoperative extracorporeal membrane oxygenation in lung transplantation: Indications and midterm results
| Autor: | Gregor Warnecke, Clemens Gras, Christian Kuehn, Fabio Ius, Nicolaus Schwerk, Joerg Optenhoefel, Axel Haverich, Igor Tudorache, Wiebke Sommer, Murat Avsar, Jens Gottlieb, Mark Greer, Thierry Siemeni, Tobias Welte, Jawad Salman, Bjoern Juettner, J. Puntigam, Marius M. Hoeper, Ulrich Molitoris |
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| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Lung Diseases Male medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Postoperative Complications law Germany Pulmonary fibrosis Extracorporeal membrane oxygenation Hospital discharge Cardiopulmonary bypass Medicine Lung transplantation Humans In patient Hospital Mortality Risk factor Retrospective Studies Transplantation Intraoperative Care business.industry Incidence Middle Aged medicine.disease Surgery Survival Rate surgical procedures operative Treatment Outcome 030228 respiratory system Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Lung Transplantation |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 35(1) |
| ISSN: | 1557-3117 |
| Popis: | Background Since April 2010, extracorporeal membrane oxygenation (ECMO) has replaced cardiopulmonary bypass for intraoperative support during lung transplantation at our institution. The aim of this study was to present our 5-year experience with this technique. Methods Records of patients who underwent transplantation between April 2010 and January 2015 were retrospectively reviewed. Patients who underwent transplantation without ECMO formed Group A. Patients in whom the indication for ECMO support was set a priori before the beginning of the operation formed Group B. The remaining patients in whom the indication for ECMO support was set during transplantation formed Group C. Results Among 595 patients, 425 (71%) patients (Group A) did not require intraoperative ECMO; the remaining 170 (29%) patients did. Among these patients, 95 (56%) patients formed Group B, and the remaining 75 (44%) patients comprised Group C. Pulmonary fibrosis and pre-operative dilated or hypertrophied right ventricle emerged as risk factors for the indication of non–a priori intraoperative ECMO. Patients in Groups B and C showed a higher pre-operative risk profile and higher prevalence of post-operative complications than patients in Group A. Overall survival at 1 year was 93%, 83%, and 82% and at 4 years was 73%, 68%, and 69% in Groups A, B, and C ( p = 0.11). The intraoperative use of ECMO did not emerge as a risk factor for in-hospital mortality or mortality after hospital discharge. Conclusions 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. |
| Databáze: | OpenAIRE |
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