Extracorporeal Membrane Oxygenation and Retransplantation in Lung Transplantation: An Analysis of the UNOS Registry
| Autor: | Thomas J. Preston, Bryan A. Whitson, Stephen Kirkby, Ahmet Kilic, Amy Pope-Harman, Robert S.D. Higgins, Don Hayes |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate Extracorporeal Membrane Oxygenation Risk Factors Extracorporeal membrane oxygenation Humans Medicine Lung transplantation Registries Intensive care medicine Aged Proportional Hazards Models Retrospective Studies Chi-Square Distribution business.industry Middle Aged Idiopathic Pulmonary Fibrosis Surgery Treatment Outcome surgical procedures operative Female business Lung Transplantation |
| Zdroj: | Lung. 192:571-576 |
| ISSN: | 1432-1750 0341-2040 |
| DOI: | 10.1007/s00408-014-9593-6 |
| Popis: | Despite limited organ availability, extracorporeal membrane oxygenation (ECMO) and retransplantation are becoming more commonplace.Using the United Network for Organ Sharing (UNOS) database, we evaluated survival of patients treated with ECMO before lung transplantation and undergoing retransplantation. A query identified cadaveric recipients from 2001 to 2012 over the age of 6 years.Of 15,772 lung recipients, 15 583 never received ECMO, whereas 189 did. Mean age was 52.1 ± 14.4 versus 46.8 ± 16.5 years for non-ECMO and ECMO groups, respectively (p0.0001). Using Kaplan-Meier method, there were survival differences between ECMO and non-ECMO groups (p0.0001) and first-time transplants with and without ECMO to retransplants with and without ECMO (p0.0001). The proportional hazards model identified higher risk with ECMO use in idiopathic pulmonary fibrosis (hazard ratio [HR] 1.09; 95 % confidence interval (CI), 1.02-1.17; p = 0.014) and retransplants (HR 1.77; 95 % CI, 1.55-2.03; p0.0001).Survival for retransplantation was similar to ECMO as a primary option with significant mortality associated with ECMO use in patients with idiopathic pulmonary fibrosis and retransplants. |
| Databáze: | OpenAIRE |
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