Extracorporeal membrane oxygenation for grade 3 primary graft dysfunction after lung transplantation: Long‐term outcomes

Autor: Pierre Bonnette, Morgan Le Guen, Edouard Sage, Alain Chapelier, Jocelyn Bellier, Pierre Lhommet, Antoine Roux, François Parquin, Philippe Puyo
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Primary Graft Dysfunction
030230 surgery
Pulmonary function testing
Young Adult
03 medical and health sciences
Idiopathic pulmonary fibrosis
Extracorporeal Membrane Oxygenation
Postoperative Complications
0302 clinical medicine
Risk Factors
Forced Expiratory Volume
medicine
Extracorporeal membrane oxygenation
Long term outcomes
Humans
Lung transplantation
In patient
Aged
Retrospective Studies
Transplantation
business.industry
Graft Survival
Retrospective cohort study
Middle Aged
respiratory system
Prognosis
medicine.disease
Respiratory Function Tests
Surgery
Survival Rate
surgical procedures
operative
Female
lipids (amino acids
peptides
and proteins)
030211 gastroenterology & hepatology
business
Follow-Up Studies
Lung Transplantation
Zdroj: Clinical Transplantation. 33:e13480
ISSN: 1399-0012
0902-0063
DOI: 10.1111/ctr.13480
Popis: Introduction Extracorporeal membrane oxygenation (ECMO) is an efficient and innovative therapeutic tool for primary graft dysfunction (PGD). However, its effect on survival and long-term lung function is not well known. This study evaluated those parameters in patients with PGD requiring ECMO. Method This single-center, retrospective study included patients who underwent LTx at our institute between January 2007 and December 2013. Patients and disease characteristics, survival, and pulmonary function tests were recorded. Results A total of 309 patients underwent LTx during the study period and 211 were included. The patients were predominantly male (53.5%), the median age was 39 years, and the primary pathology was suppurative disease (53.1%). ECMO for PGD was mandatory in 24 (11.7%) cases. Mortality at 3 months in the ECMO group was 50% (N = 12). However, long-term survival after PGD did not correlate with ECMO. Forced expiratory volume and vital capacity were significantly reduced in patients with PGD requiring ECMO, especially those with idiopathic pulmonary fibrosis. Conclusion Veno-arterial ECMO appears to be suitable for management of PGD after LTx. Patients with PGD requiring ECMO show increased initial mortality; however, long-term survival was comparable with that of other patients in the study. Lung function does not appear to be related to PGD requiring ECMO.
Databáze: OpenAIRE
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